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Training Enrolment Request


Please complete this form with all the required details and we’ll reply back to you to confirm your training. If you have any questions please contact us.
0800 967 572 | training@nzsafetyblackwoods.co.nz

Please enter the customer name


Please select a payment method
Please enter a contact name
Please enter mobile no Only numbers are allowed Phone number should be greater than 7
Only numbers are allowed Telephone number should be greater than 7
Please enter a valid email


Special characters are not allowed Only 135 characters are allowed
Special characters are not allowed Only 100 characters are allowed
Numbers and special characters are not allowed Only 100 characters are allowed
Only numbers are allowed Only 50 characters are allowed


Special characters are not allowed Only 135 characters are allowed
Special characters are not allowed Only 100 characters are allowed
Numbers and special characters are not allowed Only 100 characters are allowed
Only numbers are allowed Only 50 characters are allowed



Please select the training location

Please enter the address

Street Address is required Special characters are not allowed Only 135 characters are allowed
Special characters are not allowed Only 100 characters are allowed  
Town is required Numbers and special characters are not allowed Only 100 characters are allowed
Postcode is required Only numbers are allowed Only 50 characters are allowed




Please select the training centre
Please enter training dates
Please enter name of courses
ATTENDEE DETAILS: Note - most courses have a maximum of 12 trainees, however some do vary. First row is required.

Attendee Name(s) (First/Last)* Date of Birth (DD/MM/YYYY)* NSN (National Student Number)
Please enter name of attendee
Please enter a valid date in DD/MM/YYYY format


Please select an option

Please select an option

COURSE REQUIREMENTS

By submitting this form you confirm that you agree to the following:
  • 1. Attendees are to wear normal work clothes including covered footwear.
  • 2. Worksafe Training instructors reserve the right to suspend from training courses participants who are disruptive or unsafe.
  • 3. Courses will commence at the scheduled start time.
  • 4. Persons who arrive after the scheduled start time may not be admitted.
  • 5. If an attendee is running late they are to contact the Worksafe Training instructor or coordinator to notify of expected time of arrival.
  • 6. Persons arriving more than 30 minutes after the scheduled start time will be refused admittance to course.
  • 7. Cancellation policy:
    • a. 7 working days prior - no charge
    • b. Less than 7 working days - 50% of course fee
    • c. 24 hours from start time - full course fee

Please fill all mandatory fields marked as *

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