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

Student Enrolment Form

You are enrolling in a DMIRS Exam Preparation Course

Course Start date: 29 Aug 2024

Practical Exam Preparation 1 Day Course

DMIRS (Department of Mines, Industry Regulation and Safety) exam preparation course will assist you in gaining WA Certificate of Competency in one of the following appointments:

– Quarry Manager
– First-class Mine Manager
– Restricted Quarry Manager
– Underground Supervisor
These programs are run by our mine specialist trainers. The programs are invaluable in offering significant support before the exam.

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

Payment is Optional for this course

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