Course Registration

Name *

First Name

Last Name

Best contact number *

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Please select the course you wish to attend

AFB recognition course $100

AFB refresher course $30

AFB assessment only $50

Please indicate if English is a second language and you may need help on the day. *

The AFB Test is available in Māori, Korean, Filipino and Mandarin (Simplified Chinese). Please advise Janette if you require the above to be sent to the trainer for your course.

Yes

No

I will not attend this course if I have any respiratory illnesses including colds and flu *

I agree

I am aware that if I am unable to attend the course due to illness, I will be able to get a refund or reschedule my registration to a different date *

I understand

I am aware that I will be sent a copy of the "yellow book" as part of my registration fee for the full course. If I do not attend the course and seek a refund of my $100 paid, I understand that the cost of the book will be deducted. No "yellow book" is provided for the $30 refresher courses. *

I understand