PowerFactory Intermediate

First Name *

Last Name *

Email Address *

Unique No

Cost Center Number (Eskom Delegates)

Your Telephone *

Your Mobile *

Company Billing Address *

Company VAT Number

Company Phone *

Company Email *

Company P.O. Number

Does your company allow the use of ZOOM for online meetings * Select ...YesNoOther

Invoice To: *

If Other online meetings please specify

Do you consent to Digsilent Buyisa storing your personal information for the purposes of maintaining training records & to contact you for the purposes of support. * Yes
No

Dietary Requirements Select ...HalaalStrictly HalaalVegeterianVeganOther

Do you consent to Digsilent Buyisa sending you information about upcoming Digsilent courses and product news. * Yes
No

If Other Dietary requirements please specify

I understand and accept the terms and cancellation terms and wish to be booked on the nominated course above.