Kimberley Training & Assessing

Group Enrolment Form

You are about to book participants in a Work safely at heights course.

Course Start date: 09 Sep 2025

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

Available seats: 11

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

Full Course Cost:	$450.00	^{($450.00 per student)}
Payable for enrolment:	$450.00	^{($450.00 per student)}

I allow Kimberley Training & Assessing to store AQF Certificate/Parchment data related to these Students on the PowerQR Document Validation system for document validation purposes.

Available seats: 11

Participants

Full Course Cost:

$450.00

($450.00 per student)

Payable for enrolment:

$450.00

($450.00 per student)

^{($450.00 per student)}

^{($450.00 per student)}