Register for a Course or Program Register for a Course or Program This form is to indicate possible eligibility for training programs at Challenge Employment and Training. Please call us on (07) 3282 8000 if you have trouble filling out the form. Personal DetailsName* First Last Date of Birth* Gender* Male Female Other Phone Number*Email* Postcode* ZIP / Postal Code Are you an Australian citizen, Australian permanent resident or New Zealand citizen?* Yes No Do you hold a current QLD Drivers Licence?* Yes No What type of licence do you hold?* Learners Provisional 1 (Red) Provisional 2 (Green) Open What training would you like to undertake?Skilling Queenslanders for Work Community Work Skills Training*(Vocational placement is included in some of the programs) Warehousing & Logistics - Ipswich Warehousing & Logistics - Underwood Individual Support (Aged Care) - Deception Bay Individual Support (Aged Care) - Ipswich Construction Traineeship - Riverview Construction Traineeship - Goodna Construction Traineeship - Maroochydore Engineering - Collingwood Park Electro technology - Rocklea Electro technology - Rockhampton Electro technology - Underwood Domestic Support - Kallangur Domestic Support - Ipswich Domestic Support- Underwood Not Applicable Youth Employment ProgramFocuses on helping young people aged 15-21 become work ready or find a pathway back to education. Transition to Work Fee for Service Forklift Training & Licensing 3 day program ($500) Other ProgramHow did you hear about us?* Jobactive provider Community Organisation Social media (Facebook, Instagram) Word of mouth (e.g. friends, family) Job search website (e.g. SEEK) Other Jobactive provider if applicable:*Please specify:*Please advise what community organisation*EmailThis field is for validation purposes and should be left unchanged.