Registration Form

Personal Details

Title *

First Name (As Shown in Passport/ID) *0 / 50

Surname (As shown in passport/ID) *0 / 50

Gender *

Date of Birth *

Nationality *

Identification Card/ Passport Number *0 / 25

Job Title0 / 100

Company Name0 / 100

Mailing Address & Contact Details

Address *0 / 500

Provided Address *

Postcode0 / 100

Current Country *

WhatsApp Number *

Telephone (Phone) *

Email Address *

How did you come to know about us? *

Are you a Resit Exam Student?

Previous Learner Partner Number and Name *0 / 50

Learner Number *0 / 50

Qualification Name *0 / 50

Unit Resit *

Reason for resit the exam *

Course

Course Name *

Reason for Taking this Course *

Course Date *

Mode of Study *

Declaration of Educational

Please indicate your final level of formal learning *

English Language Proficiency *NEBOSH recommends that candidates should reach the equivalent of a scoring of 6.0 or higher under the International English Language, Please rate your level of proficiency in English language

Pre Consulting

Question 1: English Language Proficiency *Please describe a safety procedure in your workplace in English. How would you explain this procedure to a colleague who is not familiar with safety practices?

Question 2: General Understanding of Health and Safety *Can you briefly explain the importance of workplace safety and the role it plays in preventing accidents? Please provide examples if possible.

Question 3: Knowledge of NEBOSH IGC *What is the NEBOSH International General Certificate (IGC), and why is it considered an essential qualification for health and safety professionals?

Question 4: Practical Application in Safety and Health *Imagine you are working in a factory, and you notice an unsafe working condition. What steps would you take to ensure the safety of workers? How would you communicate these concerns to your supervisor?

National Identity Card Front/Passport *

National Identity Card Back/Passport *

Photo Passport Size *

Last Degree *

URN (For Resit Only) *

Payment Details

Select Account *

Reason for using this account *If you are using someone else’s account to pay the fee (i.e., the account holder is not the learner enrolling in the course), you must provide the account holder’s ID and the reason for using their account in this section.

Account Holder ID Front *

Account Holder ID Back *

Transaction Slip *

Transaction ID (As mentioned on your payment slip.) *0 / 75

Account Holder Name *0 / 75

Amount *0 / 75

Declaration

Name (As per your ID) *

Date *

Digital Signature *

I understand all the contents, syllabus guide and conditions as stated in CWD agreement and guidance documents and I am well aware about the level of my English suitability for the course and I am registering myself for the course by knowing all the conditions by CWD counsellor.

I acknowledge that I have read, understand and accepted all of the terms.

Registration Form

Personal Details

Mailing Address & Contact Details

Course

Declaration of Educational

Pre Consulting

Payment Details

Declaration

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