Work Safely in the Construction Industry
Registration
Surname
This is the surname that will be printed on the certificate.
Given Name
This is the given name that will be printed on the certificate.
These are the login details that you will use to access the course.
UserID
Password
Re-Type-Password
Other Information
Title
--Select--
Mr
Mrs
Ms
Gender
--Select--
Male
Female
DOB
Day
--Select--
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
1
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
--Select--
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
--Select--
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
Phone
This will be the address to which the ‘White Card’ will be sent.
Street No
Street Name
Suburb
State
Postcode
Payment Type
Payment Type
Credit Card
PO
Refund Policy
• There is no refund for online courses once you have accessed the course information
• For all other refunds please contact CCFWA
Level 1, 70 Malaga Drive
MALAGA WA 6090
P: 08 9249 8944
F: 08 9209 2669