WHEN EVERY SECOND COUNTScourse booking form Fill out the form below to book your Time Critical first aid and pre-hospital emergency care training course. CLIENT INFORMATIONToday's Date MM slash DD slash YYYY Company Name Company Contact* First Last Contact Email* Contact Telephone Number* TRAINING REQUIREDCourse Required*Please select your preferred course form the listHLTAID009 Provide cardiopulmonary resuscitationHLTAID011 Provide First AidHLTPAT005 Collect specimens for drugs of abuse testingHLTAID009 Provide cardiopulmonary resuscitation with anaphylaxisHLTAID014 Provide Advanced First AidHLTAID015 Provide advanced resuscitation and oxygen therapyCustomised CourseDate Course Required*These are tentative dates until confirmed by Time Critical. DD slash MM slash YYYY Alternative Date*Please provide an alternative date for your required course. If a date has already been confirmed, please use same date here. DD slash MM slash YYYY Number of Participants*Min 6 - Max 14 Participants67891011121314More than 14 participantsPlease let us know your requirements if the course exceeds 14 participants.Theory Completion Option*Please select if the participants are to complete the theory component online as pre-requisite or on-course on the day.Online Pre-requisiteOn-courseTRAINING VENUETraining Start Time* : Hours Minutes AM PM Site Contact Name and Number* Please provide us with a name and phone number for the site contact on the day of training. Training Venue Address*Please provide details of the training venue. Venue Name / Street Address Street Address Line 2 Suburb Post Code Additional Training Venue InformationPlease provide any additional information about the venue, e.g. access requirementsTechnical Training Resources*Trainers require a TV display monitor to deliver the course. Please let us know what your facility currently have. We have a TV with a USB connection. We require a USB cable to connect to the TV. We require a projector and screen COVID-19 Restrictions/Requirements for your site*Does your site have any COVID-19 requirements or directives to allow access for our Trainers and Assessors? Please reply with a No or Yes. If Yes, further explanation required. ACCOUNTS PAYABLEPlease provide the contact details of the person responsible for the accounts.Who will be paying for the account?* Individual payment by participants Company payment by invoice - please complete information below Name First Last Email PhonePurchase Order Number(Optional) If your company operates on purchase orders ACCEPTANCE AND AUTHORISATIONBy providing this booking form, you as the client confirm that the venue is suitable for training and assessment. This includes a large enough space for the intended number of participants, suitable facilities such as breakrooms and toilets, including disabled toilets. It is safe and hygienic and ready for the use of training and assessment.Name of Authorised Person First Last Consent* I accept the terms and authorise the bookingCAPTCHAUntitled NameThis field is for validation purposes and should be left unchanged.