Application Form REGISTRATION FORM Registration Form "*" indicates required fields Step 1 of 7 - Section A 14% SECTION A: PERSONAL DETAILSName & Surname* First Name* Last Name* Title* -----Please Select-----Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix Initials* Maiden Name First SA Citizen*-----Please Select-----YesNoIf NO, what is your residency status* ID Number* Upload one certified copy of your National ID document*(dated 3 months prior).Max. file size: 128 MB.Date of Birth* Month Day Year Age* Gender*-----Please Select-----MaleFemaleEquity* Black: African Black: Indian/Asian Black: Coloured White Other Equity: Other Disability*-----Please Select-----YesNoSpecifyMarital Status*-----Please Select-----MarriedSingleDivorcedWidowedUpload certified copies of your Marriage CertificateMax. file size: 128 MB.Residential Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Untitled Urban Rural Postal Address Street Address ZIP / Postal Code Phone (Work)Phone (Home)Cellular*Email (Work) Email (Personal)* Home Language* Name of High School* Highest Grade of School* Year Completed* Upload one certified copy of your Matric Certificate.Max. file size: 128 MB. SECTION B: EMPLOYMENT DETAILSAre you currently employed?*YesNoCurrent Occupation (Job Title)* Employer* Employer Phone*Manager/Supervisor Name* Manager/Supervisor Email* Employer Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country SECTION C: COURSE DETAILS:Please mark the qualification your registering for with an (x)FINANCIAL SERVICESFull Qualification FETC: Short Term NQF 4 (49929/66610) NC: Short Term NQF 5 (57918) Full Qualification FETC: Retail NQF 4 (49835) Full Qualification FETC: Long Term NQF 4 (49649) Full Qualification FETC: Wealth Management NQF 4 (57917) Full Qualification NC: Wealth Management NQF 5 (57608) Full Qualification Skills Programme FETC: Short Term NQF 4 (49929) NC: Short Term SKILLS NQF 5 (57918) FETC: Retail SKILLS NQF 4 (49835) FETC: Long Term SKILLS NQF 4 (49649) FETC: Wealth Management SKILLS NQF 4 (57917) NC: Wealth Management SKILLS NQF 5 (57608) QCTO OC: Insurance Agent: Claims Administrator NQF 4 (Assessor) (99668) OC: Insurance Agent: Insurance Underwriter NQF 5 (91784) OC: Financial Advisor NQF 6 (105026) SERVICES FETC: Contact Centre Operations NQF 4 (71489) FETC: Generic Management NQF 4 (57712) OTHER Class of Business (COB) National Credit Act compliance (NCA) Fundamental Unit Standards Facilitation National Credit Act Workshop Chartered Insurance Institute (CII) SECTION D: PAYMENT DETAILSPerson responsible for payment* Contact Number*Contact Email TERMS & CONDITIONS OF REGISTRATION:Invuya Institute of Learning is an accredited Training Institute. The following terms and conditions will apply:Registration By signing this registration form you are bound by the terms and conditions of Invuya Institute of Learning (Pty) Ltd. All registration forms, must be completed in full in order for the registration process to be successful. Incomplete registration forms which have omitted details or signatures will be returned to the candidate for completion. The candidate is required to provide Invuya with a CERTIFIED COPY of Matric Certificate, ID Document and Marriage certificate (if applicable). Learning Material will only be released once payment has been received. The registration period for a full qualification is valid for a period of 12 months from date of registration. The registration period for a Skills Program is valid for a period of 6 months from date of registration. No refund will be granted to any candidate once a registration form has been received by Invuya. Programme Pre requisite Requirements NQF 4 Qualification Entry Requirements: First , Second Language and Mathematics/ Mathematics Literacy Minimum requirements will be evaluated at registration on presentation of certified Matric Certificate. should the learner not have this requirement, this will be included in the programme. Formative Assignments / Summative Exams Learners are required to adhere to the Learning Programme Schedule provided. Competency of 50% for a Formative assessment is compulsory prior writing a summative exam. Original typed Formative Assignments must be submitted via the Invuya E-Learning System Formative Assignments may be typed on an Invuya/Inseta Template with a completed declaration of authenticity. No photocopied answers will be accepted, either in part or full for Formative Assignments. Formative Assignments without the Invuya/Inseta cover page will not be considered a submission. Formative Assignments without the learner’s full name and ID Number will not be considered a submission. The use of Tipex or any other correction fluid is strictly forbidden. Evidence of copying will be dealt with as plagiarism. This includes “lifting” evidence/articles from the internet or copying from other learners (past or present). Learners who plagiarise or otherwise engage in academic dishonesty face serious consequences. Sanctions may include, but is not limited to, failure on an assignment, grade reduction, course failure, and possibly suspension. An assessor is given a time frame of 10 - 15 working days in which to assess submissions and return to our offices for processing of results. All Invuya institute’s learning material is copyrighted and any illegal distribution can result in legal action. A deferment fee will apply should a learner fail to submit Formative Assignments on the scheduled due dates as well as not being present for a scheduled exam. A doctor’s certificate must be provided in the event of a learner being ill. A learner may not re-schedule an examination more than once. The learner is required to achieve a minimum of 50% each (for the Formative Assignment and the Summative Exam). Should the learner be deemed Not Yet Competent (NYC) after 2 attempts, the learner will be required to re-register for that particular unit standard. Integrated Summative Exam Competency Rule: Should a Learner be deemed NYC in 3 or more US on the Integrated Summative Exam. The learner is required to re-write the entire Integrated Summative Exam. Should a learner’s programme be incomplete at the expiry of registration, Invuya will have no option but to close off the file for verification. Should the learner wish to complete a course which they previously enrolled for, a re-registration fee will apply. Re-Registration will be charged per unit standard. Costs & Penalties No refunds will be granted under any circumstances once a Registration Form has been processed. The following fees will apply: Fails to submit a formative assignment as per the learning programme schedule. R345.00 (incl. Vat) Submission of an incomplete Formative Assessments R345.00 (incl. Vat) Should a learner be deemed NYC after two attempts, a Re-registration fee) per unit standard will apply. R575.00 (incl. Vat) Failure to present yourself for a scheduled examination or a deferred examination R575.00 (incl. Vat) An incomplete exam will be charged a deferment fee R575.00 (incl. Vat) Reprinting of learner-guides and/or study material (per unit standard) R230.00 (incl. Vat) Should a learner wish to appeal, the learner will have to request an Appeals Form. A re-assessment fee per unit standard will apply. R402.50 (Incl. Vat) Program Cancellation A refund will not be granted for any candidate once a registration form has been received by Invuya Institute of Learning (Pty) Ltd. Personal Information By submitting this form you are giving Invuya Institute of Learning permission to process and access your personal information for any purpose connected with this application and to verify any information contained herein. The institution is committed to maintaining your privacy at all times.Do you wish your personal information to be kept confidential between yourself and the institution?* Yes No Note: Disclosure is subject to the Promotion of Access to Information Act, Protection of Personal Information Act and other relevant laws. SECTION E: ACCEPTANCE OF TERMS AND CONDITIONSIf my application is successful and I accept the offer of a place to study at Invuya Institute of Learning, I undertake To comply with the procedure, terms and conditions, rules and regulations of Invuya Institute of Learning. To inform the relevant department immediately, in writing, if I change my address. To acquaint myself with all the rules and regulations that relate to the course for which I am applying. I/we hereby accept liability for the payment of all tuition fees or other fees which may be charged by Invuya Institute of Learning as a result of my studies at the institution. I am aware that my enrolment is valid only if it complies with the terms and conditions of the course concerned, notwithstanding the acceptance by Invuya Institute of Learning. I/We accept the responsibility of submitting all documents required by Invuya Institute of Learning before the stipulated due dates. I warrant that the information contained herein is true and correct and Invuya Institute of Learning shall be entitled to declare the contract void and cancel my registration if I have made any misrepresentation or omission in this application. Where my employer will be sponsoring me, the employer hereby accepts that it so too understands and agrees to the terms and conditions of this agreement. I (Full Name)* agree that the above information is true to the best of my knowledge. In signing this application form, I accept the terms and conditions of registration and understand the roles and responsibilities of myself and Invuya.Person responsible for payment* Should the candidate be responsible for payment, please complete the Payment Confirmation Declaration Where my employer will be sponsoring me, the employer also understands and agrees to the terms and conditions of this agreement.Candidates Signature*Date* MM slash DD slash YYYY Employer Name (If required) Employer Signature (If required)Date MM slash DD slash YYYY SECTION G: SURETYSHIPTo be completed where a person other than the applicant undertakes liability for the applicant’s financial obligations in respect of this contractI, the undersigned lawful parent/guardian/employer of the applicant, do hereby bind myself to Invuya Institute of Learning as surety in solidium and co-principal debtor with the above-named applicant for the due payment of all fees and other charges due and payable to Invuya Institute of Learning in terms of the relevant applicable schedule of fees. The surety will operate as a continuing covering suretyship. I agree that I will not be released from liability under this suretyship in any circumstances whatsoever, except with the Invuya Institute of Learning’s written consent.Full Name of Surety* First Last Identity Number* Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Which will be my domicilium citandi et executandi (permanent residential address) for all purposes under this document which means that I will accept service of all notices, documents and legal proceedings against me. In the event of me changing this address, I agree to inform Invuya Institute of Learning of any change in my address.Signature of Surety*Date* MM slash DD slash YYYY CAPTCHA