COURSE REGISTRATION FORM CONTRACTOR PTS INDUCTION IE Customer Number: If a new sponsoring company EMPLOYING please request ‘New Customer- Application’ Form ORGANISER’S NAME COMPANY DETAILS (Print Details) (Print Details) 9 7 COMPANY NAME ADDRESS TELEPHONE NUMBER- include area code EMAIL ADDRESS: TRAINING Dublin: Athlone: Limerick Junction: VENUE Contact Iarnród Éireann for available training dates. Your first choice may TRAINING DATE D D M M Y Y Y Y not always be available. Training dates are ONLY confirmed once all the necessary applications and payment are received and validated. PAYMENT DETAILS Send completed applications & Payment to: Payment is in Euro by Company Cheque, Bank Draft, Postal Order (made payable to Iarnród Éireann) Iarnród Éireann Contractor PTS Induction or by EFT (request IE bank details). Training Centre Inchicore Railway Works Personal Cheques, Third Party Cheques or Cash are not accepted. Dublin 8 General Enquires Total Amount Payable € Tel +353 (0) 1 703 3954 Fax +353 (0) 1 703 3942 Email [email protected] Terms & Conditions: CHECK LIST: 1. Contractor P.T.S. Induction is a one day training programme (Time: 09.15-17.00)- Registration Time 09.00 Please ensure that the following is 2. Attendees must be employed by a company are contracted to work for or on behalf of Iarnród Éireann completed on your application: 3. A course fee of €200 per person is applicable (subject to change with notification)- Payment must accompany this form Payment : 4. One passport photograph per attendee (print name on back of photograph)- Photographs must €200 per person accompany this form-see overleaf 5. Each attendee must be passed medically fit to a standard specified by the Iarnród Éireann Chief Passport Photograph: Medical Officer- Medical report must accompany this form Name on Back of photograph 6. Employing companies who fail to provide payment, photographs, PPS Numbers, Medical Report will result in non admittance to the course for the attendee(s) Medical Report 7. As an employing company, if you are paying for a subcontractor to attend training a separate Fit for work application form for Contractor PTS Induction Training Course must be submitted for the subcontractor. Include a cover letter stating that you are making payment for the specified sub Attendee Details: contractor. Name, DOB 8. Cancellations are accepted in writing up to 24 hours prior to the confirmed training date, after which full course fee will apply PPS Number: 9. Where participants do not show for training, full course fee will apply 10. Participants must have a good working knowledge of English 11. Participants must partake in an end of course written assessment. On successful completion of the Training Venue: Contractor P.T.S. Training Course, participants will be registered with Iarnród Éireann and issued with a registration card Customer Number: 12. Registration card is valid for a period of 3 years, after which the holder must attend and successfully complete a refresher programme 13. Registration card must be carried at all times and produced when requested Training Date: 14. Replacement registration cards are issued at a cost of €25 15. Registration cards remain the property of Iarnród Éireann 16. Registration cards will be issued within 10 working days 17. The employing company must bear all other costs associated with attending Contractor P.T.S. Induction training (employee time and travel, etc.) Neat dress is expected while attending training 18. 19. Each attendee must have a High Visibility Vest (Orange colour) and Safety Footwear on the training course. These are NOT supplied by Iarnród Éireann. Office Use Only: Sales Order: ____________ Invoice: ____________ Clearing Document: __________________ IE Contractor PTS Ver. 1 (April 2013) ATTENDEE DETAILS COPY THIS SHEET IF YOU HAVE MORE THAN 5 ATTENDING AND ATTACH TO YOUR APPLICATION (PRINT DETAILS) ATTACH WITH ATTENDEE DETAILS (Print Details) SELLOTAPE A PASSPORT QUALITY PHOTOGRAPH Name: ENSURE THE ATTENDEE NAME IS PRINTED ON Date of Birth: THE BACK OF THE PHOTOGRAPH D D - M M - Y Y Y Y PPS Number: Office Use Only: A High Visibility Vest (Orange colour) and Safety Footwear are required for each attendee on the training course, these are NOT supplied by Iarnród Éireann. I N F A ATTACH WITH ATTENDEE DETAILS (Print Details) SELLOTAPE A PASSPORT QUALITY PHOTOGRAPH Name: ENSURE THE ATTENDEE NAME IS PRINTED ON Date of Birth: THE BACK OF THE PHOTOGRAPH D D - M M - Y Y Y Y PPS Number: Office Use Only: A High Visibility Vest (Orange colour) and Safety Footwear are required for each attendee on the training course, these are NOT supplied by Iarnród Éireann. I N F A ATTACH WITH ATTENDEE DETAILS (Print Details) SELLOTAPE A PASSPORT QUALITY PHOTOGRAPH Name: ENSURE THE ATTENDEE NAME IS PRINTED ON Date of Birth: THE BACK OF THE PHOTOGRAPH D D - M M - Y Y Y Y PPS Number: Office Use Only: A High Visibility Vest (Orange colour) and Safety Footwear are required for each attendee on the training course, these are NOT supplied by Iarnród Éireann. I N F A ATTACH WITH ATTENDEE DETAILS (Print Details) SELLOTAPE A PASSPORT QUALITY PHOTOGRAPH Name: ENSURE THE ATTENDEE NAME IS PRINTED ON Date of Birth: THE BACK OF THE PHOTOGRAPH D D - M M - Y Y Y Y PPS Number: Office Use Only: A High Visibility Vest (Orange colour) and Safety Footwear are required for each attendee on the training course, these are NOT supplied by Iarnród Éireann. I N F A ATTACH WITH ATTENDEE DETAILS (Print Details) SELLOTAPE A PASSPORT QUALITY PHOTOGRAPH Name: ENSURE THE ATTENDEE NAME IS PRINTED ON Date of Birth: THE BACK OF THE PHOTOGRAPH D D - M M - Y Y Y Y PPS Number: Office Use Only: A High Visibility Vest (Orange colour) and Safety Footwear are required for each attendee on the training course, these are NOT supplied by Iarnród Éireann. I N F A IE Contractor PTS Ver. 1 (April 2013) .