Booking Form for WIRES Immediate Care Course

Please follow the steps below to book into the WIRES Immediate Care Course and pay the $100 course fee.

The booking form and payment is for the Immediate Care Course which includes an online theory and workshop component. Enrolment for this course is not into a specific workshop, the workshop registration will become available after completion of the online component.

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Step 1

First Name *

Last Name *

Email Address *

Phone *

Address *

Suburb *

State *

Postcode *

Country *

Volunteer ID (if known)

Correct Details *

By proceeding I declare the details provided above are true and correct

To ensure any appropriate assistance can be provided, please confirm if you have disability, impairment or dependency? *

Yes

Will you require help to complete the course, or to undertake volunteering activities due to your disability, impairment or long-term condition? If you are unsure please tick Yes and our Training Team will contact you to discuss options.

Yes

Payment *

Pay for $100

Full name (on the card) *