Payment RST Application Form

In light of the current health risks due to Covid-19; you must answer the following health questions before enroling.

Have you or any of the additional candidates or members of their household returned from any international travel in the past 14 days?

YesNo

Have you or any of the additional candidates or members of their households been in contact with a confirmed Coronavirus case In the past 14 days?

YesNo

Have you or any of the additional candidates or members of their households shown signs of tiredness, fever, dry cough, aches and pains, nasal congestion, runny nose, sore throat, diarrhoea and difficulty breathing?

YesNo

Risk

No registration is possible if a health risk is present.

Course 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

Gender*

FM

Primary Candidate Contact Number*

Primary Candidate Email*

Confirmation Emailexample@example.com

Are you paying for any additional candidates

NoYes

Additional Candidate details

	Surname	First Name	M/F	DOB	Contact Number	email
2nd
3rd
4th
5th
6th
7th
8th

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

How did you hear of my service?

Training Requirement - check one only - Group discounts apply*

1 & 1/2 Days Training/Assessment$390AUD

Quantity
Item subtotal:$0.00AUD

Assessment only - $290AUD

Quantity

Recognition of Prior Learning$190AUD

Quantity

Enquiry - $ FreeAUD

Enter coupon

Total $0.00AUD

Payment Details

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