Course Booking Form

Please complete the form below and check our website for full information about any of the courses or contact our office on 08 9344 1704

Job Active Provider Details

Job Active Provider Organisation* :

Job Active Provider Suburb* :

Address* :

Postcode* :

JAP Consultant First Name* :

JAP Consultant Last Name* :

JAP Consultant Email* :

JAP Consultant Phone* :

Accounts Email* :

Invoices Attention* :

PO Number* :

Student Details

First Name* :

Last Name* :

Address* :

Postcode* :

Student Phone* :

Student Email* :

LLN* :

Excellent Average Poor

Course* :

Options* :

Course Level* :

Course Date* :

Select Course Date

On receipt of your booking form you will see a Thank You page and receive a confirmation email. If you do not see this page AND get the email, your order may not have gone through. Please contact us with if you are unsure.

You can also download a pdf version of this form to fill out if preferred. Please download the form here, after filling it out please scan and email it to us at wa.forklift@licences4work.com.au .

If you would like to print this page for the purpose of creating a purchase order, please use the Print Form button below after filling in all the details. Printing the form does not mean you have made a booking nor does it submit the form so you will not get a confirmation email.

Purchase Order Number must be supplied for your booking to be processed.
All invoices have thirty (30) day terms.
Terms and conditions are in addition for all course are available at www.licences4work.com.au

Payment Method:

Discount Code

If you have a promotional code, enter it here:

I confirm that I’ve read & accepted the terms and conditions, as available on the Licences 4 Work website, related to the courses selected.

$AUD

Printing the form does not mean you have made a booking nor does it submit the form so you will not get a confirmation email.

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Employment Services Providers

Course Booking Form

Job Active Provider Details

Student Details

Payment Method:

Discount Code