LifeSafer AU Service Centre Approvals

Business Name *

Owner(s) Name(s)

Owner Name *

Phone Number *

Email Address *

Location Details *

Technician Name(s)

Technician Name *

Details of Qualification *Certificate II in Automotive Electrical TechnologyAutomotive Electrician Tradesperson CertificateEquivalent Interstate Auto Electrical QualificationOther Details of Experience or Qualifications

Other Details of Experience or Qualifications *

Mobile service capability? *YesNo

Please upload the following:

(1) Public Liability Insurance certificate of currency for $5,000,000.00 (2) National Police Clearance for all technicians who will work on vehicles

Upload file *

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