DBCT Applications – Mynesight Training

Step 1 of 3

Site Information

Unique ID

Site Induction Area(Required)

DBCT P/L - Dalrymple Bay Coal Terminal Proprietary Limited

DBIM - Dalrymple Bay Infrastructure Management

Company Name(Required)

Please select your company name from the list of approved vendors.

Company Contact(Required)

An administration contact is preferred. Do not enter the site attendee as the contact.

First Last

Contractor Contact Phone or Mobile Number(Required)

Contractor Email(Required)

All employer notifications and communication will be sent to this email account. Do not use the site attendees email.

Inductee Name(Required)

Please fill the Inductee's name as per their Driver's Licence

Prefix First Middle Last

Date of Birth(Required)

Inductee Phone Number(Required)

Inductee Email(Required)

Job Title(Required)

Has the worker previously held a DBCT proximity card?(Required)

Yes

Does the worker hold a current MSIC card?(Required)

Yes

Site access start date(Required)

Principal tasks to be performed on site(Required)

Is the work to be performed involve electrical work by an electrical licence holder?

Yes

DBCT Supervisor

DBCT Supervisor Name(Required)