Registration will be secured only on receipt of full payment.
Please send all communication, registration information and deposit slip information via e-mail:
registration@mushroomacademy.com
Bank account details for direct deposits:
Account name:
Cape Connoisseur Champignons (Pty) Ltd
Registration number 1967/010120/07
Trading as the South African Gourmet Mushroom Academy
Bank:
Standard Bank
Branch:
Stellenbosch
Branch number:
05-06-10
Account number:
073-005-878
Type of account:
Current
Please fill in the required information below:
Your prefered course date:
Personal Information:
Fields marked with an * are required.
Title:*
Surname:*
Initials:
First Name:*
Highest academic
qualification:
Occupation:
Nationality:
ID or passport no:
Date of birth:
Special dietary restrictions / Allergies:
Address:*
City:*
Province/State:*
Country:*
Telephone (Office):*
(Eg. +27218869880)
Telephone (Home):
Cellular:
Fax:
E-mail:*
Company:
VAT number:
Will make use of the complementary accommodation*:
Yes
No
Estimated time of arrival*:
Additional Comments/Requests:
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