True North Marine - Maritime Private Tutoring Enrolment Form
truenorthmarine.com@gmail.com
Enrolment Form for Maritime Tutoring
1. Name
*
First Name
Last Name
2. Email
*
example@example.com
3. Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
4. Mobile Phone Number
Please enter a valid phone number.
5. Date of Birth
/
Day
/
Month
Year
Date
6. Course Type you are currently undertaking:
Please Select
Master
7. Signature
8. Please tell us where you found us:
Please Select
Google Search
Bing
eBay
Gumtree
Friend
Email Promotion
Other
9. If 'Other' selected please tell us where:
10. Tell us about you. What experience do you have, vessels worked on and in what capacity, Certificates held and training courses undertaken etc.
Maritime Tutoring Program - 30 or 60 minute sessions
*
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Maritime Tutoring Program - 30 minute session
Maritime Tutoring program includes all training resources and video assessment. Tutoring is conducted in a 30 minute Zoom or Skype session. (Cost inclusive of GST)
$
69.00
AUD
Quantity
1
2
3
4
5
6
7
8
9
10
Maritime Tutoring Program - 60 minute session
Maritime Tutoring program includes all training resources and video assessment. Tutoring is conducted in a 60 minute Zoom or Skype session. (Cost inclusive of GST)
$
129.00
AUD
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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