Email Address:

Mobile:

State: Postcode:

Proposed Starting Time:

Australian Child Care Career OptionsWorkshop Request Form

Please provide as much information as possible pertaining to the proposed workshop. Please submit one form for each workshop requested to wor k s h o p s @acc c o.com.a u Upon approval, Australian Child Care Career Option will contact you before scheduling. Date Submitted:

Requestor Information Service Name: Phone

Number: Service

Address:

Suburb:

Proposed Workshop Date:

Workshop Topic Expected Number of Participants *minimum invoice $650 applies for onsite bookings(List workshops that apply)

Quality Area 1 Quality Area 5

Quality Area 2 Quality Area 6

Quality Area 3 Quality Area 7

Quality Area 4 O T HE R - De s ign y o u r o w n wor k s h op d e p e nd e n t on y o u r n ee d s . (Pl e ase gi v e ou tli n e)

Payment Details We will pay by EFT

Account Name: Australian Child Care Career Options | Bank: WESTPAC | Branch BSB: 034 001 | Account No. 358341Your Reference: [Your Company Name] PD Workshop | EFT Payment Advice to: accounts@accco.com.au

CREDIT CARD PAYMENT AUTHORISATION

NAME ON THE CARD

Card No.:

Expiry Date.: CVV.: Total Amount: $

Signature of card holder

We require a minimum invoice deposit to be made on booking per workshop. Balance within 7 days of date of invoice. Cancellation of booking within 7 days prior to workshop date will result in forfeit of booking deposit. Prices quoted are based on a local ACCCO consultant in your area. For areas without a local ACCCO consultant, airfares and accommodation will be added to the cost of your training. All prices are GSTincl. Price includes: Presenter, Handouts, and Certificate of attendance.

2 Hour W o r ks h op 2 hour workshop - $70 per person (minimum invoice of $650 for 9 people or less)

Comments

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Today’s Date: ____________

Please Note: Our workshops are industry focused, comply with audit requirements for PD funding and reconcile with ELYF and NQF outcomes and standards. Price is true and correct as at 24/10/17 Subject to change.