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: 13 Mar 2025

Should you wish to enrol in only Scissor and Boom Lift, please enter "EWPONLY' in notes field or email admin@equipsafe.com.au to ensure you are invoiced accordingly

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: 1

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: 1

Participants

Total price for participants: $650.00

Enrolment Fee: $650.00