South African Enrolment Student DetailsFirst Name*Surname*Email* Enter Email Confirm Email Cell Number*Alternate Contact NumberPhysical Address* Street Address Suburb City Province Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Postal Address Same as physical address Postal Address* Street Address Suburb City Province Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country SA ID Number*Occupation*Home Language*Date of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Special Circumstances*- Please SelectYesNoAre there any physical/learning disabilities we should be aware of?Details of Disability*Person Responsible for Payment*- Please Select -Student (as above)OtherWho will be paying for the course?Payee InformationFirst Name*Surname*Email* Enter Email Confirm Email SA ID Number*Cell Number*Alternate Contact NumberPhysical Address* Street Address Suburb City Province Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Postal Address Same as physical address Postal Address* Street Address Suburb City Province Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Payment Terms & ConditionsCourse*-- Please Select --AB01: You and Your CatAB02: You and Your Rescue CatAB03: You and Your DogAB04: You and Your Rescue DogCO1: Dogwise - Stage 1 - CorrespondenceCO1: Dogwise - Stage 1 - Including PracticalCO2: Dogwise - Stage 2C03: Think Cat - Stage 1C05: African Wild Dog BehaviourDipCABT: COAPE Diploma in Animal BehaviourPlease select the course you are enroling for.Dear Course Delegate Please read the following carefully. Course Cost: R3 000 (VAT inclusive) Payment terms The cost of the course is R3 000 and is payable in full on registration. Dear Course Delegate Please read the following carefully. Course Cost: R8 900 (VAT inclusive) Payment terms Payable now : Full course fee of R8 900 OR deposit of R3 000 Balance of course fee to be paid within 30 days OR by monthly payment. Dear Course Delegate Please read the following carefully. Course Cost: R7 600 (VAT inclusive) Payment terms Payable now : Full course fee of R7 600 OR deposit of R3 000 Balance of course fee to be paid within 30 days OR by monthly payment. Dear Course Delegate Please read the following carefully. Course Cost: R9 500 (VAT inclusive) Payment terms Payable now : Full course fee of R9 500 OR deposit of R3 000 Balance of course fee to be paid within 30 days OR by monthly payment. Dear Course Delegate Please read the following carefully. Course Cost: R7 600 (VAT inclusive) Payment terms Payable now : Full course fee of R7 600 OR deposit of R3 000 Balance of course fee to be paid within 30 days OR by monthly payment. Dear Course Delegate Please read the following carefully. Course Cost: R8 250 (VAT inclusive) Payment terms Payable now : Full course fee of R8,250 OR deposit of R2,500 Balance of course fee to be paid within 30 days OR by monthly payment. Dear Course Delegate Please read the following carefully. Course Cost: R5 820 (VAT inclusive) Payment terms Payable now : Full course fee of R5 820 OR deposit of R2 000 Balance of course fee to be paid within 30 days OR by monthly payment. Dear Course Delegate Please read the following carefully. Course Cost: R29 000 (VAT inclusive) Non-refundable deposit: R7 500 Payment Options: The Deposit of R7 500 can be paid over 3 months (R2 500 per month) however the final course information will only be made available to the student once the 2nd payment, or R5 000, as been paid against the deposit. The full deposit must be paid by the course start date. Full balance of the course fee can be made upfront within 1 month of registration. This option will save you R2 150 in Interest Charges. A monthly Electronic Fund Transfer of R985* per month, commencing the 1st month after registration and payable by the last day of each calendar month for 24 consecutive months. NOTE: For all the above payment options, the deposit amount must have been paid in full to enable the student to receive the link to the 1st set of lectures. * Option 4 includes a minimal 10% interest componentDear Course Delegate Please read the following carefully. Course Cost: R23 000 (VAT inclusive) Payment terms Payable now : Full course fee of R23,000 OR deposit of R5,000 Balance of course fee to be paid within 30 days OR by monthly payment. Basic Terms & Conditions Right of enrolment is reserved. Courses are not transferable. Cancellation/Refund Policy: The refund a student will be entitled to, is dependent on the progress the student has made with the course, including the assignments submitted. If a student cannot proceed with the course for whatever reason, the student must get in contact with Wendy Wilson by email (wendy@coape.org ) and the necessary arrangements will be made. The student will be responsible for the courier fees for his/her certificate. Full terms & conditions can be accessed on our website Basic Terms & Conditions Right of admission is reserved. Courses are not transferable. Cancellation/Refund Policy: The refund a student will be entitled to, is dependent on the progress the student has made with the course, including the assignments submitted. If a student cannot proceed with the course for whatever reason, the student must get in contact with Wendy Wilson by email (wendy@coape.org ) and the necessary arrangements will be made. Full terms & conditions can be accessed on our website Agree to terms and conditions* Yes I hereby agree to the abovementioned payment terms and undertake to fully settle the amount specified by the given date. I agree to being contacted for Marketing purposes*YesNoPayment & ConfirmationCourse Price Price: R3,000.00 C01 (with Practical)*Full PaymentDeposit OnlyPlease select your payment optionC01 (Correspondence Only)*Full PaymentDeposit OnlyPlease select your payment optionC02*Full PaymentDeposit OnlyPlease select your payment optionC03*Full PaymentDeposit OnlyPlease select your payment optionC04*Full PaymentDeposit OnlyPlease select your payment optionC05*Full PaymentDeposit OnlyPlease select your payment optionDipCABT: COAPE Diploma in Animal Behaviour*Full PaymentDeposit OnlyPart DepositPlease select your payment optionAdv. DipCABT: COAPE EMRA Advanced Diploma in Animal Behaviour*Full PaymentDeposit OnlyPlease select your payment optionPayment OptionsWithin 30 days of depositMonthly paymentsPlease select your installment(s) for the remainder of the course fee.Total Payable Now R0.00 To assist in our marketing please can you tell us where you heard about us from?*NameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.
