Private Course book - PracMed NZ

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Book a Private Course

Please complete the form below to book a private course at a time, date and location that suits you

private-course-book-form

Have you booked a Private Course with us before?*
- Existing Account
- New Account
Enter Your Details
First Name*
Last Name*
Email*
Mobile Number*
How did you hear about us?
Organisation Details
Organisation Name*
Head Office Street Address*
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Head Office Street Address*
City*
Region*
Post Code*
Will you be the point of contact (POC) at the course?*
- Yes
- No
Please ensure the mobile number will be contactable in case of emergency on the morning of the course.
Please list details of POC available on the day
First Name*
Last Name*
Email*
Mobile Number*

Please ensure this is a mobile number which is contactable in case of emergency on the morning of the course.
Your Requirements
Training type*
- First Aid Training
- Working at Heights
- Readiness Scenarios
- Custom Course
Course delivery style - Choose one or both (if booking multiple courses)*
- In-person
- Blended (online + in-person)

Add Course

Course	Number of students	Preferred Course Date	Course Start Time	Course Street Address	City	Region	Post Code	Actions

There are no In-Person Courses.

Maximum number of in-person courses reached.

Add Course

Course	Number of students	Preferred Course Date	Course Start Time	Course Street Address	City	Region	Post Code	Actions

There are no Blended Courses.

Maximum number of blended courses reached.

Add Course

Course	Number of students	Preferred Course Date	Course Start Time	Course Street Address	City	Region	Post Code	Actions

There are no Courses.

Maximum number of courses reached.

Add Course

Course	Number of students	Preferred Course Date	Course Start Time	Course Street Address	City	Region	Post Code	Actions

There are no Courses.

Maximum number of courses reached.

Add Course

Course	Number of students	Preferred Course Date	Course Start Time	Course Street Address	City	Region	Post Code	Actions

There are no Courses.

Maximum number of courses reached.

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Training Site Details
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Is the trainer required to complete an induction prior to accessing the site?
- Yes
- No
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Details of required induction:
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Does the trainer need any specific PPE for access to this site?
- Yes
- No
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PPE requirements:
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Does the site have a TV or a projector we can access?
- Yes
- No
- Not sure
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Does the site have wifi access?
- Yes
- No
- Not sure
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Is there parking on-site?
- Yes
- No
- Not sure
Account Requirements
Who will be paying for this course?*
- The Organisation
- Individual Students
Accounts Payable Name*
Accounts Payable Phone*
Accounts Payable Email*
Any other notes - e.g secondary course dates if your dates aren't available, or if your two day course is non-consecutive.
Is a PO required for this course?*
- Yes
- No
Note invoices must be generated within 3 days of the course date, please ensure you have all required documentation sent within this period.
Authorisation
I have read and accept the Terms and Conditions.
I have read and accept the Terms and Conditions.*
- Yes
- No
Please ensure the POC is available 1 hour prior to the course for the Trainer to set up.
Working at Heights training Memorandum of Understanding
- I have read and agree to the Memorandum of Understanding
Signature*
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Course minimum will be charged at time of booking confirmation. Additional students will be charged on the day.