Course Registration
Title *
Please select a Title.
First Name *
Please enter your first name.
Last Name *
Please enter your name.
Badge *
Please enter your Preferred Name for Badge.
Street Address *
Please enter your Street Address.
Please enter correct Street Address line 2.
Suburb *
Please enter your Suburb.
State *
Please select your State.
Post Code *
Please enter a valid four digit post code.
Country *
Please enter your Country
Mobile *
Please enter your mobile number. example +61 4xx xxx xxx
Phone *
Please enter your phone number. example +61 8 xxxx xxxx
Email Address *
Please enter a valid email address
Verify E-Mail *
Please re-enter your email address.
I, *
Please enter your name for enrollment confirmation.
wish to enrol for the: *
Please enter course you are enrolling for to confirm your enrollment.
Do you understand that a $150 administration fee applies for cancellation. *
Please tick to confirm you agree with the terms.
I understand that Sonographic Solutions Pty Ltd can not cover for Professional / Personal Indemnity Insurance.
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If your application arrives after closing date or course quota is full. Do you wish to apply for a subsequent course? *
Please confirm that you wish to book for a subsequent course, if your application arrives after closing date.
Any Special dietary requirements? *
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If Yes
Please enter course you are enrolling for to confirm your enrollment.
Are you a GPEx Registrar?
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If enrolling for x-ray course: Have you ever held an Australian radiation licence before: *
Please confirm
If Yes please specify in which state your radiation licence was it granted:
Please specify state
Year Obtained
Please enter year obtained
Last practiced
Please enter year obtained
Location
Please enter year obtained
Type the numbers you see in the picture * Type the numbers you see in the picture
Type the characters you see in the picture