Enrolment Form - JobSafe SA

Process (please read before completing an online enrolment form)

1)– Please check we have availabilities for your selected course by checking our COURSE DATES page.
2)– Complete online enrolment form no later than 4 days before start of course.
**Please note that Enrolments for HSR Level 1,2,3, WHS Refresher, Fatigue Management, Consultation Processes, Inappropriate Behaviours, Inspection & Incident Investigation MUST supply their SafeWork HSR ID#.
To obtain a SafeWork SA HSR ID# the EMPLOYER must log on to https://www.safework.sa.gov.au/notify/heath-and-safety-representatives/hsr-portal

*** JOBSAFE SA WILL NOT ACCEPT ANY FORMS FOR THESE COURSES WITHOUT THE HSR’s ID# ***

3)– JobSafe SA will contact your Employer once an enrolment form has been submitted to confirm their approval of your attendance.
4)- Once an Employer has confirmed approval, JobSafe SA will then send both the participant and the Employer a Confirmation of Enrolment letter/email.
5)– Invoice will be sent after the completion of the course.

Participant Details

Course title(Required)

Course Date(Required)

SafeWork SA HSR ID#(Required)

(if your course does not require a HSR ID# please put n/a)

Participant Title(Required)

Participant Name(Required)

Participant Surname(Required)

Participant Email(Required)

Participant Phone(Required)

Participant Job Title(Required)

Are you an Elected HSR?(Required)

Yes

Are you a Union Member?(Required)

Yes

Employer Details

Employer Organisation(Required)

Organisation Address(Required)

Street Address Address Line 2 City Post Code

Employer Contact Name(Required)

Employer Contact Email(Required)

Employer Contact Phone(Required)

Invoicing Details

Invoice Postal Address(Required)

Street Address Address Line 2 City Post Code

Invoicing Contact Name(Required)

Invoicing Contact Email(Required)

Invoicing Contact Phone(Required)

Invoice Purchase Order #(Required)

(if you do not require a p/o# please put n/a)

This field is for validation purposes and should be left unchanged.