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Student Enrolment Form

You are enrolling in a WHS BLOCK 4 - Virtual Class

Course Start date: 17 Nov 2025

****Bookings for currently enrolled students ONLY.****

9:00am - 4:00pm
BLOCK 4 - Incident Response & Return to Work Implications

1. BSBWHS416 Contribute to workplace incident response
2. BSBWHS417 Assist with Managing WHS Implications of return to work
3. Assessment day OPTIONAL

Please choose your enrolment type, then fill in the form. Fields with a red * are required.

Terms & Policies

Agreements


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Details

Full Name



Date of Birth


Gender, Identity, and Pronouns


Enter your contact details






This email address will be used as a CC email address on communications to you, please use this field to indicate if we need to CC another person / company in your communications.



Company / Organisation name


Please enter the details for your your next-of-kin / Emergency Contact

Address

What is the address of your usual residence?

Please provide the physical address (street number and name not post office box) where you usually reside rather than any temporary address at which you reside for training, work or other purposes before returning to your home.

If you are from a rural area use the address from your state or territory’s ‘rural property addressing’ or ‘numbering’ system as your residential street address.

Building/property name is the official place name or common usage name for an address site, including the name of a building, Aboriginal community, homestead, building complex, agricultural property, park or unbounded address site.



What is your postal address (if different from above)?

I have a postal address that is different to the residential address provided

RTO

RTO Specific Questions

Misc.

Language, Literacy & Numeracy

  I require LLND (Language, Literacy, Numeracy and Digital) assistance.

Upload an attachment

(To upload multiple files, please Zip the files together, and upload the Zip file)

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

Is there anything else we need to know, in regards to your enrolment?

Payment

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