Declaration of Experience

As you are enrolled in an assessment only course you must complete this form and submit before your course date.

Course Date*
DD slash MM slash YYYY
Course:*
eg: Excavator
Name*
First Last
Phone*
You must indicate your operating experience.*
Machine Make and Model/Type Location of experience Approximate Dates Approximate Hours
Total Hours
Total Days
Total Years
If found that this is not a true reflection of your operating experience you will have to undertake training at further expense. This could mean having to reschedule training for another date.*
I agree that this is a true reflection of my Operating Experience.
If found that this is not a true reflection of your operating experience you will have to undertake training at further expense. This could mean having to reschedule training for another date.

Machine Make and Model/Type	Location of experience	Approximate Dates	Approximate Hours