ECT Course Booking Form

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ECT Course Selection* This field is required.
HLTAID009 - Provide Cardiopulmonary resuscitation
HLTAID009 - Provide Cardiopulmonary resuscitation + HLTAID011 - Provide First Aid
HLTAID009 - Provide Cardiopulmonary resuscitation + HLTAID015 - Provide advanced resuscitation and oxygen therapy
HLTAID009 - Provide Cardiopulmonary resuscitation + HLTAID011 - Provide First Aid + HLTAID015 - Provide advanced resuscitation and oxygen therapy
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Regional/Branch Office* This field is required.
Sunshine Coast
North Queensland
North Barrier
Wide Bay Capricorn
Sunshine Coast
South Coast
Point Danger
State
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Wide Bay Cap Club Name* This field is required.Select your club
Branch
Moore Park
Bundaberg
Elliott Heads
Hervey Bay
Yeppoon
Emu Park
Tannum
Agnes Water
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Sunshine Coast Club Name* This field is required.Select your club
Branch
Brisbane Life Saving
Noosa Heads
Rainbow Beach
Sunshine Beach
Coolum Beach
Marcoola
Mudjimba
Maroochydore
Alexandra Headland
Mooloolaba
Kawana Waters
Dicky Beach
Metropolitan Caloundra
Bribie Island
Redcliffe Peninsula
Peregian
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South Coast Club Name* This field is required.Select your club
Branch
Brisbane Life Saving
Northcliffe
Broadbeach
Kurrawa
Mermaid Beach A.E.M.E
Nobbys Beach
Miami Beach
North Burleigh
Burleigh Heads Mowbray Park
Point Lookout
Coochiemudlo Island
Southport
Surfers Paradise
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Point Danger Club Name* This field is required.Please Select your Club
Branch
Brisbane Life Saving
Tugun
Bilinga
North Kirra
Kirra
Coolangatta
Tweed Heads and Coolangatta
Rainbow Bay
Tallebudgera
Pacific Surf
Palm Beach
Currumbin
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North Queensland Club Name* This field is required.Please Select your Club
Branch
Mission Beach
Port Douglas
Ellis Beach
Cairns
Etty Bay
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North Barrier Club Name* This field is required.Please Select your Club
Branch
Eimeo
Mackay
Sarina
Forrest Beach
Arcadian
Townsville Picnic Bay
Ayr
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Primary ECT Facilitator Details* This field is required.A qualified TAE Cert IV ECT Facilitator who holds the relevant Surf Award/s is required for the course to proceed. If you do not have a suitably qualified ECT Facilitator, please reach out to your Regional Education and Training Supervisor for assistance BEFORE submitting this form.
First, Last Name
Please enter your phone
Please enter your email
10
List additional Trainers/Assessors/FacilitatorsAdditional ECT Trainers/Assessors/Facilitators must hold the relevant TAE Qualifications
First/Last Name
Trainer/Assessor/Facilitator
Email Address
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List additional Trainers/Assessors who do NOT hold a TAE Cert IV who will be training/assessing the courseAt least one ECT Trainer needs to hold a Cert IV or a Direct Supervisor must be allocated.
First/Last Name
Trainer/Assessor/Facilitator
Email Address
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List any Probationary ECT Trainers/Assessors/FacilitatorsProbationary ECT Trainers/Assessors/Facilitators must hold the relevant TAE Qualifications.
First/Last Name
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Approximate Number of Candidates* This field is required.16 maximum number of participants Participant enrolments close 3 day prior to first session date
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Training Details* This field is required.
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Training Details* This field is required.
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Do you have your CTO approval to submit this form.* This field is required.
YESNO
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Contact CTOPlease contact your CTO before submitting this form
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Name of person completing this form* This field is required.
First , Last name
Email
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Additional commentsIf your course is submitted within 14 days of the start date please provide sufficient reasoning below
Should be Empty: