LAPO FORM

Registration Type^*

Personal details

First name:^*

Other name:^*

Surname:^*

Sex:^*
Male
Female

Date of birth(Day and Month only):^*

Nationality:^*

State of Residence:^*

Religion:^*

Contact details

Mobile number:^*

Personal email:^*

Officil email:^*

Company details

Company name:^*

Industry:^*

Office address:^*

Job Title / Position:^*

HR/People Manager details

Name of Head of HR/Training Manager:^*

Email of Head of HR/Training Manager:^*

Mobile number of Head of HR/Training Manager:^*

Permissions and Consent

In the course of your stay at LAPO Institute, photographs of you may be taken and used in our Asset Protection & Resource Management and marketing materials.
I give permission for my photograph to be used.

Yes
No

I give my permission for LAPO Institute to authorise appropriate emergency medical treatment during my stay until the conclusion of the programme.
I also consent that the bill incurred due to this treatment shall be borne by me/my organisation.

Yes
No

LAPO Institute Executive Business Course(s)