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Heavy Equipment School
Heavy Equipment School subscription form (FOR INDIVIDUALS)
Are you at least 18 years of age?
:
No
Yes
Country of Residence
:
Suriname
Guyana
French Guiana
Trinidad
Curaçao
Aruba
Bonaire
Sint-Maarten
Netherlands
Other: Caribbean Country
Other: South American Country
Other: Latin american Country
Other: European Country
Other: Asian Country
Other: African Country
Name
:
Surname
:
Gender
:
Male
Female
Birth date
:
Jan
Feb
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Mobile
:
Email
:
Education
:
Primary school
Secondary school education
Higher education
Diploma
:
Yes
No
HES course
:
Operators course
Technicans course
Equipment type
:
Bulldozer
Hydraulic Excavator
Wheel Loader
Dump Truck
Motor Grader
Forklift
Transport Trailer
Classroom period
:
Daytime
Evening
Valid Driver's license
:
Yes
No
How did you find out about us?
:
Search Engine (Google, Yahoo, Ask, etc.)
I saw it on a poster/flyer/brochure
Word of mouth (heard from a colleague, spouse, friend, etc.)
Advertisement
Social media (Facebook,Twitter,Skype,Youtube)
Saw your nameplate on the building
Phone Book/Yellow pages
Our Website
Promotional item: T-shirt,Water Bottle, Coffee Mug, Pens etc
I confirm that the information provided on this form is correct and I understand that failure to complete this form or any attempt to misrepresent information, may result in the request being refused
:
Caribbean Heavy Equipment Educational Center
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