QCTO Learner Registration QCTO Learner RegistrationCourse Registered for– Select course registered for –99573 Retail Supervisor99669 Retail Sales Advisor118731 Shelf Filler99703 Store Person99688 Visual MerchandiserCompany Sponsor Yes No, OwnCompany NameTitle– Select –MrMsMrsMissFirst NameMiddle NameLast NameSA ID NumberAlternative Number Type of Number– Select –Passport NumberNoneRefugee NumberWork Permit NumberBirth Certificate numberPhoneEmailDate of BirthEquity– Select –Black AfricanColouredIndianOtherUnknownWhiteNationality– Select –South AfricaNamibiaBotswanaZimbabweAngolaMozambiqueLesothoSwazilandMalawiZambiaMauritiusTanzaniaSeychellesZaireRest of AfricaEuropean countriesAsian countriesNorth American countriesCentral and South American countriesAustralia Oceania countriesOther and rest of OceaniaN/AUnspecifiedHome Language– Select –EnglishAfrikaansisiXhosasePediseSothoseTswanasiSwatitshiVendaxiTsongaisiZuluisiNdebeleSouth African Sign LanguageOtherGenderAs defined by ID numberMaleFemaleCitizen Status– Select –South AfricaDual (SA plus other)Permanent ResidentUnknownOtherImigrant Status– Select –ImmigrantRefugeeSA CitizenDisability– Select –NoneSight (even with glasses)Hearing (even with a hearing aid)Communication (talking, listening)Physical (moving, standing, grasping)Intellectual (difficulties in learning); retardationEmotional (behavioural or psychological)MultipleDisabled but unspecifiedDegree of disability– Select –No difficultySome difficultyA lot of difficultyCannot do at all.Cannot yet be determined.May be part of multiple difficulties (TBC)May have difficulty (TBC)Former difficulty – none nowSocio Economic Status– Select –EmployedUnemployed, looking for workNot working – not looking for workHome maker (not working)Scholar/student (not working)Pensioner /retired (not working)Not working – disabled personNot working – not wishing to workNot working – Not elsewhere classifiedAgedInstitutionUnspecifiedNext of Kin Next of kin Relationship– Select –FatherMotherSpouseFamily (other)OtherContact NumberYour Home AddressAddress Line 1Address Line 2City/TownPostal CodeProof of Identify (Certified within three months)Choose File (PDF or JPG) Proof of Highest Qualification (Certified within three months)Choose File (PDF or JPG) Latest available CV. Please ensure accurateness.Choose File (Docx, PDF or JPG) I have read and agree to the POPI Act Policy Yes NoI have read and agree to the Privacy Policy Yes NoSubmit Form
