ONLINE DRIVER TRAINING PROGRAM
ONLINE DRIVER TRAINING PROGRAM ENROLMENT FORM Organisation Details _________
Organisation Postal Address
__
Contact Person
__
Position
__
Phone
__
Email
__
Enrolment & Payment Please use one of the following options 1.
Email or Fax Registration Form paying by Credit Card Credit Card: [ ] Mastercard
[ ] Visa
Credit Card Number: _
/
Expiry Date:
/
_
/
_ _
__ /
_
_
Participant Details Participant Name Position
_________ _______
___
Email Address
Name on Card:
________
Signature:
________
__ __
Please use a separate form for additional participants.
2.
Fees Payable
Email or Fax Registration Form & request invoice Please complete and email to: [email protected] or fax to IPWEA on (02) 8267 3073
Please complete payment method (see right) and fax/email this form to IPWEA
[ ] Please send invoice
Online Driver Training Program
Purchase Order No:
__
Please note: Program cost is per participant Please tick:
SYSTEMS.PLUS Subscribing Organisation + 10% GST (Australian participants only) TOTAL
= $315 (ex GST) = $31.50 = $___________
Non-Subscribing Organisation + 10% GST (Australian participants only)
= $395 (ex GST) = $39.50 = $___________
TOTAL
3.
Mail Registration Form with Cheque [ ]
Cheque enclosed. Mail to: IPWEA Ltd, Level 12, 447 Kent St, Sydney, NSW, 2000 ABN 42 087 934 898
Cancellation Policy: Cancellations must be made prior to participants receiving log in details. Please note: Enrolment in this program is not transferable.
Become a SYSTEMS.PLUS Subscriber Please note: Subscription price is per organisation
Enquiries
Please tick:
SYSTEMS.PLUS Basic + 10% GST (Australian subscribers only) TOTAL
= $500 (ex GST) = $50 = $___________
TOTAL
= $1,200 (ex GST) = $120 = $___________
SYSTEMS.PLUS Premium + 10% GST (Australian subscribers only)
For more information visit www.ipwea.org/systemsplus
visit:
www.ipwea.org/OnlineDriverTraining
email:
[email protected]
phone: +61 (02) 8267 3003
Organisation Postal Address
__
Contact Person
__
Position
__
Phone
__
__
Enrolment & Payment Please use one of the following options 1.
Email or Fax Registration Form paying by Credit Card Credit Card: [ ] Mastercard
[ ] Visa
Credit Card Number: _
/
Expiry Date:
/
_
/
_ _
__ /
_
_
Participant Details Participant Name Position
_________ _______
___
Email Address
Name on Card:
________
Signature:
________
__ __
Please use a separate form for additional participants.
2.
Fees Payable
Email or Fax Registration Form & request invoice Please complete and email to: [email protected] or fax to IPWEA on (02) 8267 3073
Please complete payment method (see right) and fax/email this form to IPWEA
[ ] Please send invoice
Online Driver Training Program
Purchase Order No:
__
Please note: Program cost is per participant Please tick:
SYSTEMS.PLUS Subscribing Organisation + 10% GST (Australian participants only) TOTAL
= $315 (ex GST) = $31.50 = $___________
Non-Subscribing Organisation + 10% GST (Australian participants only)
= $395 (ex GST) = $39.50 = $___________
TOTAL
3.
Mail Registration Form with Cheque [ ]
Cheque enclosed. Mail to: IPWEA Ltd, Level 12, 447 Kent St, Sydney, NSW, 2000 ABN 42 087 934 898
Cancellation Policy: Cancellations must be made prior to participants receiving log in details. Please note: Enrolment in this program is not transferable.
Become a SYSTEMS.PLUS Subscriber Please note: Subscription price is per organisation
Enquiries
Please tick:
SYSTEMS.PLUS Basic + 10% GST (Australian subscribers only) TOTAL
= $500 (ex GST) = $50 = $___________
TOTAL
= $1,200 (ex GST) = $120 = $___________
SYSTEMS.PLUS Premium + 10% GST (Australian subscribers only)
For more information visit www.ipwea.org/systemsplus
visit:
www.ipwea.org/OnlineDriverTraining
email:
[email protected]
phone: +61 (02) 8267 3003
