Pivot Solutions Pty Ltd trading as Mine Training Australia and Pivot Institute

Student Enrolment Form

You are enrolling in a WHS Block 2 - BSBWHS412+BSBWHS413+BSBWHS414 - Face to Face Class

Course Start date: 27 May 2024

You are booking into Block 2 face to face class at 46 Edward Street, Osborne Park WA 6017
Arrive for 8:45am and finish approx 4:30pm each day.
Units covered in this class are:
BSBWHS412 Assist with workplace compliance with WHS laws
BSBWHS413 Contribute to the implementation and maintenance of WHS consultation and participation process
BSBWHS414 Contribute to WHS risk management

Please fill in the Registration form below. Fields with a red * are required.

Student details

Title

Given Names*

Middle Names

Surname*

Date of Birth *

Gender *

Email *

Additional Email

Mobile *

Home Phone

Preferred Contact *

Res. Address - Unit No

Street No *

Street Name *

Town/Suburb *

Postcode *

State/Territory *

Company

Terms

Parent/Guardian acknowledgment and consent. *

I have read and I agree to the terms and conditions. *

Finalise

ID Drivers Licence and/or Medicare Number *

Main Study Mode-Face2Face/Virtual class or Self Paced *

Company Purchase Order# if applicable

Student Status Aus Citizen/PermVisaHolder/Subclass# *

Funded Concession Eligibility HCC/PCC

How did you hear about us? *

LLN Assistance
I require Language, Literacy and Numeracy assistance.

Attachment (if applicable) (pdf, doc, docx, zip, png, jpeg - 3MB maximum)

Additional Notes

Invoice Type