Registration Form

Logix Training > Registration Form

Please complete this form using BLOCK CAPITAL letters in black or blue ink only. Please Provide Passport Size Photograph Only (Please write full name and date of birth on back side of photograph). Please ensure that all details you enter are accurate, up to date and match those displayed on your identification documents.
All are mandatory fields; failure to complete this form in clear, accurate and up to date information will result in delays to your course results.

"*" indicates required fields

Course Details*

Title*

Full Name*

Gender*

DATE OF BIRTH*

Contact No*

Email:*

Full Address*

Nationality*

Proof of address (Please Specify and submit at center)*

Any Disability*

I confirm that I have declared disability and any injuries, which may affect to participate. I confirm that I am fit and able to participate in this course. I confirm that the information provided on this form is correct. I confirm that I give my consent to be enrolled on this course and center can publish my details for marketing. I confirm that I have been made aware of the center’s appeals and complaints procedures. I confirm that I have read, understood and comply with the above-mentioned notes of this form. I confirm that at all time 100% attendance and punctuality is compulsory for every course. I understand that money is non-refundable incase the above instructions are not followed. I understand that course results will take up to 4 to 6 weeks after exam day.

I understand and agree

I disagree

COVID – 19 AND HEALTH DECLARATION: I have not been exposed to a person with a confirmed or suspected case of COVID-19; or where I have been exposed to a person with a confirmed or suspected case of COVID-19, the date of exposure was more than 14 days prior the date this declaration. I am not shielding on health grounds/been advised to remain at home, following the government guidance. I have not, nor has anyone in my household, experienced COVID-19/ cold or flu-like symptoms in the last 14 days (including fever, new continuous cough, loss of taste/smell). If I experience, or if anyone in my household experiences, any COVID-19/cold or flu-like symptoms after completing this declaration I will notify the LOGIX TRAINING host as soon as possible. By signing this form, you are also declaring that you have not travelled outside to the UK within the last 14 days. If you have travelled outside to the UK within this period, please state country and date of entry to the UK here:

If you are unable to sign this declaration due to exposure to/displaying COVID-19 symptoms, please notify the LOGIX TRAINING Centre’s host you are visiting, who will rearrange your allocated timeslot. In line with government advice, I agree to wear a face covering in all indoor locations on the center premises.

I agree

I disagree

Learner's Name and signature

Note: After Submission of this form you will be redirected to the Self Study Form which also needs to be filled out.

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