Students Registration Form

Registration Form (Fiche d’Inscription) For further information or guidance on selection, please contact: Training Director Tel:021256465 0r 024687145 SMS Text: 024-4287407 Please Note: All sections must be completed in full to qualify for consideration. Telephone number and email for future communication must be provided.

Full Name: ……………………………………………………………………………………………………………………………………… ………… Phone:……………………………………………………………… ……………………………………………………… Date of Birth: ………………………………………….......... Birth……………………………………………. Nationality: ……………………………………………………..

Email :

Place of

Male

Female

Courses available (please make your choice)

Desired Certificate or Diploma

Cours disponibles(s’il vous plait faites votre choix)

Certificat ou Diplome desire

Practical Course Networking

Short Practical Training

Hardware

Certificate Course

Networking

Diploma Course

Electronic

Long Term Training

Auto CAD

Certificate Course

Cisco

Diploma Course

Microsoft

Marketing / Business

Website Development Certificate Course Graphic Design

Diploma Course

Microsoft Office

Degree Course

Medical Assistant

Masters Course

Languages MBA

English formation

Mode of training-Mode de

French Campus Learning Course details:……………………………………………………………..

Distance Learning

Please confirm your registration by submitting the present form at J-Prompt head office Accra Circle Ghana within two weeks; otherwise, the present form shall be invalid. Veuillez confirmer votre inscription en soumettant la presante fiche ala direction generale de J-Prompt Situee a Accra Cerde Ghana dans un delai maximum de deux semaines; faute de quoi la present fiche sera invalide.

Fees paid are not Refundable and non Transferable. Add Two Passport SIZE photograph to Registration Form

Student’s Name:……………………………………………………………...Date: ………………………… Signature………………………………… Tel/Fax:021-256-465, cell:024-6867145, Website:www.jprompt.com, Mail: [email protected]