Equip-Safe

Group Enrolment Form

You are about to book participants in an EQS OrangeCard Scissor & Boom Lift - Operate EWP up to 11 metres course.

Course Start date: 11 Nov 2024

If you are wishing to enrol in Scissor Lift only ($400) only please enter "SLONLY" in the discount field.

If you consider you may be eligible for the Construction Training Fund Rebate or relevant membership discount please contact Equip-Safe directly.

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

Available seats: 10

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 *

ABN*

Postal address*

Preferred Payment Method

Purchase Order

Participants

Surname

Given Names

Date of Birth

Gender

Mobile

Available seats: 10

Participants

Total price for participants: $460.00

Enrolment Fee: $460.00