EmailMe Form - Introduction to Surface Diamond Driller

Participant Information

Full Name

First Last

Phone Number

### - ### - ####

Email Address

Mailing Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Emergency Contact

Name

First Last

Relationship

Phone Number

### - ### - ####

Program Commitment

I understand this program will require weekends, some evenings, and a total commitment of 17 days, running from November 13, 2026, to November 29, 2026.

Program Length: 13 days (including 3.5 days of field training) Daily Schedule: 8:00 a.m. to 6:30 p.m.

Yes, I can commit to these times

Experience & Background

Do you have prior drilling or mining experience?

Yes

No

If yes, please describe:

Why do you want to take this program? Please explain:

Payment & Funding

Do you have First Aid?

Yes

No

If not, First Aid training will be provided.

Health & Safety

Are you applying through a funding program (e.g., Skills Development, employer sponsorship)?

Yes

No

Motivation

Relevant Certifications (if any):

I understand the cost of the program is $5,500 plus applicable taxes. If accepted into the program, I agree to pay 50% of the program fee upon acceptance, with the remaining balance due by November 6th, 2026.

Yes, I understand and agree to these payment terms.