Urban Pest Management Training and Assessment

(02) 4322 0331

VIC ONLY - MPL Training Centre Pest Courses Enrolment Form

To immediately ensure a place in your chosen course you can complete the form below or download a form from here and return with payment by fax, email or post.

If you are not comfortable filling in your credit card details on this form please contact our office on (02) 4322 0331 with your credit card details.

IMPORTANT -  Your enrollment isn't confirmed until full payment has been made either by credit card, cheque or direct deposit.

Please ensure all fields marked with * are filled in.

Today's Date:*

Company Information

If you are a Pest Management Company and are enrolling one of your employees or if you are working for a pest management company and enrolling in a course please fill out the details below. 

Name to be shown on Tax Invoice:*
Company Name:
Company Contact Person (if applicable)
Company Phone:
-
Company E-mail

Student Information

Please enter the student information below; all fields marked * are required.

Students Name:*
Address:*
Postal Address (if different from above):
Students E-mail*
Mobile/Phone Number:*
-
Date of Birth:*
 / 
 / 
City of Birth:*
Country of Birth:*

Identification

Please fill in the following identification fields. Fileds marked with * are required.

USI (Unique Student Identifier):

If you don't have a USI number you must provide a photo copy of one of the following forms of ID - use the attachment button at the bottom of the form to attach your ID  ( * Required)

Identification Options:

Course Selection - PORT MELBOURNE - VICTORIA

Please choose the course/courses you would like to enrol in. The total cost of each course will total automatically at the bottom of this section.

NOTE: If you enrol in both the General Pest License & Termite & Timber Courses you will receive a discount of $190.

Courses:
Total:

Payment Advice Options

IMPORTANT -  Your enrolment isn't confirmed until full payment has been made either by credit card, cheque or direct deposit.

Cheques

Please send cheques to MPL Training Centre P.T.Y. L.T.D  PO Box 6121 Kincumber NSW 2251

Direct Deposit

Please include your surname and first name on direct deposit information. To ensure a place in the course email or fax a copy of your transaction receipt to info@mpltraining.com.au

National Australia Bank. Account Name: MPL Training Centre Pty Ltd   BSB: 082-528 Account number: 57-190-6375

Total Amount Owing:
Credit Card (Tick One):
Credit Card Number :
Credit Card Expiry Date:
Name On Credit Card:
Enclosed is my cheque for $:
Click on this button to attach photo copies of your form of identification..
Word Verification (type the words exactly):