NOTE: Please register ONE participant at a time. Course Details Course Name Course Date CONTACT DETAILS OF PARTICIPANT Title First Name Surname Preferred Name Staff Number Position Title What is your Academic or HEW Level Faculty/Division ADFA Arts & Social Sciences Built Environment Business COFA Division of the Chief Operating Officer Division of the DVC (Research) Division of the DVC (Academic) Engineering Law Medicine Science SCHOOL/UNIT/INSTITUTE/CENTRE TELEPHONE Emergency Number (mobile preferred) EMAIL Academic or Professional & Technical (P&T) staff member? What is your primary job function? What do you want to learn from attending this course? How will you use what you learn in your current job? Do You Supervise or Manage Staff? YES NO Name of your Supervisor Account Details for Financial Processing For statistical collection, we would appreciate if you could answer the following: Are you Male or Female? Male Female Are you from a Non-English speaking background? YES NO Are you an Australian Aboriginal or Torres Straight Islander? YES NO Do you have a disibility? YES NO

If you are unable to attend a course, please notify OSDS as soon as possible on x53111.

 

An administrative fee of $50 will be applied if a staff member cancels their enrolment within 3 working days prior to the commencement of the course or does not turn up on the day of the course.