Hand Pump Sprayers Course

Approved User Pindone
To gain this certificate there are 3 x sections you need to complete:

1. Form below filled in with all details.

2. Payment completed and received.

3. Information read and assessment completed (the assessment link will show on the Thank You page after you have completed payment and submitted the form. It will also be in the confirmation email you will receive shortly after submitting this form).
Today's Date*

DayMonthYear
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone

Area CodePhone Number
Mobile Number*
Email Address*
Date of Birth*

DayMonthYear
Photo ID - upload a photo of your PASSPORT or BIRTH CERTIFICATE - please note Drivers Licence isn't an accepted form of ID.*

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Please upload a copy of photo ID, either Passport or Drivers licence. Cancelof
Employer Name
Employer Address - if different from above

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Work Number - if different from above

Area CodePhone Number
Work Email - if different from above
Area Office Work for *
If Other please state who
Please confirm province you complete majority of your work in.
Years worked in industry?
Purchase Order Number

AC Regional Parks North - 12345
Payment Options - $339.50 inc GST*

Credit Card via PayPalBank Transfer / Direct CreditInvoiceFarmlandsRuralco
Credit Card payment via PayPal. You will be redirected to the Paypal payment page once you submit the form below.
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Pindone Certificate$339.50NZD
Bank Transfer Payment Options:

If you'd like to complete payment via this option, please deposit $339.50 inc GST direct into our bank account.

Details:
Adroit Solutions Ltd
BNZ - 02 0922 0256838 25

Please note certificate won't be issued until payment has been received.
Invoice Payment Option:

If you'd like to complete payment via this option, we will send an invoice address to employer name and email address stated above.

Please note certificate won't be issued until payment has been received.
Farmlands Payment Option

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Please upload a photo of our Farmlands card if you wish to pay via this option. Cancelof
Ruralco Payment Option

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Please upload 2 photos of your front and back of your Ruralco card if you wish to pay via this option. Cancelof
Order Number
please add order number if required
This assessment is to be completed only by the named person above*

YesNo
I agree there is a maximum application period of 3 months to provide all required information to Adroit Solutions. Additional fees will apply if my application is not completed in the above timeframe.*

Yes
How did you hear about this Course?*

Word of MouthFacebookGoogleSupplierAdvertisementOther
Adroit Solutions Terms of Engagement & Disclaimer

1. Confidentiality: All information provided to Adroit Solutions will be kept confidential. 2. Conflicts of Interest: If a conflict of interest arises Adroit Solutions will advise the Applicant. 3. Adroit Solutions holds Professional Indemnity Insurance & Public Liability Insurance cover. 4. Problems & Complaints: Please tell Adroit Solutions promptly if unhappy with, or uncertain about any aspect of our work or billing. 5. Application Cost: No Application is formally accepted until all fees have been paid unless prior arrangements are made with the PCBU/Trainer. 6. Termination: Adroit Solutions may terminate this engagement at any time if requested information is not received within a reasonable period. 7. Advice Statement: In providing services, Adroit Solutions do not accept responsibility or liability to any parties who may be affected by our performance of the services. Our advice is opinion only, based on the facts known to us and provided by the applicant and their PCBU. We are not liable for errors in, or omissions from any information provided by third parties. We will not owe any other party any duty or liability in respect of any related or other matters. We may communicate with you and with others by electronic means. If communications are lost or affected for some reason beyond our control, we will not be liable for any damage or loss caused thereby.
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Approved User Pindone