Training Course Booking Form

Participant Name:
Company Name:
Company Address:
Telephone Number:
Email Address:
Course	Course Date	Cost $	GST
☒ Dangerous Goods Acceptance – Air (3 days)	-	$0.00	$ 0.00
☐ Dangerous Goods Recertification – Air (1 day)	$0.00	$ 0.00
☐ Dangerous Goods Acceptance – Sea (2 days)	-	$0.00	$ 0.00
☒ Dangerous Recertification – Sea (1 day)	$0.00	$ 0.00
☐ Dangerous Goods – Shipper (2 days)	-	$0.00	$ 0.00
☐ Dangerous Goods – Shipper Recertification (1 day)	$0.00	$ 0.00
Enter $0.00 CC Surcharge BELOW if you wish to pay via CC (2% if applicable see below)	$0.00
SubTotal	$0.00
ENTER CC Charge as calculated above here	$0.00
Total Cost GST Inclusive ($)	AUD $0.00	GST $0.00
Direct Payment	ANZ Banking Corporation, BSB:015901 A/C:230242355 Name: Enlog Pacific Holdings P/L. Please fax remittance to 0883764499 or email to remit@enlog-aus.com
Credit Card Payment	Please forward completed CC details to fax 0883764499 or email ccpayments@enlog-aus.com (Please note there is a 2% credit card fee applicable)
Credit Card Details	☐Mastercard | ☐Visa Card
Card Number
Name on Card	Expiry Date	Security Code:
YES, I declare that by providing my Credit Card details I acknowledge and agree to the additional 2% Credit Card surcharge as advised above:
Cardholder’s Signature

I understand that EnLog Pacific Holdings Pty Ltd assumes no legal responsibility for the accuracy of any information or advice tendered to participants in the EnLog training courses.

I understand that EnLog Pacific Holdings Pty Ltd reserves the right to cancel or amend courses if the minimum number of attendees has not been met.

Course Cancellation Fees & Refunds

Cancellations will only be accepted in writing.

If a cancellation is received 10 or more working days before the course commencement, a full refund or transfer will be made.

If a cancellation is made less than 10 work days prior to the commencement of a course, a 50% refund or transfer will be made.

If no notification is received and there is non-attendance at the course, no refund or transfer will be made.

PLEASE EMAIL THE COMPLETED AND SIGNED FORM TO:TRAINING@ENLOG-AUS.COM OR

FAX THE COMPLETED AND SIGNED FORM TO: +61 8 8376 4499