Equip-Safe

Group Enrolment Form

You are about to book participants in an EQS OrangeCard Combo - Operate EWP up to 11 metres (BL & SL) and WSAH course.

Course Start date: 12 Nov 2024

Should you wish to enrol in only Scissor and Boom Lift, please enter "EWPONLY' 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: 8

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: 8

Participants

Total price for participants: $650.00

Enrolment Fee: $650.00