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Workplace Urine Drug Testing (Unit Standards 25511 & 25458) Enrolment Form

Company Name

Your Name

Your Email Address

Your Phone Number

Email Address for Invoices

Purchase Order Number

Course date

Course date

List of Attendees

Please provide the name and the date of birth. If you are booking in multiple attendees, put each one on a new line.

Email Addresses and Phone Numbers of Attendees

Please provide the email address and phone number for each attendee. If you are booking in multiple attendees, put each one on a new line.

Who will be paying for this course?

Who will be paying for this course?
A
B

Costs

This course costs $550 + GST per attendee, please confirm you accept this cost.
Costs
If you don't have the AS/NZS 4308:2023, this will need to be purchased here: https://www.standards.govt.nz/shop/ASNZS-43082023

Training Material

The training pack includes the following, please confirm you accept the cost below:
• 2x Medix Pro-Split cups
• 2x Sober Check chain of custody forms
• 1x Canterbury Health Laboratories confirmation kit
• 1x Canterbury Health laboratory forms
• 2x pairs of disposable gloves
• 1x security seal
• 1x spill sheet
• 1x blueing tablet
• 1x adulterant card

Delivery Address

What address should we send the course material to? Physical addresses only, no PO boxes.

Comments

This course has a theoretical element: a level of reading, writing and the ability to comprehend English is required. If you have any concerns regarding this, require a reader/writer, or have a specific learning requirement, please contact Sober Check prior to the course to discuss options.
To support equity in the government's education strategy, please indicate if you fit any of the following groups (optional):
Untitled checkboxes field

Gender

Optional, for statistical purposes.
Gender
A
B
C
CANCELLATIONS, SUBSTITUTIONS OR NO SHOWS Modification to enrolment is accepted without penalty up to ten (10) working days prior to course commencement. Thereafter any alteration will be treated as follows: Late Substitution, Late Cancellation or No Show: Full Fee The invoice is to be paid by 20th Day of Month following invoice. Overdue account(s) may be charged interest of 2.5% per month that the account(s) is overdue.
By signing and/or submitting this form I hereby declare that I have engaged Sober Check for the work specified and agree with the Terms and Conditions.