Registration Form - Yolanda Gail and Associates

Client Registration Form

First Name

Middle Name

Surname

ID Number

Mobile Number

Physical Address

Street Address

Address Line 2

City

Province / State

Postal Code

Country

Preferred Contact Method

Highest Qualification

Employment Status

Name of Employer

How did you hear about us?

Payment Options

Full Payment

Deposit (R1,500) followed by 4 monthly Installments of R750 (Month 1,2,3,4) + 5th & Final Installment of R999

Important Notice: A minimum deposit payment of R1500 is required and is Non-refundable.

I hereby declare that the information provided is accurate and I consent to the processing of my personal data for registration purposes.

By checking the box, you acknowledge and agree that you have read, understood, and agreed to the payment schedule options, refund policy, and enrollment terms.

I have read and agree to the Terms and Conditions , Privacy Policy and Refund Policy.