<p> EDUCATION STAFF DEVELOPMENT DEPARTMENT S1A Level 3 Tel. No. : (+966) 01- 5620000 Ext. 4024/4029 Fax # . : (+966) 01- 5624652 Email: [email protected] </p><p>Course Registration Form. PARTICIPANT DETAILS – Please complete all fields in CAPITAL letters:</p><p>First Name: Family Name:</p><p>Title (Dr, Mr, Mrs, Ms): Position : </p><p>Organization/Company: Email:</p><p>Mailing Address: City:</p><p>Postal code: Country:</p><p>Telephone: Fax:</p><p>Mobile Phone:</p><p>COURSE: Please specify below your Course Date/Time Tuition payable amount</p><p>SR </p><p>TOTAL PAYABLE REGISTRATION FEE AMOUNT SR </p><p>Important Notes: (1) Registration deadline is ten days before program date. (2) Course registration confirmed only upon: a. Receipt of full payment. Please email or fax your bank slip ASAP.</p><p>Cancellation Policy: (1) All cancellations to be received in writing, via email or fax. (2) Any cancelled registration will be subject of a processing fee of 25%. (3) No refunds for cancellations received after registration deadline. Note: All refunds will be processed after the course dates.</p><p>Payment method: Account Name: Sultan Bin Abdulaziz Humanitarian City Bank Name: Saudi British Bank Account No. : sa7945000000018-063388-006 Bank Branch: Takhasusi Branch</p><p>I accept the conditions stated in this form</p><p>Date ____/____/____ Participant’s Signature : ______</p>