Registration
Full Name: (Required)
Date of Birth: (Required)
Choose your gender by ticking the box next to "Female" or "Male." (required)
FemaleMale
Email: (Required)
Phone / WhatsApp: (Required)
Province: (Required) —Please choose an option—CentralChimbu (Simbu)East New BritainEast SepikEastern HighlandsEngaGulfHelaJiwakaMadangManusMilne BayMorobeNational Capital District (NCD)New IrelandNorthern (Oro)Southern HighlandsWest New BritainWest Sepik (Sandaun)Western (Fly)Western Highlands
District: (Required)
Highest Education Level: (Required) —Please choose an option—Grade 12CertificateDiplomaBachelor's DegreeMaster's DegreePhD
Year Completed: (Required) —Please choose an option—202420232022202120202019201820172016201520142013201220112010
Course Applying For: (Required) —Please choose an option—Certificate II in WHS (Year 1)Certificate IV in WHS (Year 2)Diploma in WHS (Year 3)
Training Dates: (Required) —Please choose an option—January - MarchApril - JuneJuly - SeptemberOctober - December
Course Duration: (Required) —Please choose an option—3 Months6 Months1 Year
Face-to-face trainingOnline trainingCombination of online and face-to-face training
Why did you choose this mode of study? (Required)
Date (Auto):
Automatically filled in with today’s date for system use.
