Gauteng Travel Academy

GTA Travel Academy (Pty) Ltd
Suite 126, 103 Club Avenue,
Waterkloof Heights Centre
Private Bag 11291
Maroelana, Pretoria, 0161

Docex 3 Menlyn
Tel: +27 12 346 2735
Fax:+27 12 460 4611

GTA Travel Academy (Pty) Ltd Cape Town
1st Floor, Hill House
43 Somerset Road
Green Point,
Cape Town

Tel: +27 21 421 2575

Enrolment Form

Please select the Course that you would like to enrol for:

PERSONAL DETAILS

Title:

First Name: *

Surname: *

Middle Name(s):

Age: *

Date of Birth: *

(ex 1977/08/30)

Identity Number:

If you do not have a National Identity Number, please provide an alternative Identification Number:

Alternative Identification Type:

Alternative Identification Number:

Equity:

Nationality:

Gender:

Citizen Residence Status:

Home Language:

Socio-Economic Status:

Disability Status:

Medical Aid Name:

Medical Aid Number:

Medical Aid Main Member:

Remarks: (Allergies / Special Needs)

Home Address: *

Code: *

Postal Address:

Code:

Province:

Phone Number: *

Fax Number:

Cell Phone Number:

E-Mail Address: *

Alternate E-Mail Address:

GTA Travel Academy