This form is for existing registered clients of Working at Height Limited who wish to do a bulk booking for Working at Height Limited Courses.

NOTE: If you have never registered with Working at Height Limited please do not use this form. 

All courses have a Delegate to Instructor ratio’s form 4:1 – 6:1 – 8:1 – 12:1 – If this form does not reflect that please re -use the form for register more delegates .

Clients must book a minimum of 4 delegates, or up to a maximum of 8 delegates at a time in this form. Make sure you have a digital image of each delegate to upload.

 

Authorised Applicant First Name*

!

Authorised Applicant Last Name*

!

Authorised Applicant Email Address*

!

Authorised Applicant Tel/Mob Number*

!

Company/Business Postal Address*

!

Company/Business Name*

!

Delegate 1 - Name - Address - Email - Date of Birth - Mobile Phone Number. (In this Order)*

!

Delegate 1 - Photo for your certificate here*

! For more guidance on what a digital photo must meet, technical specifications log on to: https://workingatheight.ie/tandc/ and go to Section 16 ISSUING of Certification, and then subsection (C) online registration photo guidelines.

Delegate 2 - Name - Address - Email - Date of Birth - Mobile Phone Number. (In this Order)*

!

Delegate 2 - Photo for your certificate here*

! For more guidance on what a digital photo must meet, technical specifications log on to: https://workingatheight.ie/tandc/ and go to Section 16 ISSUING of Certification, and then subsection (C) online registration photo guidelines.

Delegate 3 - Name - Address - Email - Date of Birth - Mobile Phone Number. (In this Order)*

!

Delegate 3 - Photo for your certificate here*

! For more guidance on what a digital photo must meet, technical specifications log on to: https://workingatheight.ie/tandc/ and go to Section 16 ISSUING of Certification, and then subsection (C) online registration photo guidelines.

Delegate 4 - Name - Address - Email - Date of Birth - Mobile Phone Number. (In this Order)*

!

Delegate 4 - Photo for your certificate here*

! For more guidance on what a digital photo must meet, technical specifications log on to: https://workingatheight.ie/tandc/ and go to Section 16 ISSUING of Certification, and then subsection (C) online registration photo guidelines.

Delegate 5 - Name - Address - Email - Date of Birth - Mobile Phone Number. (In this Order)

!

Delegate 5 - Photo for your certificate here

! For more guidance on what a digital photo must meet, technical specifications log on to: https://workingatheight.ie/tandc/ and go to Section 16 ISSUING of Certification, and then subsection (C) online registration photo guidelines.

Delegate 6 - Name - Address - Email - Date of Birth - Mobile Phone Number. (In this Order)

!

Delegate 6 - Photo for your certificate here

! For more guidance on what a digital photo must meet, technical specifications log on to: https://workingatheight.ie/tandc/ and go to Section 16 ISSUING of Certification, and then subsection (C) online registration photo guidelines.

Delegate 7 - Name - Address - Email - Date of Birth - Mobile Phone Number. (In this Order)

!

Delegate 7 - Photo for your certificate here

! For more guidance on what a digital photo must meet, technical specifications log on to: https://workingatheight.ie/tandc/ and go to Section 16 ISSUING of Certification, and then subsection (C) online registration photo guidelines.

Delegate 8 - Name - Address - Email - Date of Birth - Mobile Phone Number. (In this Order)

!

Delegate 8 - Photo for your certificate here

! For more guidance on what a digital photo must meet, technical specifications log on to: https://workingatheight.ie/tandc/ and go to Section 16 ISSUING of Certification, and then subsection (C) online registration photo guidelines.

Select Your Course*

!

Choose options

	Introduction to Workplace Safety, Health and Welfare (eLearning)
	Abrasive Wheels (In-Person/Zoom)
	Manual Handling (In-Person/Zoom)
	Basic Fire Safety (In-Person)
	Fire Safety with Fire Warden (In-Person)
	Cardiac First Response - PHECC-CFR (In-Person)
	First Aid Response - PHECC-FAR (In-Person)
	Wilderness First Aid (In-Person)
	First Aid Advanced International (In-Person)
	High Performance First Aid (In-Person)
	Trauma at Height (In-Person)
	Fall Protection (In-Person/Zoom)
	Fundamental Principles for Installers (In-Person)
	Aerial & Satellite Installations Basic (In-Person)
	Attic Safety (In-Person/Zoom)
	MEWP Operator Training “1b”(In-Person)
	Ladder Safety (In-Person)
	Roof Top Safety (Pitch Roof) (In-Person)
	Roof Top Safety (Flat Roof) (In-Person)
	Pole Top Rescue (In-Person)
	Horizontal Life Line (Temporary) Awareness & Installation (In-Person)
	Pylon Access & Rescue (In-Person)
	Telecoms Level 1 (In-Person)
	Telecoms Level 2 (In-Person)
	Access & Rescue Wind Turbine Generator (In-Person)
	First Aid Advanced Wind Turbine Generator (In-Person)
	Confined Space Entry Level 1 (In-Person)
	Confined Space Entry Level 2 (In-Person)
	Chemical Spill Management Part 1 (In-Person)
	Chemical Spill Response Part 2 (In-Person)
	Safety Netting Inspection & Management (In-Person/Zoom)
	Rope Access Level 1 “SPRAT” (In-Person)
	Rope Access Level 2 “SPRAT” (In-Person)
	Rope Access Level 3 “SPRAT” (In-Person)
	Rope Access Direct Entry “SPRAT” (In-Person)
	ISO Rope Access Level 1 (In-Person)
	ISO Rope Access Level 2 (In-Person)
	Rope Rescue Level 1 Operator (In-Person)
	Rope Rescue Level 2 Supervisor (In-Person)
	PPE Inspection – Competent Person (In-Person)
	Ladder Inspection – Competent Person (In-Person)
	Instructor Course – Instructor Development (In-Person/Zoom)
	Instructor Course - Fire Safety & Fire Warden (In-Person)
	Instructor Course – Working at Height Instructor (In-Person)
	Instructor Course - Abrasive Wheels (In-Person/Zoom)
	Instructor Course – Fall Protection Licensed Course (In-Person/Zoom)
	Instructor Course – Ladder Safety Licensed Course (In-Person)
	Instructor Course – PPE Inspection Licensed Course (In-Person)
	Business Management – Managing bullying in the workplace (eLearning)
	Business Management – Introduction to Ergonomics Risk Assessment (eLearning)
	Business Management – Certified Training Center Professional for Manager’s (In-Person/Zoom)
	Business Management – Business Administration & Management (In-Person/Zoom)
	Bespoke Training Course

Max Selection 5

Do you request any reasonable accommodations?*

! Nothing selected NoYes

If any Delegate requires reasonable accommodations Please enter ther name here.

!

Please confirm that you have downloaded the Learner Handbook (Ref #: 5.9.TC.3.19) an you will ensure its distrabution to all delgates.*

! Nothing selected Yes i HaveNo I Have Not https://workingatheight.ie/learner-resources

MEDICALLY FIT FOR TRAINING. It is the responsibility of the approved individual making the application on behalf of the organization to ensure that candidates attending the courses are free of any of the medical conditions. I Applicant can confirm that the Delegates have been assessed and are Medically Fit for any Endurance Based related Training with Working at Height Limited. {E.G. Access & Rescue}. Please Select below.*

! Nothing selected YES, They areNO, They are not For more information go to https://workingatheight.ie/tandc/ Section 17.

I the Applicant on behalf of the Business/Company have you read, understood and accepted the Working at Height Limited Terms & Conditions*

! Nothing selected YES, I accept WAHL-T&C For more information go to https://workingatheight.ie/tandc/

Electronic Consent*

! Nothing selected YES - I Consent By Selecting YES within the box on this form, you are consenting to the use of your name as an electronic consent in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic consent. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.

Date:*

!

Promotion Code:

! If you have a promotion code, Type in the code above.

Company Data*

!

I Confirm.

By checking this box, I confirm that I want to register my Company/Business and I give my consent to the Working at Height Limited to process our company data for the purpose described in the privacy statement (that is, to receive information requested on different topics in the area of (a) service(s), (b) courses, (c) safety alerts of the Working at Height Limited through our registration, newsletter or notifications).

Please Wait

Submitting the form

Submit

Note: Bookings are regarded as confirmed only upon receipt of a full payment for your course or a company purchase order.

Data Protection Notice

The information you supplied to Working at Height Limited through this registration form will be held and used by us solely for the purpose of booking purposes and will only be retained only for that purpose.