BK-6
UNIVERSITY OF JOHANNESBURG
REGISTRATION OF SHORT LEARNING PROGRAMME
1.
STUDENT’S PERSONAL PARTICULARS
SURNAME
TITLE
(Dr/Mr/Ms, etc.)
FIRST NAMES
EMPLOYER
PREFERRED
POSTAL ADDRESS
POSTCODE
CELLPHONE
TELEPHONE
HOME
WORK
HOME LANGUAGE
IDENTITY NO.
E-MAIL:
GENDER (mark with an X)
2.
MALE
FEMALE
COURSE DETAILS
COURSE NAME
Department of Public Governance, Humanities Faculty.
DEPARTMENT
DATE OF PRESENTATION &
VENUE
(e.g. 1 March - 30 June 1996, Auckland Park)
HAVE YOU BEEN REGISTERED FOR A COURSE AT UJ / RAU BEFORE?
IF ‘YES’, NAME THE
YES
NO
COURSE/S AND STATE THE
YEAR/S (IF AVAILABLE)
I HEREBY DECLARE THAT THE ABOVEMENTIONED INFORMATION IS CORRECT.
__________________________________
STUDENT’S SIGNATURE
____________________
DATE
THE STUDENT IS ACCEPTED FOR THE COURSE.
__________________________________
COURSE LEADER’S SIGNATURE
____________________
DATE
[BK-VORM-ENG-06]
WELCOME TO UJ – ENJOY THE COURSE!
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