City *State/Province/Region *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemen Arab Rep.Yemen DemocraticZambiaZimbabwePrefix *SelectMr.Mrs.Ms.Miss.Dr.First Name *Middle NameLast Name *Please be aware that this is how your names will appear on your certificate, should you be successful.Company NameJob TitleEmail Address *Phone Number *Level of Education *-- Select --No Formal EducationPrimary EducationSecondary Education or High SchoolVocational QualificationBachelor's DegreeMaster's DegreeDoctorate or HigherCertificate and DiplomaID Type *-- Select --National ID / Ghana CardPassportDriver's LicenseUpload A Picture of Your IDChoose FileNo file chosenDelete uploaded fileNote: Take a clear snap and ensure the words readable.Date of Birth *DaySelect day12345678910111213141516171819202122232425262728293031MonthSelect month123456789101112YearSelect Year212421232122212121202119211821172116211521142113211221112110210921082107210621052104210321022101210020992098209720962095209420932092209120902089208820872086208520842083208220812080207920782077207620752074207320722071207020692068206720662065206420632062206120602059205820572056205520542053205220512050204920482047204620452044204320422041204020392038203720362035203420332032203120302029202820272026202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924Course of Interest *NEBOSH International General Certificate in Occupational Health and SafetyNEBOSH Incident InvestigationNEBOSH Managing Stress at WorkNEBOSH Manual Handling Risk AssessmentNEBOSH IIRSM Risk ManagementNEBOSH HSE Risk Management and Risk ManagementISO 45001 Lead Auditor CourseForklift TrainingOtherSpecify The Course *Course preferences *Classroom Session: Weekdays (Monday to Friday)Classroom Session: Weekends (Saturdays and Sundays)Virtual-Weekdays (Monday to Friday)Virtual-Weekends (Saturdays and Sundays)Virtual-Evening Classes (8pm to 9pm)E-Learning (Self Study)Which of our training centres do you wish to attend your class? *AccraKumasiTakoradiObuasiSunyaniOtherHow did you hear about us? *Social MediaOur WebsiteDirect MailAn EventOtherCourse Enrolment Notification and Learning AgreementThe purpose of the learning agreement is to help learners understand their role in the overall process. It is an understanding between Millennium Health and Safety Consult (MILHASC) and the learners as to who takes responsibility for what. It needs to be honoured by both parties if the learning is to be successful. Your course is demanding and requires significant time and commitment from you and MILHASC to ensure you pass your exams with ease.Millennium Health and Safety Consult (MILHASC) will: Provide you with suitable materials, sufficient for your course, at the appropriate times. Ensure you are enrolled and registered with the appropriate awarding institutions for your examination as required (If we believe you are ready and prepared). Do our best to ensure that the course material conforms to the relevant syllabus. Encourage you during your study. Provide an expert tutorial team who can be contacted by a range of methods. Provide appropriate administrative support during working hours. Remind you if assignments have not been submitted by the agreed deadlines. Return tutor-marked assignments (TMA) and mock exam feedback within 2 weeks. Provide constructive and individual feedback on your progress. Deal with any difficulties promptly and fairly. Send you a copy of our complaints procedure on requests. Operate an equal opportunity policy. Learners will: Ensure that all fees are paid by the agreed-upon times. Complete the study planner to plan and track your progress through the course. Ensure that all actions detailed in the study planner are completed. Carry out a sufficient private study of textbooks, further reading, and references (as detailed in the study planner and study guide) to maintain progress on your learning programme. Attempt revision questions in the study guide, as directed by the study planner. Complete exam registration forms when requested and pay the appropriate fees. Learners enrolled in the classroom sessions must attend classes as planned. Learners must not conduct themselves in a way that would disrupt the class. Learners who persistently disrupt the class may be asked to excuse themselves. Agreement by Millennium Health and Safety Consult:Hussein Osman IDipNEBOSH CMIOSH (Senior Managing Consultant, Millennium Health and Safety Consult)Please verify that:You have read the prior knowledge requirements of this course and you have met them. *YesNoYou have read all the joining instructions and can meet all the requirements. *YesNoNotes/Any special requirements (e.g. dietary, building access, etc)Consent *By submitting this form, I confirm that the details above are correct and I accept the terms and conditions below:SubmitPlease do not fill in this field.