Occupational Audiometry Refresher Course Form

For assistance with completing your registration, please our Course Coordinator, Lynne Miles, on 0478 776 039 or admin@hearingcompany.com.au.

Participant Details

Surname/Family name*

Given name*

Preferred name

Title

Job Title/Occupation*

Mobile Phone Number*

Email*

Dietary requirements*

Specify other dietary requirements

Office Phone Number

Registration Type

Please indicate if this is a company or private registration*

Company registration
Private registration

Company & Manager Details

Company Name*

Company Contact Name*

Company Contact Job Title*

Company Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Contact Phone Number*

Company Contact Email*

Additional information we should be aware of

Course Date Selection

This is a 1-day course and attendance at all sessions is required (8:15am - 5:00pm). Please tick your preferred course date.*

Please tick your preferred course date(s)*

18 March 2024 [SYDNEY] (registrations close 1 March)
6 May 2024 [BRISBANE] (registrations close 19 April)
I wish to be notified of future dates and locations

Payment Details

The fee for this course is $810.00 including GST ($810.00 + $81.00 GST)

PLEASE NOTE: Payment in full is required to secure a place on the course.

Want to send the invoice/receipt to a different email?*

No
Yes

Email for tax invoice/receipt*

Payment method*

EFT
Credit Card
Invoice/Quote

EFT Payment

Bank: ANZ

BSB: 016-350

Account: 429413238

Account Name: The Hearing Company Pty

(N.B. Cash deposits cannot be accepted)

Once the EFT payment has been successfully processed, please send the transaction evidence to admin@hearingcompany.com.au clearly stating the Company name and name of student that the payment relates to.

Our staff will then process the registration and send formal confirmation within 2 - 3 days.

Credit Card Payment

Please provide card details below.

Our staff will process and email a receipt within the next 2 - 3 days.

Occupational Audiometry Refresher Registration

Price:

Credit card transactions incur a 1.8% surcharge.

Credit Card*

Invoice or Quote

Please advise if your company requires a formal quote or invoice for generating a Purchase Order or to process payment through Accounts Department.

Please indicate if you require a quote or an invoice*

Quote
Invoice

Cancellation/Transfer Policy

The following fees are payable should a participant withdraw from the course:

Following registration: 10% of the full fee

Within 3 weeks of the starting date: 50% of the full fee

Within 1 week of the starting date: 100% of the full fee

PLEASE NOTE:

1. A registration may be transferred to another person within the same course at no additional charge.

2. We do not offer "transfers" to another course. Withdrawal from a course after confirmation of registration will be treated as a cancellation and subject to the cancellation fees outlined above.

Cancellation Policy Agreement*

I confirm that I have read, understood and agree to the Cancellation/Transfer Policy as outlined above.

Confirmation and Course Information

Following registration, formal confirmation and a tax invoice/receipt will be emailed within 2-3 working days. Please contact the Course Manager, Lynne Miles on 0478 776 039 or admin@hearingcompany.com.au if you do not receive a confirmation email.

The confirmation email will contain information about the venue and an outline of what to expect during the course. It will also have important information about pre-course reading and the documents to bring with you.

Audiometry Practice Support

For reference, The Hearing Company specialises in supporting audiometry practices with a range of quality services and products including:

> Audiometric booth assessments

> Audiometer sales

> Audiometric booth sales

> Audiometry program auditing and advice

> Audiometry accessories

> Full Audiological testing

Please contact Glenn Johnson on 0414 452 007 or glenn@hearingcompany.com.au to discuss your requirement for support in any of the areas outlined above.

THIS COMPLETES YOUR REGISTRATION - THANK YOU! PLEASE CLICK SUBMIT

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Occupational Audiometry Refresher Course Registration Form

Occupational Audiometry Refresher Registration Form