Student Enrolment Form

(* denotes that this field is compulsory)

Is this the first time you have enrolled with CeaseFire? YES NO

[date* coursedate class:datepick]


 Male Female

[date dob class:datepick]

Workplace Contact/Invoicing Details

Emergency Contact

Course Conduct

In submitting this electronic enrolment from you agree that your failure to advise CeaseFire of your inability to attend with a minimum of 24 hours notice to the above mentioned course, will incur a fee of 20% of the course cost. Please tick to confirm your agreement * 

A confirmation email will be sent to the sender’s email, it is the sender’s responsibility to circulate this to course attendants.

Please copy the security code below before sending *