Testing form 0 (0) Enrollment Details Course Name (required) Delivery mode * DistanceFace to FaceCombination Is RPL being sought as part of this qualification? If yes, please contact your trainer for further details YesNo Course Commencement Date Your Details First Name * Middle Name* Last Name* Street Address * Suburb * State * Postcode * Mobile * Other Phone Email* Your Gender MaleFemale Date of Birth Unique Student Identifier (USI) Are You* AboriginalTorres Straight IslanderAboriginal Torres Straight IslanderNone Where you born in Australia?* YesNo If no, in which country you born? Is English your first spoken language ? * YesNo Do you speak a language other than English at home? YesNo If yes, what other language do you speak? How well do you speak English? * WellNot wellNot at all Do you have a disability, impairment or long term health condition? YesNo If yes, please advise condition. Do you or your partner/dependant hold a health or pensioner care card with your name on it? * YesNo If yes, please upload a copy of your card. Your Message Password * As part of our commitment to ensuring the privacy of your personal and academic details, please provide us with a password. This password will allow you to access your own student information. Please note that any access by a third party will still require your written consent in each instance. Next to Kin Name * Relationship to you * Mobile phone * Other phone Education details Are you currently attending high school? * YesNo If yes, what year are you in? What is your highest completed school level? * Year 9Year 10Year 11Year 12 Have you successfully completed any of the following qualification levels? Please select all that apply. Certificate ICertificate IIICertificate IVDiplomaAdvanced DiplomaBachelor Degree or higherNone Name of highest qualification? Year completed Have you started but not completed any qualifications? YesNo If yes, please specifyPlease select all that apply. Certificate ICertificate IICertificate IIICertificate IVDiplomaAdvanced Diploma of Association DegreeBachelor Degree or Higher Degree levelMiscellaneous Name of Qualification Year Started Employment status and details Of the following, which best describes your current employment status ? * EmployerFull time employeePart time employeeUnemployed - seeking full time workUnemployed - seeking part time workSelf employed but not employing others If working, how many hours per week do you work? Employer Details Legal Name Trading Name Date employment commenced with Employer Reason For Study What is your main reason for undertaking this course? To get employmentTo change careersJob requirementTo develop existing skillsTo get a better jobPersonal interestTo start my own businessTo get a promotionTo get into another course of study Traineeships/ Apprenticeships only Employer details Please note: applicable for Traineeships/ Apprenticeships only. Business Trading Name Workplace Supervisor Name Street Address Suburb State Postcode Phone Fax Email How did you hear about us? Please select all that apply. FacebookGoogle SearchWord of MouthOther Declaration Student Declaration Declaration * I confirm the accuracy of the information providedI have received and read the Student Information HandbookI have read, understood, and agree to the Refund PolicyI consent to the disclosure of my details by the RTO to government agencies as required under the Training and Employment ActIf doing a post school certificate III qualification under the Queensland Certificate III Guarantee Scheme, I understand I extinguish my entitlement to a subsidised training place once it has been successfully completed Verification Please enter any two digits * By submitting this form, I agree to the information entered being used strictly within the framework of my request. * * These fields are mandatory How useful was this post? Click on a star to rate it! Submit Rating Average rating 0 / 5. Vote count: 0 No votes so far! Be the first to rate this post.