Enrolment Form for NON-VET Accredited Courses

EMAIL: ENROLMENT@ITS.EDU.AU | CALL: 1300 585 866 | WEB: WWW.ITS.EDU.AU

SECTION A

SELECT YOUR COURSE AND ENROLMENT OPTIONS

Baby and Me First Aid Course for Parents and Guardians*

Please note, children under 14 years of age are free to attend, learn and participate. Anybody over the age of 14 in attendance will be classified as a full enrolment.

Price:

How many children under the age of 14 will join you on this course?

PLEASE NOTE:

Children under the age of 14 are FREE to attend this course with you.

Price: $ 0.00

ESTIMATED ENROLMENT FEE

PLEASE NOTE: The final enrolment fee will be calculated at the end of this form after selecting your preferred payment method.

SECTION B

PERSONAL DETAILS

Name

Prefix First Middle Last

Date of birth*

Select your date of birth using the calendar to avoid formatting errors

CONTACT DETAILS

If possible, PLEASE provide us with BOTH your home (landline) and mobile numbers.

As this course requires the coordination of yourself and our trainers, it may become important for our team to contact you should the need arise.

Telephone: Home

Telephone: Mobile*

Your preferred email address*

Enter Email Confirm Email

RESIDENTIAL ADDRESS

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please provide the physical address of where you usually reside - street number and name, not post office box. Do not provide any temporary address at which you reside for training, work or other purposes. If you are from a rural area, use the address from your state or territory's rural addressing or numbering system as your residential street.

MAILING ADDRESS

Is your mailing address the same as your residential address?*

YES

NO

Please enter your mailing address below.

Please enter your mailing address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

NOTE: This will be the address our team will send out your Certificate should you choose to have a printed copy sent to you

SECTION C

EMERGENCY CONTACT DETAILS

This course requires participants to practice and perform CPR on a child and baby manikin alongside other practical elements of first aid. In the unlikely event of a medical emergency such as a heart or asthma attack, we require you to provide us with some emergency contact details.

Please ensure that the person you nominate below is aware of your medical history and will be available to contact on the day of your training.

Who would you like us to contact in the unlikely event of an emergency?

Name

Prefix First Last

Telephone: Mobile*

Telephone: Other

Relationship: How this is person related to you?*

SECTION D

NOMINATE A THIRD PARTY TO PAY FOR THIS COURSE

Is this course being paid for by a third party such as an employer, school, employment agency or other organisation?*

NO

YES

If Yes, please complete the details below

Organisation Name

Organisation ABN (Australian Business Number)

Contact Person*

Organisation Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Organisation | Contact Telephone*

Organisation | Contact Email Address*

Enter Email Confirm Email

Enrolment In: BABY AND ME COURSE – FIRST AID FOR PARENTS & GUARDIANS – Reservoir – Wednesday 26th June 2024

Enrolment Form for NON-VET Accredited Courses

SECTION A

SELECT YOUR COURSE AND ENROLMENT OPTIONS

SECTION B

PERSONAL DETAILS

SECTION C

EMERGENCY CONTACT DETAILS

SECTION D

NOMINATE A THIRD PARTY TO PAY FOR THIS COURSE

SECTION E

TERMS AND CONDITIONS & STUDENT DECLARATION

OPTIONAL ADDITIONAL PRODUCTS & PAYMENT DETAILS

Section Break

PREFERRED PAYMENT METHOD