Please submit the form if you want to take part in a Lifters and Handlers course

Please note that all fields marked with * are mandatory

APPLICANT INFORMATION

NAME * :

SURNAME * :

ID NUMBER * :

CELL PHONE * :
CURRENT ADDRESS * :
CITY * :
EMAIL * :

EMPLOYMENT INFORMATION

CURRENT EMPLOYER * :
CELL PHONE * :
ADDRESS :
CITY :

COURSE INFORMATION
PLEASE SELECT THE COURSE YOU WANT TO APPLY FOR

I hereby confirm that the above information is correct to the best of my knowledge.

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