Booking Form - Third Party/Company/JSA


All sections must be completed

Participant Details
Please record enrolling participant details in the table below (use an additional form for extra names):
IMPORTANT: You must disclose if any of the listed people have difficulty with Reading, Writing or Calculations (language, literacy, numeracy – LLN)
All details must be completed-including if LLN Support is needed (please tick)


Direct Deposit – BSB: 332 051 Account no: 553 986 295
Reference: your invoice number.
Credit Card - Please contact your local DATS office to make payment before your course commences.
A separate Registration Form, including an LLN indicator, will be forwarded to you for each course participant to complete. Please return these to us as soon as possible before the course. Dickens Assessment and Training Services may be able to assist participants who are not confident in any of the LLN areas.
Please note that this booking is not confirmed until proof of payment or PO has been received.

Student Declaration and Consent

  • The company’s representative and/or the Participant(s) have informed DATS of any physical impairment that may impacton a participant’s training.

  • The company’s representative and/or the Participant(s) have read and understood the Student Handbook (including the Complaints & Appeals Policy) and the course flyer for the course in which they are enrolling.

  • The company’s representative ensures the participant(s) meet the pre-requisites for the course in which they are enrolling (if applicable).

  • The company’s representative and/or the Participant(s) understand that SafeWork NSW or WHSQ may request that a High Risk Work Licence holder be re-assessed anytime and that SafeWork NSW/WHSQ may suspend, cancel, refuse to issue or renew a High Risk Licence if the licence holder refuses or fails to comply, without reasonable excuse, with the requirements set out in a written notice.