OCCUPATIONAL SAFETY & HEALTH COORDINATOR (OSH-C) TRAINING PROGRAM - REGISTRATION FORM
3-Day Course
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DATE & TIME OF TRAINING PROGRAM *
VENUE *
PAYMENT METHOD *
NAME OF COMPANY/ ORGANIZATION *
COMPANY/ ORGANIZATION SSM REGISTRATION NO. *
ADDRESS OF COMPANY/ ORGANIZATION
*
FULL NAME OF PARTICIPANT (AS PER NRIC/ PASSPORT)
*
NRIC/ PASSPORT NO. OF PARTICIPANT
*
NATIONALITY *
JOB ROLE IN COMPANY/ ORGANIZATION *
GENDER
*
MOBILE PHONE NO.
*
EMAIL ADDRESS
*
RESIDENTIAL ADDRESS *
MEAL PREFERENCE *
COURSE FEE *
REGISTRATION & PAYMENT
1.) Registration is on a first-come-first-serve basis. Upon submission of this Registration Form to our company, ADVANCED HSE SOLUTIONS SDN. BHD., you are deemed to have read and accepted the terms and conditions. The program would also be deemed as confirmed unless informed otherwise.

2.) All registration together with the payment should be made before the event date. Certificate will only be issued upon full payment received. Please email the proof of payment to oshc@advhsesol.com to confirm your participation. The invoice will be emailed to you within 3 - 5 working days after payment made.

3.) Kindly make your payment to our banking account:
(i.)  Beneficiary Name : ADVANCED HSE SOLUTIONS SDN. BHD.
(ii.) HONG LEONG BANK BERHAD A/C No: 05900422862
(iii.) SST Registration No: P13-2209-32000004

4.) For SBL-KHAS, grant approval must be provided to OUR COMPANY AT LEAST 3 DAYS BEFORE the event. An attendance of 100% is a must, otherwise employers will be billed in full. Please email the GRANT APPROVAL to oshc@advhsesol.com to confirm your participation.

Remarks:-
For HRD CORP Registered Employer, 
- The course fee is claimable under HRD Corp SBL-Khas Scheme.
- No payment is to be made to OUR COMPANY.
- Fee will be deducted from the employer’s HRD Corp contributions. Thus, the levy balance must be sufficient.
- Full payment is to be made to OUR COMPANY in the event that no disbursement from HRD Corp under any circumstances.
NAME & POSITION OF OFFICER-IN-CHARGE *
CONTACT NUMBER OF OFFICER-IN-CHARGE *
EMAIL ADDRESS OF OFFICER-IN-CHARGE *
REPLACEMENT/ CANCELLATION***
* Must be made in writing with reasons to our company, ADVANCED HSE SOLUTIONS SDN. BHD. if any.
* 100% of the course fee will be charged by OUR COMPANY for any cancellation made 7 WORKING DAYS OR LESS BEFORE the event date.
* 50% of the course fee will be charged for cancellation made between 8 - 14 WORKING DAYS BEFORE the event date.
* NO CHARGES for cancellation made 15 WORKING DAYS BEFORE the event date.
* NO SHOWS will be charged at 100% of the course fee.
* Replacement can be accepted at no additional cost with prior notice before the event date.
* And OUR COMPANY reserves the right to cancel or reschedule the program.
By clicking the checkbox below, I have read and agree with all the terms and conditions mentioned above. *
Required
For any enquiries, kindly contact our training coordinator below:
Ms. Mimi (010-2926521
Ms. Irah    (014-9486521)

Or you may drop us an email at oshc@advhsesol.com
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