Occupational Safety and Health v1.0 - Etisalat Academy
Occupational Safety and Health v1.0 - Etisalat Academy
Occupational Safety and Health v1.0 - Etisalat Academy
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Attendee Details<br />
Registration Form<br />
Name: .............................................................................. Title:......................................................................... Tel: .......................................... email: ............................................<br />
1<br />
Course Code: ................................................................ Course Name: ......................................................................................................... Starting Date: .............................<br />
Course Code: ................................................................. Course Name: ....................................................................................................... Starting Date: .............................<br />
Name: .............................................................................. Title:......................................................................... Tel: .......................................... email: ............................................<br />
2<br />
Course Code: ................................................................ Course Name: ......................................................................................................... Starting Date: .............................<br />
Course Code: ................................................................. Course Name: ....................................................................................................... Starting Date: .............................<br />
Name: .............................................................................. Title:......................................................................... Tel: .......................................... email: ............................................<br />
3<br />
Course Code: ................................................................ Course Name: ......................................................................................................... Starting Date: .............................<br />
Course Code: ................................................................. Course Name: ....................................................................................................... Starting Date: .............................<br />
Company Details<br />
Organisation: .................................................................................................................................................... Industry: ..........................................................................................<br />
Address : ...........................................................................................................................................................................................................................................................................<br />
Post Code: ................................................................. Country: ................................................................ Tel: ...................................................Fax: ........................................<br />
Approving Manager Signature<br />
Name: .................................................................................................................................................................. Job Title: ..........................................................................................<br />
Email: .................................................................................................................................................................... Tel: ...................................................Fax: ........................................<br />
Authorising Signature * (M<strong>and</strong>atory):<br />
Company Stamp:<br />
Payment Details<br />
Bank Account Name<br />
: <strong>Etisalat</strong> <strong>Academy</strong><br />
Bank<br />
: National Bank of Abu Dhabi<br />
Branch<br />
: Deira Branch, Dubai, U.A.E. SWIFT CODE NBADAEAADEI<br />
Dirhams Bank Account No : 195 001 7744<br />
Please fax the remittance advice to +971 4 264 8888 or email a scanned copy to info@etac.ae<br />
For further clarifications, you may contact +971 4 204 3383<br />
( +971 4 264 4444 7 +971 4 264 8888 * info@etac.ae
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