ADIA BS EN16005 Accredited by City & Guilds Signup Form PLEASE COMPLETE BS EN16005 REFRESHER COURSES HERE Company DetailsADIA Member Company Name* Company Representative Name (optional) First Last Representative Email Address (optional) The Login / Course information will also be sent to this person additionally to the engineer. This is useful to have a copy of the login details and information Would you like to use this as your free course?*Please ChooseYesNoInstaller members gain one free course per year. We will check this against your account at the point of issuing the invoice.Engineers DetailsName First Last Engineers Date of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920This is needed for the City & Guilds databaseEngineer Mobile Number*This is important as we will send a reminder text message to the engineer about the course date and login detailsEmail Address* Enter Email Confirm Email If this email address is already in use on the system please add a number to the end of the email addresses and we will forward the engineer the login details. For example: if engineer@emailaddress.co.uk change to engineer@emailaddress.co.uk1 E-Learning Signup DetailsUsername* This will be the username for the engineer to login to the Self Study Part of the course.This has to be unique containing the engineers name and a numberPassword* Enter Password Confirm Password Strength indicator This will be the password that the engineer will use to login to their self study part of the course. Please use a strong password by making the password a minimum of 6 characters, include special characters like $%& and capital lettersPlease click here to agree to ADIA Terms & Conditions* I Agree HiddenCourse LevelBS EN16005 Δ