JNC Group | Register

General details

Please use the form to register an account before you take the JNC Group safety induction courses. All fields marked with an * are compulsory. After submitting this form a password will be sent to the email address you provide, your username will be the email address you provide.

Name*

First Last

Company*

General OHS&R induction card number*

National certificate of competency licence*

Other qualifications

If any, please list here.

Drivers licence and health

Drivers licence number*

Expiry*

Class*

Are you an Australian citizen?*

Yes
No

Do you have a working knowledge of the spoken English language and can read and write to a sound level?*

Yes
No

Do you have any known allergies or medical conditions that could affect your ability to accomplish your daily tasks and fulfil your role responsibilities?*

If ‘yes’ please provide details in the section below.

Yes
No

Please list below if relevant to the conduct of the position you are undertaking, or if JNC Group may be required to assist with particular requirements if you become involved in an incident. This information will be stored confidentially within JNC Group.*

Contact information

Mobile contact number*

After hours contact number*

Company phone number*

Email address*

Next of kin

Name*

First Last

Contact mobile number*

Alternate contact number*

Disclaimer

I certify that it is myself, without assistance from others, that will complete all courses.*

Yes

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