By filling in this form, you declare:

I am a Health and Safety Representative elected by my workgroup. 

In accordance with the Workplace Health and Safety Act 2011, I nominate the ASU as my training provider for HSR training.

The ASU is unable to provide Health and Safety Representative training to those who have not already been elected to this position by their workgroup. 

If you are unsure or have questions about this, please contact us at [email protected] before completing this form. 

Please write your full name in the box provided.