Enrol (Zeek Nurse Endorsements) | ACT Australian Certified Trainers

Registration Form (Zeek Nurse Endorsements)

This registration form is for NEW ENROLEES who are being endorsed by Zeek Nurse to ACT only. If you have not been endorsed by Zeek Nurse and would like to learn more about our programs or speak with a team member, please use our Contact Form or email us at info@actrainers.com.au.

"*" indicates required fields

Last Name/Surname (as indicated in your ID/passport)*

Last

Given Name/s and Middle Name (as indicated in your ID/passport)*

Nickname/Preferred Name (We will address you by your first given name if this is left blank.)*

Email (Please ensure you can receive emails at this address. We will not respond to messages sent from an unregistered email address.)*

Mobile/WhatsApp Number*

Home Country/Country of Citizenship*

Valid Passport*

Accepted file types: jpg, png, pdf, Max. file size: 50 MB.

Full Payment of Fees (for OSCE Candidates)*

(For OSCE candidates) I understand that I will be required to pay the full amount of the program fee, regardless of my current mode of payment, before I can be allowed to attend the face-to-face training.

Read the Terms and Conditions.

This field is for validation purposes and should be left unchanged.