Registration Form for ConSASS Practical Learning Workshop

Registration Form for ConSASS Practical Learning Workshop (14 SDU Points)

New 2020 ConSASS Checklist
As we are required to verify the participants identity for course registration and certificate issuance purpose, Personal Data such as NRIC Number may be collected during registration. Please refer to our Data Protection Notice for more information. In addition, for all SSG-funded courses, we are required to submit the trainees information to TRAQOM
Company Name
Leave blank if self-sponsored
Billing Address *
PIC Name *
PIC E-mail *
PIC Contact Number (Mobile Preferred) *
Client Type / Fees per pax *
Number of Participants *
Course Date Selection *
Details of Participant

Participant 1
Full Name as per NRIC/FIN *
Email *
example@example.com
Contact Number *
Safety Officer Card Number (if any)
Details of Participant

Participant 2
Full Name as per NRIC/FIN *
Email *
example@example.com
Contact Number *
Safety Officer Card Number (if any)
Details of Participant

Participant 3
Full Name as per NRIC/FIN *
Email *
example@example.com
Contact Number *
Safety Officer Card Number (if any)
Details of Participant

Participant 4
Full Name as per NRIC/FIN *
Email *
example@example.com
Contact Number *
Safety Officer Card Number (if any)
Details of Participant

Participant 5
Full Name as per NRIC/FIN *
Email *
example@example.com
Contact Number *
Safety Officer Card Number (if any)
Should be Empty:

Details of Participant