Course Name:
Course Date: 26-Sep-2025 09:00am
Participant Information
Name:
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City/Town:
Province:
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Ontario
Prince Edward Island
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Postal Code:
Birth Date:
Home Phone:
Cell Phone:
E-mail:
This email will receive important notices (e.g., cancellations and virtual course invites). Please ensure it’s correct.
Have you attended other Construction Safety Nova Scotia courses? Yes
No
How did you hear about this course?
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I reviewed the “services catalogue” digital pdf
I reviewed the printed physical version of the “services catalogue”
I got a physical mail piece in my mailbox
I got an email from CSNS
On social media
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A web advertisement
I am familiar with CSNS and check the online calendar when I need a course
A bus ad
A billboard
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On TV
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Word of mouth
Employer / Union
Employer / Union:
If address, phone, and fax are same as above, check box.
Mailing Address:
City/Town:
Province:
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Ontario
Prince Edward Island
Quebec
Saskatchewan
Northwest Territories
Nunavut
Yukon
Postal Code:
Business Phone:
Business Fax:
E-mail:
PO #: