Personal Details

Full Name (required)

Email Address (required)

Date of Birth (required)

Gender (required)

Select GenderMaleFemaleOther

State of Origin (required)

Nationality (required)

Residential Address (required)

Phone Number (required)

Course Registration

Which course level are you registering for? (required)

Select Course LevelBeginnerIntermediateAdvanced

1. What interests you most about this fashion course? (required)

2. What do you hope to achieve in your fashion career? (required)

3. How do you see this course helping you reach those goals? (required)

Guarantor’s Information

Guarantor’s Name (required)

Relationship to Student (required)

Guarantor’s Phone Number (required)

Guarantor’s Address (required)

Referee’s Information

Referee’s Name (required)

Referee’s Occupation (required)

Referee’s Phone Number (required)

Referee’s Address (required)

Other Information

How did you hear about the academy? (required)

InstagramFacebookWebsiteReferralOther

Do you have any medical conditions we should be aware of? (required)

YesNo

If yes, please specify:

Emergency Contact Name & Number (required)