Polyethylene Jointing Registration

Polyethylene Jointing Registrationconor2021-03-27T11:04:18+12:00

All fields are required

Please complete one registration form per trainee

Full Name:
First & Last Names - in capitals please

D.O.B:

Company - Full Company Name

Company Postal Address (including Post Code):

PO Box (Preferred)

OR

Street address, Suburb, City

Company Email Address Please leave this field empty.

Phone

Accounts Email Address

Purchase Order Number

Select Course: (All dates to be advised)

New CourseYes

Day 1: Perform Electrofusion Jointing on Polyethylene Pipe for a Network - Unit Standard 10980 Cost: $485.00 + GST

Day 2: Perform Butt Fusion Jointing on Polyethylene Pipe for a Network - Unit Standard 10987 Cost: $485.00 + GST

Do you require your Unit Standards reported to NZQA? YesNo

If Yes, please provide your National Student Number: (Don't know your number? Ring NZQA on 0800 697 296 or 04 463 3000)

Credit Reporting Fees:
Unit Standard 10980 Electrofusion: $65.00 + GST
Unit Standard 10987 Butt Fusion: $65.00 + GST

Refresher CourseYes

Refresher ElectrofusionCost of Electrofusion Refresher: $250.00 + GST

Refresher Butt FusionCost of Butt Fusion Refresher: $250.00 + GST

Combined cost of Electrofusion & Butt Fusion Refreshers: $500.00 + GST

2 yearly Refresher Courses are available to keep your CoC current.

Are you in a Connexis Training Plan for NZC in Infrastructure Works (Pipeline Construction & Maintenance) Level 4?
YesNo

Do you require Unit Standard 31532: Demonstrate Knowledge of Fusion Jointing of Polyethylene Pipes for Water Networks?
Yes I require Unit Standard 31532

What is your training advisor's name?
What is your training advisor's email & phone number?

What is your training plan ID number? (TP-)

No I don't require Unit Standard 31532

Terms & Conditions

Enrolment forms must be completed and submitted before being accepted.
Payment is required on the 20^th of the month following the invoice date.
Course assessment will be completed when payment has been received in full.
If you withdraw from a course within 5 days from the course dates, the full fee will apply.
Candidates are responsible for their travel and accommodation if required.
You can transfer a person enrolled for another person of the same company, providing they do the same course.
Candidates to bring and wear appropriate PPE as per your Company requirements; e.g. Safety footwear, Hi-Viz vest or equivalent.
Fee for replacement of lost welding card is $35.00 + GST per card.
Please note: outstanding assessments will only be processed up to 1 month after the course date.

I have read and agree to the terms and conditions and am responsible for payment.

Once the completed application form is received by us and we have sufficient numbers for a course, we shall set a course date.

A: 788 High Street, Boulcott, Lower Hutt 5011

E: kristina@jwall.co.nz

Phone: 027 410 0082