1) Student Student Name* DOB* Gender* MaleFemaleOther Email* Mobile* Blood Group Nationality 2) Address (Global) Local/Street* Landmark/Area Country* Select CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua And BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamas TheBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo The Democratic Republic Of TheCook IslandsCosta RicaCote D'Ivoire (Ivory Coast)Croatia (Hrvatska)CubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFiji IslandsFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambia TheGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernsey and AlderneyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHondurasHong Kong S.A.R.HungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacau S.A.R.MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMan (Isle of)Marshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlands AntillesNetherlands TheNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian Territory OccupiedPanamaPapua new GuineaParaguayPeruPhilippinesPitcairn IslandPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint HelenaSaint Kitts And NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent And The GrenadinesSaint-BarthelemySaint-Martin (French part)SamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth SudanSpainSri LankaSudanSurinameSvalbard And Jan Mayen IslandsSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad And TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican City State (Holy See)VenezuelaVietnamVirgin Islands (British)Virgin Islands (US)Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabwe State/Province* Select State City / District* Select City3) Course SelectionHold Ctrl/Cmd to select multiple.—Please choose an option—-- Select course(s) --ADIS - Advanced Diploma in Industrial SafetyDiploma in Industrial Safety Management (DISM)OTHM Level 6 Diploma in OHSOTHM Level 7 Diploma in OHSNEBOSH IGCIOSH Managing SafelyOSHA 30-Hour (Construction)OSHA 30-Hour (General Industry)ISO 9001:2015 QMS Lead AuditorISO 14001:2015 EMS Lead AuditorISO 45001:2018 OHSMS Lead AuditorOHSMS (General)Integrated Management System (9001/14001/45001)Risk Assessment TrainingPermit to Work System (PTWS)Electrical Safety TrainingFire & Life Safety TrainingFire Technician (6 Months)First Aid & CPRFirst Aid & CPR with AEDScaffold Safety TrainingScaffold InspectorRigger Level I - BasicRigger Level II - AdvanceRescue: Working at HeightWorking at HeightGas TesterFire WatcherIncident Reporting & Accident InvestigationLegal Aspects of HSEConstruction SafetyOther – type below Other course (if any) Mode* OnlineOfflineHybrid 4) Education & ID Highest Qualification* 5) Guardian & Emergency Father/Guardian* Mother Emergency Name* Relation Emergency Mobile* 6) Documents (tick)Passport PhotoAadhaar / Govt. ID10th Marksheet12th MarksheetUG MarksheetPG MarksheetDiploma/OthersERP Enrollment7) Uploads Photo (JPG/PNG, ≤2MB)* Signature (JPG/PNG, ≤1MB)* Highest Education Certificate (PDF/JPG/PNG, ≤5MB)* ID Proof (PDF/JPG/PNG, ≤5MB)* 8) DeclarationI declare that the information provided is true and I agree to abide by the institute's rules and refund policy.[acceptance* declaration] I accept Please leave this field empty.
