Australian Management & Safety Training

Group Enrolment Form

You are about to book participants in an Emergency Response and Rescue RPL course.

Course Start date: 01 Jan 2022

Please contact our office on (07) 4966 8007 to see if you are a suitable candidate to complete a RPL for RII30719 Certificate III in Emergency Response and Rescue.

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

Organisation Name *

First Name *

Last Name *

Email Address * Please CC me at the above email address in correspondence to the following participants I am booking.

Phone Number *

Preferred Payment Method

Purchase Order

Participants

Surname

Given Names

Date of Birth

Gender

Mobile

Participants

Total price for participants: $2,750.00

Enrolment Fee: $2,750.00