Residential Address *City *State/Province/Region *ZIP / Postal Code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabwePrefix *SelectMr.Mrs.Ms.Miss.Dr.First Name *Middle NameLast Name *Please be aware that this is how your names will appear on your certificate, should you be successful.Company NameJob TitleEmail Address *Phone Number *Course of Interest *Date of Birth *DaySelect day12345678910111213141516171819202122232425262728293031MonthSelect month123456789101112YearSelect Year212521242123212221212120211921182117211621152114211321122111211021092108210721062105210421032102210121002099209820972096209520942093209220912090208920882087208620852084208320822081208020792078207720762075207420732072207120702069206820672066206520642063206220612060205920582057205620552054205320522051205020492048204720462045204420432042204120402039203820372036203520342033203220312030202920282027202620252024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925Level of Education *-- Select --No Formal EducationPrimary EducationSecondary Education or High SchoolVocational QualificationBachelor's DegreeMaster's DegreeDoctorate or HigherID Type *-- Select --National ID / Ghana CardPassportDriver's LicenseUpload A Picture of Your IDChoose FileNo file chosenDelete uploaded fileNote: Take a clear snap and ensure the words readable.Which exam do you want to register? *Which month do you want to write this exam? *Which unit do you want to register? *Which learning partner are you currently studying with? *What is your NEBOSH student number (If Applicable)Have you written your mock exams? *YesNoHow did you hear about us? *Social MediaOur WebsiteDirect MailAn EventReferralOtherCourse Enrolment Notification and Learning AgreementThe purpose of the learning agreement is to help learners understand their role in the overall process. It is an understanding between Millennium Health and Safety Consult (MILHASC) and the learners as to who takes responsibility for what. It needs to be honoured by both parties if the learning is to be successful. Your course is demanding and requires significant time and commitment from you and MILHASC to ensure you pass your exams with ease.Millennium Health and Safety Consult (MILHASC) will: Provide you with suitable materials, sufficient for your course, at the appropriate times. Ensure you are enrolled and registered with the appropriate awarding institutions for your examination as required (if we believe you are ready and prepared). Do our best to ensure that the course material conforms to the relevant syllabus. Encourage you during your study. Provide an expert tutorial team who can be contacted by a range of methods. Provide appropriate administrative support during working hours. Remind you if assignments have not been submitted by the agreed deadlines. Return tutor-marked assignments (TMA) and mock exam feedback within 2 weeks. Provide constructive and individual feedback on your progress. Deal with any difficulties promptly and fairly. Send you a copy of our complaints procedure on requests. Operate an equal opportunity policy. Learners will: Ensure that all fees are paid by the agreed-upon times. Complete the study planner to plan and track your progress through the course. Ensure that all actions detailed in the study planner are completed. Carry out a sufficient private study of textbooks, further reading, and references (as detailed in the study planner and study guide) to maintain progress on your learning programme. Attempt revision questions in the study guide, as directed by the study planner. Complete exam registration forms when requested and pay the appropriate fees. Learners enrolled in the classroom sessions must attend classes as planned. Learners must not conduct themselves in a way that would disrupt the class. Learners who persistently disrupt the class may be asked to excuse themselves. Terms and Conditions on our course fees:Our course fees are pegged to GBP. In case of fluctuations in the Ghanaian currency in the exchange rate market, the GBP equivalence will always be charged. MILHASC reserves the right to alter fees at any time depending on the economic situation in Ghana.Agreement by Millennium Health and Safety Consult:Hussein Osman IDipNEBOSH CMIOSH (Senior Managing Consultant, Millennium Health and Safety Consult)Please verify that:You have read the prior knowledge requirements of this course and you have met them. *YesNoYou have read all the joining instructions and can meet all the requirements. *YesNoNotes/Any special requirements (e.g. dietary, building access, etc) *Consent *By submitting this form, I confirm that the details above are correct and I accept the terms and conditions belowSubmitPlease do not fill in this field.