Home Courses Infection Our people Enrolment Form
Home
Courses
Infection
Our people
Enrolment Form
Course Enquiry
Inspiration
Body Piercers
Training Dates
Dermal Implants
Shop
Model Register
Partners
Contact Us
Legal
Feedback Form
  
Application for Course Participation
Please Click Submit when fully completed

*indicates required fields 
  *Name:
  *Home Address:
  *City:
  *Post Code:
  *State:
  *Phone:
  *Mobile:
  *Email:
  *Fax:
  *Business Name:
  *Address:
  *Business Phone:
  *Fax:
  *Telephone in Emergency:
  *Emergency Contact:
  *Currently Employed as:
  *Date Of Birth:
  *Issues with the following:  Health
 Literacy
 Numeracy
 Not Applicable
  *Tick the following:  Employed As A Piercer
 Setting Up Your Own Business
 Looking for a job as a Piercer
 Adding Piercing To Existing Business
 Beauty
 Tattoo
 Pharmacy
 Medical
 Retail
 Other
  *Where did you here about us?:  Yellow Pages - Book
 Yellow Pages - On Line
 Trade Show
 Internet/Web
 Magazine
 Newspaper
 Other
 Referral
 Google
 Eze Training Staff
  *Estimated commencement date in the industry:
  *Course you wish to undertake:
  *Course State:
  *Course Date:
  *Would like a starter kit?:
  *Total cost of Course:
  Credit card Name:
  Credit Card Number:
  Expiry Date:
  CCV Number:
  I Authorize Eze Training to Deduct my Credit Card:  Yes
 No

By Submitting you are have read our attached Terms and Conditions and Agree with them.

EZE_TERMS_AND_CONDITIONS_V2_181011.pdf

 

Home | Courses | Infection | Our people | Enrolment Form
Site Map