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Learning Account Registration Information
Welcome to the registration form for
Surgo Learning Academy
, a premier online learning platform brought to you by Surgo Pty Ltd. We are delighted that you have chosen to embark on a journey of knowledge and growth with us.
By completing this registration form, you are joining a vibrant community of learners from around the world, united by a shared passion for knowledge. Get ready to unlock new horizons and seize exciting opportunities for personal and professional development.
Title
*
Mr.
Mrs.
M/s.
Maiden Name
*
Home Number
Fax Number
Username
*
First Name
*
Middle Name
Mobile Number
*
Email Address
*
User Password
*
Confirm Password
*
Surname
*
Residential Information
Street Name & Number
*
Postal Code
*
City
*
Area/Suburb
*
Province
*
Western Cape
Gauteng
Limmpopo
North West
Kwa-Zulu Natal
Northern Cape
Free State
Eastern Cape
Mpumalanga
Indentification Information & Educational Background
Identification Type
*
1 - National ID
521 - SAQA Member ID
527 - Passport Number or Foreign
ID Number
529 - Driver's License
531 - Temporary ID number
533 - None
537 - Student Number
538 - Work Permit Number
539 - Employee Number
540 - Birth Certificate Number
541 - HSRC Register Number
561 - ETQA Record Number
565 - Refugee Number
535 - Unknown
ID Number
*
Nationality
*
SA South Africa
SDC SADC except SA
ANG Angola
BOT Botswana
LES Lesotho
MAL Malawi
MAU Mauritius
MOZ Mozambique
NAM Namibia
SEY Seychelles
SWA Swaziland
TAN Tanzania
ZAI Zaire
ZAM Zambia
ZIM Zimbabwe
AIS Asian countries
AUS Australia Oceania countries
EUR European countries
NOR North American countries
SOU South / Central American c
ROA Rest of Africa
OOC Other & rest of Oceania
NOT N/A: Institution
U Unspecified
Home Language
*
Afr Afrikaans
Eng English
Nde isiNdebele
Oth Other
SASL South African Sign Language
Sep sePedi
Ses seSotho
Set seTswana
Swa siSwati
Tsh tshiVenda
Xho isiXhosa
Xit xiTsonga
Zul isiZulu
U Unknown
Equity
*
Black : BA
Black : Coloured : BC
Black: Indian : BI
Asian
White : WH
Unknown
Date of Birth
*
Gender
*
Male
Female
Unknown
Socio Economic Status
*
Employed
N/A: Aged < 15
N/A: Institution
Not Working – disabled person
Not Working – housewife – home maker
Not Working – scholar / full time student
Not Working – not looking for work
Not Working – not wishing to work
Not Working – pensioner / retired person
Not Working – None of the above
Unemployed – looking for work
Unspecified
Disability Status
*
None
Sight (even with glasses)
Hearing (even with hearing aid)
Communication (talking, listening)
Physical (moving, standing, grasping)
Intellectual (difficulties in learning); retardation
Emotional (behavioral or psychological)
Multiple
Disabled but unspecified
Unknown
Special needs we can assist with (optional)
Highest Qualification Achieved
*
I accept and acknowledge the Terms and Conditions of this website
*
Accept
Read Our Terms and Conditions
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