First Aid Enrolment

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HLTAID003 - PROVIDE FIRST AID Level 2 (One day course)

PARTICIPANT ENROLMENT FORM

To enrol in HLTAID003 - PROVIDE FIRST AID (Level 2) with Training To Care, please complete the form below or CLICK HERE to download an enrolment form. Please contact our office for group bookings of 10 or more.

Course Date *

VENUE: Unit 5 / 675 Boronia Road, Wantirna Vic 3152

TIME: 9am until 3.30pm

Cost: $120

Promotional Code (if applicable) *

Payment Options *

Paypal / Credit Card Bank Transfer (Account Details provided on confirmation) Invoice your Organisation

What name do you want displayed on your Certificate
(please check spelling)

First, Last Name *

Do you want your title displayed on your certificate? *

Yes No

Title *

Preferred Name *

Name of Organisation (applicable to organisation/group bookings) *

Organisation Postal Address *

Organisation Phone *

-

Street Address *

Suburb *

State *

Postcode *

Postal Address (if different to street address) *

Suburb *

State *

Postcode *

Phone: *

Mobile: *

Email *

VSN No: (Victorian Student Number) *

Date of Birth:

Day *

Month *

Year *

Gender *

Emergency Contact Person: *

First

Last

Emergency Phone: *

Relationship *

Why are you doing this course? *

In which country were you born? *

How well do you speak English? *

Please indicate how you found out about our course: *

Website / Google Facebook Flyer / Advertising Word of Mouth Other

Please Specify *

THIS INFORMATION IS STRICTLY CONFIDENTIAL

Do you have a disability / Impairment / Religion /Culture – that would affect the way the trainer delivers the course? If yes, please speak with your trainer. *

Yes No

Please tick if any of these areas relate to you: *

Hearing/Deaf Vision Physical Intellectual Illness Religion Cultural Other Condition/Situation

Please Specify *

Would you like to be reminded about courses in the future, including updating your First Aid? *

Yes No

Submit

HLTAID003 - PROVIDE FIRST AID Level 2 (One day course) PARTICIPANT ENROLMENT FORM

THIS INFORMATION IS STRICTLY CONFIDENTIAL

HLTAID003 - PROVIDE FIRST AID Level 2 (One day course)

PARTICIPANT ENROLMENT FORM