10 CPD Point Bundle Enrolment Form

10 CPD Point Bundle - PM Focus

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Member details
This form is pre-populated with your member details, and cannot be used to enrol another member.

Please note you will be automatically enrolled in the following courses:

    3 CPD point Mandatory (classroom)
    3.5 CPD point Elective (classroom)
    3.5 CPD point Elective (online) chosen below

Title:
Entity Data - Profile - Title
Do you have a 'single name' only?
Basic - Radio buttons
First name:
Students with only a ‘single name’ must enter their full name in the 'first name' field.
Entity Data - Profile - First Name
Middle name:
Entity Data - Profile - Middle Name
Last name:
Entity Data - Profile - Surname
RA/RR number:
Entity Data - Identification - Licence Number
Date of birth:
Entity Data - Profile - Birth Date
Phone:
Entity Data - Contact - Home - Mobile Number
Email:
Entity Data - Contact - Home - E-mail Address
Please select your 3.5 CPD online course from the options below:
Basic - Checkboxes

Dietary requirement

Do you have any dietary or food allergies requirements?
Basic - Radio buttons
Please indicate any requirements you may have:
Basic - Checkboxes
Do you have any specific requirement?
Basic - Smart Question
Terms and conditions:
Basic - Checkboxes

Payment

Payment Options

Select a Payment Option


Pay Now

Select this option if you want to pay now.
You'll be redirected to the Payment Gateway.

Pay Later

Select this option to pay later. An invoice will
be provided to you, or your sponsor, post
submission.

Please select from the following options:

Member Invoice
Elective CPD 		$227.27
$227.27
$22.73
$250.00