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Course Registration Form
Course Title (*)
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Hold down the Control key and select courses that you wish to register
Title (*)
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Full Name in English (*)
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Name as want on certficate (*)
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الاسم بالعربي
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Nationality (*)
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Gender (*)
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Mobile No. (*)
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Date Of Birth (*)
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Private Phone No
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Private Email (*)
Please, enter valid email
Home Address
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Company Name (*)
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Business Address
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Job Title
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Business Phone
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E-mail Address
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Business Fax
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Method Of Payment (*)
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Details of person to send invoice to (*)
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Payments
   - Please note that full payment must be received one week before starting date.
   - Payment of 140 JD for cancellation one week before the course begins.
   - Money transfers to bank account as written below.
   - Kindly send a scanned copy of money transfer or the number of the transfer.

Name: Reliance Way for Studies & Researches
Bank Name: Housing BANK/Shmesani Branch
Account No: 028-245725-01-01(JOD) or 001-778708-02-01 (USD)
Swift Code: HBHOJOAXXXX