Perth Training Institute

Student Enrolment Form

You are enrolling in a Health and Safety Representative (HSR)

Course Start date: 27 May 2024

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

Title *

Given Names*

Middle Names

Surname*

Date of Birth *

Gender *

Email *

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Additional Email

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Preferred Contact *

Res. Address - Unit No

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