E-Learning Certificate Registration Form

Participant Information

Full Name:(Required)

You are(Required)

Bachelor Student

Master Student

Doctoral Candidate

University Staff

Practitioners

Student ID / Matriculation Number (if applicable)(Required)

Name of School(Required)

Institution of Affiliation(Required)

Date of Birth(Required)

DD dash MM dash YYYY

Email(Required)

Enter Email Confirm Email

Phone(Required)

Address

Street Address City Country

Technical Requirements(Required)

Reliable Internet Connection

Laptop or PC

Webcam and Microphone

University Platform Access

Declaration of Consent

(Required)

I confirm that the information provided above is accurate.

(Required)

I agree to abide by the academic integrity and participation guidelines of this course.

Consent(Required)

I consent to the storage and processing of my data for course administration purposes, in accordance with the Ghana Data Protection Act, 2012 (Act 843),