JNC Group | Register

Account registration

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*
Date Format: DD slash MM slash YYYY
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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Account registration

General details

Drivers licence and health

Contact information

Next of kin

Disclaimer

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