Course Registration Form

Please fill in all the required details to register for your chosen course.

Personal Information

Please provide your personal details accurately.

Full Name *

Date of Birth *

Mobile Phone *

Email *

Address *

Select Gender *

Male

Female

Course Selection

Choose your preferred course and qualification details.

Select Course *

Highest Qualification *

Name of Institution *

Year of Graduation *

Professional Background

Tell us about your work experience and certifications.

Current Job Title

Have you undergone any Safety Certification or Course? *

Yes

Years of Work Experience *

Additional Information

Help us understand your goals and how you found us.

Purpose & Expectation

How did you come to know about this course? *

Terms & Conditions

Please read and accept our terms and conditions.

Declaration *

I certify that the foregoing information is correct, and I understand that any false or misleading statement made on this form, or failure to disclose information relevant to this application being rejected/registration being terminated and/or may lead to legal proceedings. I agree to supply information that I am asked for in relation to this application. I understand that this information will be treated in confidence.

Consent *

I agree to the terms and conditions of the PGDIS application and understand that incomplete applications may not be considered.

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