Training @ La Trobe Course Registration for Staff without a StaffOnLine account This form is only to be used by La Trobe University staff who do not have a StaffOnLine account. Course registration requests for staff with a StaffOnLine account must be submitted online. See the StaffOnLine User Guide for registration instructions. Participant’s Details (Block letters only – please complete all fields) Staff Number: Title: Miss Ms Mrs Mr Other (please specify) First name: Middle Initial: Last name: LTU User Name: (e.g. jbloggs) Campus Bundoora Bendigo Albury/Wodonga Other (please specify) Faculty: Department: La Trobe email: @latrobe.edu.au Home Email: Work Phone: Home Phone: Mobile: Fax: Special Needs: Please include any information that will provide you with an optimum training environment. If you have a visual or hearing impairment or require a special mouse or chair, please note your requirements and we will endeavour to accommodate you. Course Title Course Date/s Course Cost Payment Details and authorisation - All details must be completed Name of Head of Department Cost centre: (or equivalent) Signature of Head of Department Fund number: (or equivalent) Course registration policy: Where class sizes are limited, places will be allocated in order of registrations received. Training @ La Trobe reserves the right to postpone or cancel courses if sufficient student numbers are not attained. Cancellation policy: Non-attendance of the above course/s or cancellation less than 24 hours prior to the course start date may incur a charge of up to 100% of the full course fee. Student substitutions are acceptable at any time. Send the completed form by Fax: 03 9479 5088 or mail to: Training @ La Trobe, BSU, David Myers Building, La Trobe University, Bundoora, VIC. 3086 Thank you. You will be notified of the outcome of your application by email within two working days of its receipt.