Student Name and Surname
Year of Study (1st, 2nd or 3rd)
Please note that for a student to attend NewBridge College and receive our voluntary and additional support for their chosen external qualification, they need to be registered with the institution selected in the table above.
South African Citizen:
Relationship to Student Title
Expiry Date Nationality
Cell Tel (H/W)
Email Address 1 Email Address 2
Name Account Holder ID Number
Branch Code Account Number
Contact Number Email Address
I/we hereby authorise NewBridge College to draw against my/our account with the above-mentioned bank (or any other bank or branch to which I/we may transfer my/our account) the amount necessary for payment of monthly instalments due in terms of the Registration Contract on the above indicated day of each month of the repayment period.
All such withdrawals from my/our bank account by NewBridge College shall be treated as though they had been signed by me/us personally.
I/We agree to pay any bank charges relating to this debit order instruction. Rejected debit orders will incur a R200 administration charge. I/We understand that I/we shall not be entitled to any refund of amounts that have been withdrawn while this authority is in force if such amounts were legally owing to NewBridge College. This authority may only be cancelled by me/us on the proviso that the outstanding amount owing has been settled and that NewBridge College is given 30 days’ notice in writing.
Receipt of this instruction by NewBridge College shall be regarded as receipt thereof by my/our bank.
NewBridge College full fees
Email your proof of payment to email@example.com to confirm your application.
I/We the undersigned have read, completed and understood the entire contents of this Registration Contract and are hereby jointly and severally bound and accept all terms and conditions of this Registration Contract.
If you get a RED warning after submitting, press the button again, if you filled the whole form out.