STUDENT ENROLMENT FORM

    Personal Details

    * Required fields

    Passport number *

    Passport Expiry Date *

    Country of birth *

    Visa Number

    Visa Expiry Date

    Nationality

    First Name *

    Middle Name

    Surname *

    Date of birth *

    Title ( Mr /Mrs / Miss /Ms /Dr )

    Home phone

    Work phone

    Mobile *

    Unique Student Identifier (USI), If known

    What is the address of your usual residence?

    Building/ property name

    Flat/unit details *

    Street or Lot Number *

    Street name *

    Suburb, locality or town *

    State/Territory (If applicable) *

    Postcode *

    Country *

    Postal address same as the above?


    If yes, please make sure the required address fields are filled up

    What is your postal address (if different from above)?

    Building/ property name

    Flat/unit details *

    Street or Lot Number *

    Street name *

    Suburb, locality or town *

    State/Territory (If applicable) *

    Postcode *

    Country *

    Visa Details - not applicable for Australian Citizens and Permanent Residents

    Do you already have an Australian Visa that allows you to study here?

    If yes, what type of visa?

    Enrolment Details

    Qualification/Course

    Please select your Additional Study Interest below:

    Preferred start date:


    Delivery mode: (If applicable)

    General Information

    1. Gender

    2. Do you speak a language other than English at home?
    If more than one language, indicate the one that is spoken most
    often

    If yes please specify:

    3. How well do you speak English?

    4. Have you completed a test of English Language Proficiency?

    If other please specify:

    When:

    Score:

    5. Are you of Aboriginal or Torres Strait Islander origin?

    6. Do you consider yourself to have a disability, impairment or long-term condition?

    If yes, please indicate the area of disability, impairment or long-term condition. (Tick as many as apply)


    If other please specify:

    7. What is your highest COMPLETED school level (tick one box only)

    8. In which YEAR did you complete that school level?

    9. Are you still attending secondary school?

    Previous qualifications

    10. Have you SUCCESSFULLY completed any of the following qualifications?

    If YES, then tick ANY applicable boxes (you may indicate more than one)

    Please list any qualifications you have completed and the year of completion.

    11. Do you wish to apply for Course Credit? If YES, certified copies of transcripts from previous qualifications must be provided with this form.

    12. Do you wish to apply for Recognition of Prior Learning?
    If you indicate yes, you will be contacted to discuss this further

    Overseas Student Health Cover (OSHC) - not applicable for Australian Citizens and Permanent Residents

    No. of months required to cover

    Employment

    Of the following categories, which BEST describes your current employment status? (tick one box only)

    Study Reason

    Of the following categories, which BEST describes your main reason for undertaking this course?

    Employment Details- if applicable

    Employer’s legal name

    Your position

    Business address

    Postcode

    Postal address: (if different from above)

    Postcode

    Phone

    Email

    Fax

    Supervisor

    Position

    Next of kin/emergency contact

    Name *

    Relationship to you *

    Address

    Email *

    Home phone

    Work phone

    Mobile *

    Application Checklist – Provide a copy of the following documents with your application (you will need to bring the originals to your orientation day for verification):

    Valid visa (if you have one)

    High School certificate or other relevant certificates

    Passport copy/ Identification Card

    Proof of English Language Proficiency

    Any other relevant documents to support your application e.g. resume

    Agreement

    In signing this Enrolment Form you agree:

    • That the information you have provided on this form is true, correct and complete
    • That you have been provided with appropriate and sufficient information to make an informed
      decision about your enrolment in this course.
    • That you have read and understood RTO’s Information Privacy Policy
    • That you have been provided with detailed information about the fees and charges associated with your course enrolment including information on tuition fees, administration fees, materials fees, payment terms and the applicable Refund Policy.
    • To provide RTO with up to date and accurate contact details and notify them if anything changes
    • To be bound by RTO’s Student Code of Conduct, and other student policies and procedures as well
      as National and State legislation and regulations including any variations that are made from time to
      time.

    Student Signature:

    Draw signature below

    Printed Name:

    Date: