PROGRAM ENROLLMENT FORM

Full-Stack Web Development Program

Instructions: Please complete all sections clearly. Fields marked with * are required.

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A. APPLICANT'S PERSONAL INFORMATION

Surname *

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First Name *

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Middle Name

Date of Birth *

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Gender *

Male Female Prefer not to say

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Phone No (WhatsApp Enabled) *

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Email Address *

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Residential Address *

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Highest Educational Qualification *

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How did you hear about us? *

Social Media Friend/Referral Google Search Other

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B. PROGRAM & TECHNICAL BACKGROUND

Program: Full-Stack Web Development

HTML, CSS, WordPress, PHP, JavaScript + Python Intro
Duration: 3 Months
Schedule: 3 Days per week
Post-training career support included

Do you have prior programming experience? *

Yes No

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Primary motivation for joining? *

Please enter your motivation

How will you use the skills? *

Career Change Upskilling Entrepreneurship

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C. MODE OF LEARNING

Select your preferred mode of learning: *

Online On-site

Please select your preferred learning mode

D. COURSE FEES & PAYMENT PLAN

Fee Structure

Total Tuition Fee: ₦750,000.00

Additional costs apply for specialized software tools and printed course materials

Select your preferred payment plan: *

OPTION 1: FULL PAYMENT

I will pay the full tuition fee of ₦750,000 before the program commences.

OPTION 2: INSTALLMENT (Referral Only)

I was referred and will pay an upfront fee of ₦450,000 (60%) before commencement, and the balance of ₦300,000 (40%) within one month of the start date.

Who referred you? Referrer's Phone Number

Please select a payment plan

E. APPLICANT'S DECLARATION & AGREEMENT

I certify that all information provided is accurate *

Please enter your full name to agree

I have read and fully understand the program details, fee structure, and payment policy of SalientWeb Designs & Tech Academy.

I understand that all tuition fees must be paid according to the selected plan for me to be admitted into and complete the program. I agree that failure to complete my payment as scheduled (under the installment plan) may result in suspension from the program.

I agree to abide by the code of conduct, rules, and regulations of the academy throughout my training period.

Applicant's Signature

Date

Application Submitted Successfully!

Thank you for your interest in joining SalientWeb Designs & Tech Academy. Your application has been received and is being processed.

Email Confirmation Sent

A confirmation email has been sent to with your application details and next steps. Please check your Spam/Inbox

What's Next?

Click on Print/Save button above to download or print your Application Form for further instructions.
Our admissions team will review your application within 2-3 business days.
You will receive an email with further instructions and payment details.
Upon payment confirmation, you will receive your class schedule and materials.
Program orientation will be scheduled before the start date.