Online Application - Masterclass in Food Security

Please complete the application form in full

Please take note of mobile numbers’ country code fields

Title

PERSONAL DETAILS

First Name

Last Name

Mobile No.

Email Address

Country

Nationality

Job title

Do You Have Internet & PC Access?

Yes

Select Start Date

PAYMENT DETAILS

For Personal or Business Account?

Select Payment Plan

For the attention of:

Invoicing address

SIGNATURE

The signatory hereby applies for registration on the short course of this application form and agrees that upon acceptance of this application by BSN, a legal binding agreement between him/herself and BSN is established. Should the applicant/student have misrepresented the truth in this application form then this should be grounds for termination of this agreement by BSN. Termination of the agreement based on this misrepresentation is no cause for restitution of the course fees to applicant/student.

I agree and consent to the terms of application

Applicant name

Place and Date

Message / Comments