Executive Counselling and Training Academy Pte Ltd

* Required field

APPLICATION FORM FOR SHORT COURSES

Course Commences:
25 September 2020
Closing Date:
18 September 2020
Course fee:
$749
Course Commences:
3 December 2020
Closing Date:
26 November 2020
Course fee:
$224.70
Course Commences:
7 January 2021
Closing Date:
31 December 2020
Course fee:
$711.55
Course Commences:
28 November 2020
Closing Date:
21 November 2020
Course fee:
$401.25
Course Commences:
14 September 2020
Closing Date:
7 September 2020
Course fee:
$353.10
Course Commences:
28 October 2020
Closing Date:
21 October 2020
Course fee:
$160.50
Course Commences:
17 October 2020
Closing Date:
10 October 2020
Course fee:
$936.25
Course Commences:
28 January 2021
Closing Date:
21 January 2021
Course fee:
$1284
Total Fees: $0

(Minimum Entry Requirement: Diploma or equivalent)

1. PERSONAL DETAILS
Name (as in NRIC / Passport) *
NRIC / Passport Number *
Country of Birth *
Gender *    
Citizenship *
Ethnicity *
Marital Status *    
Date of Birth *
Address according to Identity Card (NRIC) *
Mailing Address
(if different from above)
Phone Numbers
Mobile *
Home
Office
Fax
Email Address *
Name to be printed on Certificate of Completion *
2. EDUCATION DETAILS
Highest Academic Qualification(s)
Name of Institution
Year Attended

3. ADDITIONAL INFORMATION
(a) Other qualifications *
If Yes, please provide details
Year of completion
(b) Are you sponsored by an organisation? *
If "Yes", please provide name of organisation

4. CURRENT EMPLOYMENT

Details of relevant employment or work experience

Organisation
Position or Title
5. PAYMENT OPTIONS
Total Fees: $0

Payment Method *

Cheque should be crossed and made payable to "ECTA".
Please write your name and contact number on the reverse of the cheque.

Payment

To be sent to:

Executive Counselling and Training Academy Pte Ltd
1 Kay Siang Road
#08-01/02
Singapore 248922


6. STUDENT SUPPORT: SPECIAL CONSIDERATIONS / NEEDS
I confirm that I
do
do not
require any special considerations / needs for my course of studies. *

If Yes, what support do you need?


If Yes, please elaborate:


7. NOTICE

In line with the Personal Data Protection Act, the organisers of this course would like to inform you on the collection, use and disclosure of your personal data.

Personal data (full name, mobile telephone number, email address, current role and workplace) will be collected for the purpose of enrolling you for the short courses that you have applied for.


8. APPLICANT DECLARATION / ACKNOWLEDGEMENT
  1. I am aware that I will not be eligible for exemptions (Academic Credit) should I decide to join the Master of Counselling (Advanced) accredited and awarded by the Swinburne University of Technology.
  2. I understand that I may from time to time participate in events organised by the academy where my image may be captured in photographs or video-recordings, and may be used on the academy’s website or in its publications for publicity purposes.
*

Verification *


Executive Counselling and Training Academy
CPE Registration Number: 200209120M
(Period: 20 June 2018 to 19 June 2022)