Workmate Training Academy

Student Enrolment Form

You are enrolling in a WA - MRWA Operate Truck Mounted Attenuator (OTMA) REFRESHER -011

Course Start date: 27 Feb 2025

Prior to enrolling in this course, you must have a Unique Student Identifier.

Please ensure that you enter your name as it appears on your ID documents.

Please ensure when completing form, that the email address and mobile number are for the student whom will be attending training.

By completing this online registration you are agreeing to the following:

You have read and understand all information about this course, as outlined on the course information page.

You have read, understood and agree to the Student Handbook, which can be found here:
https://www.wta.edu.au/wp-content/uploads/2024/10/Student-Handbook-v4.0-2024.pdf

That you understand WTA cancellations and refund policy outlined in our student handbook.

Please note that bookings can only be fully confirmed after full payment or purchase order has been received.

Upon acceptance of your enrolment, you will receive a booking confirmation email with all of the details for your chosen course.

We look forward seeing you soon and if you have any questions please dont hesitate to contact our team.

ENROLLING ON BEHALF OF AN EMPLOYEE? If you are completing this form on behalf of your employee, please use the Group Enrolment function below.

To continue to the Enrolment form, scroll to the bottom of this page and tick the boxes to agree to our Privacy Notice and Terms & Conditions and click “Next” to continue. Fields with a red * are required.

Terms & Policies

I have read and I agree to the Workmate Training Academy Privacy Notice *

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

Student details

Enter your full name

Title *

Family name (surname)*

First given name/s*

Second given name (middle)

Enter your birth date

Date of Birth *

Please select your Gender

Gender *

Enter your contact details

Email *

Confirm Email *

Alternative email address (optional)

Additional Email

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.

Mobile *

Work Phone

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

Full Name *

Phone/Mobile *

Relationship *

Address(es)

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.

Building/property name

Flat/unit details

Street or lot number (e.g. 205 or Lot 118) *

Street Name *

Suburb, locality or town *

Postcode *

State/Territory *

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

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

Building/property name

PO Box

Flat/unit details

Street or lot number (e.g. 205 or Lot 118)

Street Name

Suburb, locality or town

Postcode

State/Territory

RTO Questions

RTO Specific Questions

Drivers Licence

White Card

Refresher (eg. 01, 02 etc.)

QLD Combo- Shirt Size

Are you an Australian Permanent Resident/Citizen *

Misc.

How did you hear about us?

Referral Type

Upload an attachment

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

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

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

Additional Notes

Payment

Payment is Optional for this course

Payment is optional, Would you like to pay now?

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