Agsafe

Enrolment

Please complete this form to enrol for Agsafe training.

Fields marked with an asterisk (*) are required.

Personal Details

* Title:
Title (if Other):
* Last Name:
* Given Name(s):

Business Address

* Organisation:
* Street Address:
 
* Suburb:
* State/Territory:
* Postcode:
* Telephone:
Fax:
Mobile:
* E-mail:

A tax invoice will be sent to the address provided below.

Mailing Address

As Above?
Organisation:
Address:
 
Suburb:
State/Territory:
Postcode:
Telephone:
Fax:

Special Offer Code

Special Offer Code (if applicable):

Type of Business

Retail Buying Group (if applicable):

* What type of business do you work in?

Sales Office Retail Store Warehouse
Head Office Govt Dept Other
Details, if Other:

Workplace Role

* What is your role in your current workplace?

 

Agsafe Training

Have you previously completed Agsafe training?

 

If No, you will be registered for Basic training (Personnel Accreditation Course).

If Yes, which course did you last complete?

 

Which re-accreditation course would you be interested in attending this time? Tick any which apply.

AgVet Industry Update
Occupational Health & Safety
Chemical Handling Storage & Transport
AgSAFER Risk Management
Emergency Planning & Response
Principles of Pest Management

If registering for a scheduled course*, please indicate which course you are interested in:

Course:
Venue:
Date:

* scheduled courses can be found on the Agsafe training calendar

Do you have any special training needs?*

 

If Yes, please specify:

 

* for example physical disability, visual or hearing impairment

Do you have any special dietary needs?

 

If Yes, please specify:

 

Agsafe is required by law to ascertain whether any particpants are under the age of 18. Please tick the box below if at the time of attending the Agsafe course you expect to be under 18 years of age:

I will be under 18 years of age at the time of attending this course.

I have read and understand the Agsafe Recognition Assessment Process

I wish to apply for credit transfer or recognition of prior learning.

I have read the Learner Handbook and agree to the terms and conditions of Agsafe training.

Fees (GST exclusive):

Agsafe Basic Training $650
Agsafe Re-accreditation $550