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1.Personal Details

Surname:

Forename

National Identification Number

Address for correspondence

District of residence Select District Flacq Grand Port Moka Pamplemousses Plaines Wilhems Port Louis Rivière du Rempart Rivière Noire Rodrigues Savanne

Phone Number:

Mobile Number:

E-mail address (for all correspondences from HRDC):

Gender : Male Female

Date of Birth:

Are you currently unemployed? : Yes No

Please Select Course Name:

2. Study Background

Please Select your educational level : < Select Educational Level Below CPE CPE Form 1 Form 2 Form 3 Form 4 SC Lower Six HSC Diploma Degree

Please Select your level of language proficiency :

English: Elementary Intermediate Advanced

French: Elementary Intermediate Advanced

3. Work Experience

What was your previous occupation:

Please indicate your latest working experience
Years of experience	Sector

I ascertain that I am presently unemployed. I undertake to inform the HRDC immediately in writing in case my Employment status changes. I authorize sharing the above information for the purpose of the NTRS Please note that as per the requirements of the authorities (Government Gazette of Mauritius No.73 of 2 June 2021), all trainees aged 18 or above need to be vaccinated with Covid vaccine to have access to training centres.

AGREE & SUBMIT