Onsite Course Booking Request Onsite Course Booking Request Onsite Course Booking Request Organisation Details Company Name * Course Contact Person Name First Course Contact Person Last Name Last Course Contact Email Course Contact Mobile Number * Accounts Payable Person * Accounts Payable Phone * Accounts Payable Email * Purchase Order No. (If applicable) * Course Details What type of course would you like us to run for you? (Please select from dropdown menu below) Courses * Provide cardiopulmonary resuscitation refresher/XPRESS HLTAID001 Provide first aid – fastrack/refresher/XPRESS HLTAID003 Provide an emergency first aid response in an education and care setting HLTAID004 Occupational first Aid Skill Set HLTSS00027 Provide advanced first aid HLTAID006 Provide advanced resuscitation HLTAID007 VIC Course in First Aid Management of Anaphylaxis 22300 VIC Course in the Management of Asthma Risks and Emergencies in the Workplace 22282 Demonstrate first attack firefighting equipment CPPFES2005A Operate as part of an emergency control organisation PUAWER005B Perform rescue from a live LV panel UETTDRRF06B Manual Handling Awareness (Non-accredited) Customised course Please give details of the Custom Course required. Course Completion Date * Please advise when you require the course to be completed by. Preferred Start Time * 7:00 AM7:30 AM8:00 AM8:30 AM9:00 AM9:30 AM10:00 AM10:30 AM11:00 AM11:30 AM12:00 PM12:30 PM1:00 PM1:30 PM2:00 PM2:30 PM3:00 PM3:30 PM4:00 PM4:30 PM5:00 PM5:30 PM6:00 PM6:30 PM7:00 PM7:30 PM8:00 PM Approximate No. of Attendees * Course Location Details Address * Address Address Address Suburb Suburb State State Post Code Post Code Additional Course Address Details * Example: Nearest cross street, security information, special instructions, etc Training Room Description * (Eg. Indoor/ Outdoor/ Room Size/ Tables/ Chairs/ Airconditioning/ Projector/ Whiteboard) Parking Instructions * Students Attending Please click on the link below to complete the list of student details of all the students that will be attending this course. https://medilife.edu.au/wp-content/uploads/2017/12/Onsite-Attendance-Register.xlsx Please then upload this file complete with this booking form. Alternatively, if you require more time to gather student's details you can email it to groupbookings@medilife.com.au 7 days prior to the course. Attach Attendance Register Here Drop a file here or click to upload Choose File Maximum upload size: 2.1MB *An invoice will still be created post course and will be based on the number of actual attendees therefore please list all possible attendees. Comments/ Special Instructions Do you wish to run a custom course? Did we miss something? Let us know here. Cancellations/ Transfers for Definite Bookings I/ We understand that by submitting this Onsite Booking Form that a cancellation / transfer fee may be applicable should I/ we cancel/ transfer the course date once it has been confirmed by Medilife Pty Ltd. Name * Job Title * Signature * Send me a copy of my responses Yes reCAPTCHA Submit
