Training Course
Participant Registration Form
Authorised Company Representative
First Name
Last Name
Position
Company/Business Name
Company/Business ABN
E-mail of Authorised Company Representative
*
example@example.com
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Select Training Course
2 Day Emerging Leaders Program (Leading with Clarity Courage and Care) (Without One to One Coaching) $750 per person + GST
2 Day Emerging Leaders Program (Leading with Clarity Courage and Care Plus One to One Coaching) $990 per person +GST
3 hour HR Business Coaching Package $500 per person + GST
1 Day Enabling High Performance Leadership Workshop
1 day Team Building Workshop (Includes TMS profile) POA
1/2 Day Team Building Workshop (Includes TMS Profiles) POA
Team Management Profile, (+Debrief and 2 hr coaching package $650 per person + GST
360 Linking Leaders Profile, (+Debrief)and 4 hr coaching package POA
2 Day Mental Health Training Workshop
Number of Participants to be Enrolled
Participant 1 - Full Name
First Name
Last Name
Participant 1 - Email
example@example.com
Participant 1 - Food Allergies
Please Select
No
Yes - Nuts
Yes - Dairy
Yes - Gluten
Yes - Egg
Yes - Soy
Yes - Other (Please contact training provider to advise)
Participant 2 - Full Name
First Name
Last Name
Participant 2 - Email
example@example.com
Participant 2 - Food Allergies
Please Select
No
Yes - Nuts
Yes - Dairy
Yes - Gluten
Yes - Egg
Yes - Soy
Yes - Other (Please contact training provider to advise)
Participant 3 - Full Name
First Name
Last Name
Participant 3 - Email
example@example.com
Participant 3 - Food Allergies
Please Select
No
Yes - Nuts
Yes - Dairy
Yes - Gluten
Yes - Egg
Yes - Soy
Yes - Other (Please contact training provider to advise)
Participant 4 - Full Name
First Name
Last Name
Participant 4 - Email
example@example.com
Participant 4 - Food Allergies
Please Select
No
Yes - Nuts
Yes - Dairy
Yes - Gluten
Yes - Egg
Yes - Soy
Yes - Other (Please contact training provider to advise)
Participant 5 - Full Name
First Name
Last Name
Participant 5 - Email
example@example.com
Participant 5 - Food Allergies
Please Select
No
Yes - Nuts
Yes - Dairy
Yes - Gluten
Yes - Egg
Yes - Soy
Yes - Other (Please contact training provider to advise)
Submit
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