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Occupational Health & Safety
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Course Registration

To ensure your enrolment in one of our scheduled courses  please complete all all fields marked with * before submitting and include company name and ABN if applicable.

                            
Please select course  *         
 
Date of course *                                            

Number of Participants  *                               

Name/s of participant/s *                             

Contact Details                                             
                        Company Name                     

                        ABN :                                   

                        Phone Number *                   

                        Fax Number                         

                        Email *                               

                       Street  Address *                  
   
                       City *                                   

                       State *                                 

                       Post Code *                          

Terms and conditions:

By submitting this form it is acknowledged that the terms and conditions listed below have been accepted..

                1:   An invoice will be issued on receipt of this form and
                2:   All fees are are due and payable prior to the date of training and no later then 7 days of the date of
                      the invoice and
                3:   Registration is not complete until payment in full has been received and
                4:   Payment will be deemed to have been made when funds have been applied to our account and have
                      been cleared for use and
                5:   Job Safety Assistance Pty Ltd reserves the right, if deemed necessary to apply a surcharge to credit card
                      payments and
                6:   On payment of all fees, details of the training venue and location will be emailed/mailed to the address
                      given by the applicant on this form and
                7:   WorkCover NSW requires 100 points of ID for accredited courses. If you have insufficient ID on the day you
                      will not be admitted and cancellation fee of 30% of the course fee will apply, and
                8:   A cancellation fee is due and payable at the time of cancellation and will be deducted from any payment
                      made by the applicant prior to crediting any fees and   
                9:   Cancellations are to be made by email, fax or post, on receipt of a cancellation notification Job Safety  
                      Assistance Pty Ltd will send either by email or post an acknowledgment notice confirming your
                      cancellation and 
               10:  No certificates will be issued until all fees and charges are paid in full and
               11:  Job Safety Assistance Pty Ltd disclaims any liability for any additional costs, losses or damages incurred by
                      applying these terms and conditions.
               
               



              
                                            

                                      To view our privacy statement please follow this link