Coxswain Course Enrolment Form

1. Name*

First NameMiddle NameLast Name

2. Email*

example@example.com

3. Mobile Number*

4. Address*

Street Address

Street Address Line 2

SuburbState

Post Code

5. Date of Birth*

Date

6. Gender*

7. Course*

Please Note: Coxswain Exam Questions and AMPA included in Coxswain Enrolments

8. Preferred Course Date*

Click Please Select above to see current vacancies

9. Language and Cultural Diversity - which country were your born in?*

10. Do you speak a language other than English at home?*

If other selected, please specify in the box below:

11. Indigenous Information: Are you of Aboriginal or Torres Strait Islander origin?*

12. Do you consider yourself to have a disability, impairment or long term condition?*

If Yes selected, please specify details in the box below. Please Note: course requires physical activities.

13. What is your HIGHEST completed school level?*

14. Are you stilled enrolled in secondary or senior secondary education?*

15. Previous qualifications achieved: Have you SUCCESSFULLY completed one of the qualifications listed below?*

16. Employment: *

17. Study reason:*

18. Unique Student Identity # (USI Number). If you do not have one you can obtain one at usi.gov.au*

Additional Comments - Please tell us about your background and work experiences. do you have maritime or non maritime work experience?, Undertaken previous courses?, Have a Boat Licence etc.

Signature*

My Products*

Coxswain NC1 Complete Enrolment - Use this payment to pay course fees in full in 1 payment and receive a $255.00 DISCOUNT.

Select this payment to obtain a $255.00 discount for pre payment for Coxswain NC1

$2,525.00AUD

Coxswain NC1 Initial Enrolment - Use this payment to pay course fees in 2 instalments.

This is the initial enrolment for Coxswain NC1. Final balance due is $1490.00. Please see pre payment discount option. Complete pre study and attend 2 days practical session.

$1,290.00AUD

Coxswain NC2 Complete Enrolment - Use this payment to pay course fees in full in 1 payment and receive a $195.00 DISCOUNT.

Select this payment to obtain a $195.00 discount for pre payment for Coxswain NC2

$2,285.00AUD

Coxswain NC2 Initial Enrolment - Use this payment to pay course fees in 2 instalments.

This is the initial enrolment for Coxswain NC2. Final balance due is $1290.00. Please see pre payment discount option. Complete pre study and attend 2 days practical session.

$990.00AUD

Coxswain NC3 Complete Enrolment - Use this payment to pay course fees in full in 1 payment and receive a $145.00 discount.

Select this payment to obtain a $145.00 discount for pre payment for Coxswain NC3.

$1,340.00AUD

Coxswain NC3 Initial Enrolment - Use this payment to pay course fees in 2 instalments.

This is the initial enrolment for Coxswain NC3. Final balance due is $495.00. Please see pre payment discount option. Complete pre study and attend 1 day practical session.

$990.00AUD

Coastal Navigation - Required for Coxswain NC1 only when operating to the 15nm limit

Coxswain NC1 are required to completed the Unit of Competency MARH013 to obtain an unrestricted Certificate of Competency. Includes all chart equip. (we mail this to you) and final assessments.

$495.00AUD

Total

$0.00AUD

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Email

example@example.com

All Hands on Deck Maritime Training Coxswain Course Enrolment Form