Payment RST Application Form

Course Date

special date

Call Mike on 0406787070 if you wish to lock down a specific date not shown

Depending on daylight, attendance and weather, course can stretch to two days. Winter practicals conducted on Moore River.

Primary Candidate Surname

Primary Candidate First Name

Primary Candidate DOB

DayMonthYear

Primary Client Age

Currently

Sex

Primary Candidate Contact Number

Primary Candidate Email

example@example.com

Fill in Person 2

P2 Surname

P2 First Name

P2 DOB

DayMonthYear

P2 Age

Currently

P2 Sex

P2 Contact Number

Email Same as Primary Applicant

P2 Email

example@example.com

Fill in Person 3

P3 Surname

P3 First Name

P3 DOB

DayMonthYear

P3 Age

Currently

P3 Sex

P3 Contact Number

P3 Email

example@example.com

Fill in Person 4

P4 Surname

P4 First Name

P4 DOB

DayMonthYear

P4 Age

Currently

P4 Sex

P4 Contact Number

P4 Email

example@example.com

Additional Candidate String

On an assessment day, all clients must provide PROOF OF IDENTITY either by:

One full proof identity document, or
1. One primary and
2. One secondary proof of identity document

No documents - no assessment - see website for definitions

Important: The address on the reverse of your drivers licence is where your Skippers Ticket will be sent to, unless a POSTAL address is added to the application. Ask for more details.

FullProof Identity Document Examples

Primary POI Document Examples

Secondary POI Document Examples

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Comments

Application Date

DayMonthYear

Training Requirement - check one only - Group discounts apply

1 & 1/2 Days Training/Assessment$400 AUD

Quantity
Item subtotal:

Assessment only - $300 AUD

Quantity

Recognition of Prior Learning$200 AUD

Quantity

Enquiry - Free

Enter coupon

Total $0.00 AUD

Payment Details

RST Application Form for up to Four

Training Requirement - check one only - Group discounts apply*

Payment Details

Training Requirement - check one only - Group discounts apply