NLRD Registration - Mind-the-Gap

Personal Information for Registration on NLRD

Please note that you will also need to upload a Certified copy of your ID/Passport, Grade 12 Certificate and Highest Qualification as part of your enrolment.

Learner Details:

Training Programme / Qualification:*

Start Date:*

Group Name / Company:*

Your Reference:*

Learner First Name:*

Learner Middle Name:

Learner Surname:*

Previous Surname in brackets if applicable

Title:*

Birth Date:*

YYYY-MM-DD

ID/Passport Number:*

Equity / Race:*

Nationality:*

Province of Residence:*

Gender:*

Home Language:*

Disability Status:*

Home Telephone:

Work Telephone:

Cell Number:*

Email address:*

Postal Address:

Postal Address Line 2

Optional

City:

Postal Code:

Residential Address:*

Residential Address Line 2

Optional

Suburb:*

City:*

Area Code:*

Name you would like on your certificate/statement of results:

Title:*

Initials:

First Names:*

Surname:*

Education Details:

Highest Grade achieved at school:*

Year when highest grade achieved at school:*

School achieved highest grade:*

Municipality of school:*

Further Education: YesNo

Degree/Diploma/Certificate Name:

1st Degree/Diploma/Certificate

Duration:

Year obtained:

Institution:

Degree/Diploma/Certificate Name:

2nd Degree/Diploma/Certificate

Duration:

Year obtained:

Institution:

Degree/Diploma/Certificate Name:

3rd Degree/Diploma/Certificate

Duration:

Year obtained:

Institution:

Employer Details (if employed):

Name of Employer:

Address of Employer:

Telephone Number:

Work Email Address:

Position:

Period of Employment:

MTG Communication & Marketing:

Would you like to be featured on our web page / social media (photo, articles etc.)?YesNo

MTG communication preferred method of contact?EmailText

Next of Kin:

Next of Kin Name:*

Next of Kin Relationship:*

Next of Kin Contact Number:*

Upload documents:

Upload Certified copy of your ID or Passport*

JPG, PNG, GIF, PDF (Max file upload size: 5MB)

Upload Grade 12 Certificate

JPG, PNG, GIF, PDF (Max file upload size: 5MB)

Upload Highest Qualifcation

JPG, PNG, GIF, PDF (Max file upload size: 5MB)

Upload your CV

JPG, PNG, GIF, PDF (Max file upload size: 5MB)

Personal Information for Registration on NLRD

Learner Details:

Name you would like on your certificate/statement of results:

Education Details:

Employer Details (if employed):

MTG Communication & Marketing:

Next of Kin:

Upload documents:

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