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Student Registration Form

Please fill out all sections clearly and accurately.

Full Name *

Date of Birth *

Gender *

National ID / Passport No. *

Phone Number *

Email Address *

Postal Address

Emergency Contact Name

Emergency Contact Phone

Student Photo (passport size) *

Photo must be passport size. Max upload 300KB. jpg / png only.

Upload ID / Birth document

Accepts pdf / jpg / png. Max 1MB.

Course Details

Course Applied For *

Preferred Intake Date

Training Schedule

If Other, specify

Declaration

By submitting this form I declare that the information provided is true and correct to the best of my knowledge. I agree to abide by the rules and regulations of the Barista Training Institution. Certification and course enrollment may be subject to full payment and successful completion.

[acceptance* agree-declaration] I confirm that the information above is correct and I agree to the terms and conditions.

Signature (type full name) *

Date *

Disclaimer: By submitting this form, you consent to the use of your image, photographs, or videos taken during training for promotional purposes by the institution. These materials may be used on social media, websites, or other marketing channels without additional compensation.