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S previously and/or currently registered at Unisa or at any other centre/institute at Unisa 1 Existing CTCET Student number (eg 70770947) 3 Please indicate your student number here 2 Qualification code (eg 72060) Surname, Initials, Title (eg. Moon M B Mr) 4 Maiden name and/or previous surname 6 Date of birth 9 First names 5 Identity/Passport number Male 10 11 Year Month Day 7 Gender Are you physically disabled? Yes If YES , indicate the nature of.

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