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  • Learning Centre - Walk-In Registration Form

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    Anthony Basanta
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    This document is a walk-in registration form for a learning centre. It requests information such as name, address, occupation, contact details, payment method, current employer, identification number and details of the training being registered for such as course name and date. The form also tracks details of the registration like receipt number, amount paid, and date of receipt for record keeping purposes.

    Original Description:

    Registration for PLEA

    Original Title

    Registration

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    This document is a walk-in registration form for a learning centre. It requests information such as name, address, occupation, contact details, payment method, current employer, identification number and details of the training being registered for such as course name and date. The form also tracks details of the registration like receipt number, amount paid, and date of receipt for record keeping purposes.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    3 views1 page

    Learning Centre - Walk-In Registration Form

    Uploaded by

    Anthony Basanta
    This document is a walk-in registration form for a learning centre. It requests information such as name, address, occupation, contact details, payment method, current employer, identification number and details of the training being registered for such as course name and date. The form also tracks details of the registration like receipt number, amount paid, and date of receipt for record keeping purposes.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    LEARNING CENTRE | WALK-IN REGISTRATION FORM

    Method of Payment: Linx ☐ Visa ☐ MasterCard ☐ Deposit Slip ☐ Cheque ☐ Direct Deposit☐

    Name:

    Address:

    Occupation: Cell/Home#:

    Please tick: ☐ PLEA Card Renewal ☐ First Time


    Did you complete the PLEA 10-Hour Training within the last 6 months? ☐ Yes ☐ No
    If yes, please indicate the name of the Training Provider
    Please tick the PLEA company that you currently work for:
    ☐ Air Liquide ☐ Arcelor Mittal ☐ Atlantic LNG ☐ IGL ☐ IPSL ☐ Methanex ☐ Nu Iron ☐ NGC/NEC ☐ PCS Nitrogen
    ☐ Petrotrin ☐ PLIPDECO ☐ PLNL ☐ POWERGEN ☐ PPGL ☐ Shell ☐ TCL ☐ Trinity Power ☐ Yara Trinidad

    Note: The identification number must be 9 digits; if using your T&T national ID card number,
    do not enter the first 2 digits; all other forms of ID please enter zeros before the number

    Training Date: Use a separate form for each training day

    Identification Number Last Name First Name Name of Course

    FOR OFFICIAL USE ONLY


    Front Desk Receipt Amount Date
    Initials Number Paid of Receipt

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