Registration for Training Course Form

Contact details:

business name:___________________________________________________________________

abn: _______________________________________________

surname:____________________________________________

given  name:_________________________________________

address for  invoice:_________________________________________________________________

phone:__________________________________

mobile:__________________________________

email:___________________________________

TRAINING COSTS:

total price= $195.00 + GST  (Total $214.50)        (class situation, other costs by prior arrangement)

PAYMENT DETAILS:

easytest eft details: bsb 610-101: account 070921435, Adelaide Bank

credit card: (circle one)            visa                     bankcard                 mastercard

card number: ---------/---------/---------/--------      card expiry:_________/__________

name on card: ____________________________________________________

amount to charge:_________________________

signature:____________________________________________ (authorised person)

date:___________/__________/___________

Please send this completed form (with cheque, or credit card details) to: easytest Pty Ltd, PO Box 589, Salisbury SA 5108

or email or  

Please note: Payment must be made 14 days prior to attendance at training course. A tax invoice will be sent once payment has been received.