Online Registration

Personal Details

Course Title

Title*

Name*

First Last

Residential Address*

Post Code

Phone Number (Mobile)*

Email*

Date of birth*

Gender*

Emergency Contact Details

Contact Name*

First Last

Relationship*

Phone*

Employment Details

Business Name

Contact Name

First Last

Email

Address

Phone Contact

Disability

Do you consider that you have a disability, impairment or long-term condition? (You may indicate more that one area)

Study Reason

Of the following categories, which best describes your main reason for undertaking this course/traineeship /apprenticeship?*

Course Fees

To qualify for a course which is fully subsidised by the Construction Industry Training Board (CITB) you must be eligible for a CITB Passport Number, and currently working in the Construction industry (SA Participants only).

A course which is partially subsidised by either an organisation such as a local Council, or by the CITB if you hold CITB Passport Number, will require a co-payment as shown.

You are required to pay the full course fee including GST.

CITB Number

Declaration

*

I understand that information contained in these forms may be provided to State and Commonwealth agencies and research organisations and I consent to that occurring. I certify that all details provided on these forms are correct.

Additional Information

Personal Details

Emergency Contact Details

Employment Details

Disability

Study Reason

Course Fees

Declaration

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