Enrolment Form: Technical Skills Assessment Weekend

Bushwalking Leadership SA training checklist

Technical Skills Assessment Weekend Enrolment Form

This course weekend is available to registered students, who should contact their Adviser to discuss their participation at this weekend. Registration and payment is due two weeks prior to the start of the assessment.

Section 1: Enrolment
Name*
Prefix First Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Phone 1 (suggest mobile)*
Phone 2 (suggest home)
Address*
Post Code*
Email Address*
Dates Of Course You Are Enroling In:*
Section 2: Payment
Year*
Please select fee*
- Enrolment Fee $200
- Enrolment Fee $180 - Concession
Please select your payment method*
EFT Bank Transfer:
Account Branch: ANZ (Marion Branch)
Account name: Bushwalking Leadership SA
BSB: 015220
Account Number: 476944904

Please put your name in reference to payment. When payment is made please email through the a receipt to blsa@bushwalkingleadership.org.au.

Over-the-counter bank transfer:
Bank: ANZ (any branch)
Account name: Bushwalking Leadership SA
BSB: 015220
Account Number: 476944904

Please put your name or phone number as the reference to payment. When payment is made please email through advise to blsa@bushwalkingleadership.org.au.
- EFT Bank Transfer
- Over-the-counter bank transfer
- Cheque / Money Order
Section 3: Upload - Medical Information & Risk
Upload Document: Medical information & Acknowledgement of Risk Form
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You need to download any one of the following form file type options, save/scan it and attach it here:
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Accepted file types: doc, docx, jpg, gif, png, pdf.
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Phone
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Technical Skills Assessment Weekend Enrolment Form

Section 1: Enrolment

Section 2: Payment

Section 3: Upload - Medical Information & Risk

Form Submission