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Genesis Of Practical Training Skills
Address: Room 308 Old Wing Mosi Oa Tuya Building‫׀‬Tel: +260 953 250 337 ‫ ׀‬Email: genesisstc@tech-center.com
APPLICATION FORM
STUDENT DETAILS

First Name: ___________________________ Other Name: ______________________ Sex: __________

Last Name: _________________________ Cell: ______________________ Email: __________________

Any Medical Conditions Yes No Passport / NRC Number: _________________________________

If yes please specify: ____________________________________________________________________

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Education level: _______________________________________________________________________

Course selection tick on the course

COMPUTER COURSE CHEMICAL ENGINEERING


OURSES
Computer Networking Pine Gel Making
Information Technology Dash Washer Making
Graphic Designing Air Freshener
Computer Repairing Perfume
Web Development Bleach
CCTV Installation Wine Making
Microsoft Office Package Whisky Making
Video Editing and Camera Handling Beer Making

Do have any background knowledge of the course selected if not why do you select this course?
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None refundable form fee of K100 please insure you get a receipt upon payment
For Official Use Only

Accepted Rejected
Notes:
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