Registration Form, 4 days ex Full Training or 3 years Ex Refresher Training

Ex Refresher OnlineTraining 7-8 April 2022

Registration form
IMPORTANT: By filling in this form and clicking on submit your registration is confirmed
Participant *

First Name Last Name
Email *
example@example.com
Phone Number *

Area Code Phone Number
Company Name *
Job Title
Invoice details
Company Country *

Street Address

Street Address Line 2

Country
Billing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Order Received Number or Purchased Order Number:
Company Director/Manager Authorising this Application *

First Name Last Name
Email *
example@example.com
Phone Number *

Area Code Phone Number
Does the participant register at Operative or Responsible Level? *

Operative Level Responsible Level
Did the candidate has already attend an EASA Ex Full Training or EASA 3 years Ex Refresher Training in the past. If yes, when (which Year)?
How many years pre-course experience does the candidate have in the field? *
Has the company experience in the Repair and Overhaul of Explosive Atmosphere Equipment? *

Yes No
How many years of experience?
Should be Empty:

Ex Refresher OnlineTraining 7-8 April 2022