Register Which course are you registering for?*Choose a CourseWillmot, NSWName* First Last Age*15-2425-3435-4445-5455-6465+Date of Birth* Date Format: DD slash MM slash YYYY Do you identify as Aboriginal or Torres Strait Islander?* Aboriginal Torres Strait Islander Neither Country of Birth*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsMain Language Spoken at Home*Is your partner attending? Yes Partner's Name First Last Partner's Age*15-2425-3435-4445-5455-6465+Partner's Date of Birth* Date Format: DD slash MM slash YYYY Does your partner identify as Aboriginal or Torres Strait Islander?* Aboriginal Torres Strait Islander Neither Partner's Country of Birth*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsPartner's Main Language Spoken at Home*Residential Address* Street Address Address Line 2 City State Post Code This is also my postal address*YesNoPostal Address Street Address Address Line 2 City State Post Code MobileLandlineEmail* How did you hear about the course?*Ages of Children/Grandchildren*Knowing the ages of children in your care helps us to tailor the course to suit this age group. Course Fees (select which applies to you)*Individual - $50Couple - $70Individual (concession) - $30Couple (concession) - $50Individual (sponsored) - $0Couple (sponsored) - $0Course Fees (select which applies to you)*Individual - $0 (sponsored course)Couple - $0 (sponsored course)Total $ 0.00 Payment*I'd like to pay via direct depositI'd like to set up a payment planThanks for choosing to pay via PayPal, you will be redirected to the PayPal website after you click submit to complete your payment.You can make your payment into the following account: Fusion Training BSB: 037-012 A/c: 110679 *Please use FC followed by your surname as payment reference E.g. FCDavidson We will send a receipt when your payment has been receivedYou can make your payment into the following account: Fusion Australia Ltd WA State Account BSB: 036 037 Account number 390959 *Please use FC followed by your surname as payment reference E.g. FCDavidson We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Mornington BSB: 033-243 Account Number: 390462 *Please use FC followed by your surname as payment reference E.g. FCDavidson We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Sydney North General Account BSB: 032-084 Account Number: 390013 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Bendigo BSB: 033 688 Account Number: 226032 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion WA State Account BSB: 036 037 Account Number: 390959 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Aust Ltd - Southern Tasmania BSB: 037-012 Account Number: 248694 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Australia BSB: 112-879 Account Number: 054 789 932 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Australia BSB: 112-879 Account Number: 054 789 932 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Australia BSB: 112-879 Account Number: 054 789 932 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Riverina BSB: 032-750 Account Number: 228211 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Riverina BSB: 032-750 Account Number: 228211 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Training BSB: 037-012 Account Number: 110679 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Training BSB: 037-012 Account Number: 110679 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Training BSB: 037-012 Account Number: 110679 We will send a receipt when your payment has been receivedWe will be in touch shortly to discuss payment plan options. Total $ 0.00
