COXSWAINS RESTRICTED BOOKING PAGE

Recreational Skippers Ticket, skippers ticket at perth boat school

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Coxswains Restricted Course Enrolment Form

* STUDENT DETAILS

* Title	* Surname * First Name
Other Names
Date of Birth	Company (if applicable)
* Email	* Telephone

* Postal Address		* Postcode

I.D (Drivers Lic or Passport No)
* Do you have a Recreational Skippers Ticket? Yes No
(This is a course requirement. You need to do it either with us or someone else, before you do the Practical day.)

* Do you have a VHF Licence? Yes No
(This can be done at the same time as the Coxswains Restricted. We send you the study book, then give you the VHF exam on the same day as we do the Practical)

* COURSE DETAILS

Course Title Certificate II in Transport & Distribution (Coastal Maritime Operations Coxswain Restricted)

When would you prefer the Practical day, it needs to be after you complete the Theory which takes 3 evenings usually. This is a pencil booking only to assist us in pre-planning - it can be changed later.

Course Date		Theory Section delivery via
Course Time		Practical training assessment on

* PAYMENT DETAILS

Direct Debit (Pay via netbank transfer to Perth Boat School; Bank: Bankwest BSB: 306074 A/c No: 0683827)

Credit card (via secure BankWest / eWay gateway)

*Card Holders Name

*Card Number

*Card Expiry

*Card Type

Other

Describe

$490 Cox Res Course		$178 Rec Skippers Ticket
$50 Small Ships Manual (course requirement)

Commercial Vessel Hire

$250 single student only	or	$650 / group (day) booking

Include VHF Study book and Exam


$25 Office of Maritime Communications VHF Handbook (course requirement)
$59 Office of Maritime Communications Licence and Exam processing (course requirement)
$60 Invigilator Fee (course requirement)

Student Policy Declaration

By Submitting this I acknowledge I have read and understand the Policies below:

REFUND POLICY:

Participants who withdraw from a course prior to receiving any of the course may be entitled to a part refund. For a refund please contact us on 08 6468 2763. Sliding scale refunds are determined by the amount of notice provided. For a full copy of Perth Boat School's Refund Policy, please see our website (www.BadgeGroup.com.au) If for any reason the course is canceled by the Perth Boat School after your enrollment, a full refund of fees will be made. Perth Boat School however does not accept any liability for airfares or pre-paid accommodation expenses.

IMPORTANT INFORMATION:

All enrollments will be confirmed in writing before the course starts, giving all details. In the unlikely event not receive confirmation of a course prior to the commencement date, please contact the school immediately.

PRIVACY STATEMENT

The Primary purpose of collecting personal information that you supply on this form is to process your registration. We may also use these details to keep you informed of legal issues relating to boating and your qualification. We will not disclose your information to a third party. For more details of Perth Boat School's Privacy Policy, please visit the website at www.badgegroup.com.au or contact the Director, Perth Boat School.

For further information phone 08 6468 2763 or email admin@perthboatschool.com.au.

Perth Boat School is a trading name of (Registered Training Organisation) Badge Group Pty Ltd.

2012-02-23 02:25:47