DEFERMENT OF REGISTRATION FORM
 

Application for deferment of registration:

KINDERKINETICIST / ASSISTANT KINDERKINETICIST

  * Fields are mandatory
   
 

No application fee is due for deferment

   
  *
     
  Last name:
  First:
  Initial:
  Title:
  Marital status:
  Maiden name:
  Identity number / Passport:
  Nationality:
  Address:
 
  Ethnic group:
     
  Gender:
 
   
  *
     
  Telephone number:
  (Home):
  (Work):
  (Cellphone):
  E-mail address:
     
  Occupation:
     
  Kinderkineticist
  Assistant Kinderkineticist
     
 
     
  Institution of training:
  Honors year:
  Employment:
     
  Motivation or reasons why membership want to be deferment:
   
 
   
   
 

Please Attach:

  • Documentations and evidenced necessary for approval of deferment
   
  Please Upload The Required Documents :
 
   
   
 

Declaration:

I, hereby apply deferment of registration as Kinderkineticist / Assistant Kinderkineticist at SAPIK and declare that all information provided (including copies) is completed and correct. I also declare that I have read and understand the updated Ethical Guidelines of SAPIK, and that I accept responsibility to keep updated with any changes made regarding the guidelines and re-applying.

   
  Signature:
 
   
  Date:
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