Enrolment form

Course details
Personal details
Name *
Date of birth
Date of birth
Home address
Home address
Employment details
Employer postal address
Employer postal address
Please provide the details of the Point of Contact, within your organisation, to whom we can issue an invoice for this course.
Town and State
Previous qualifications achieved
Have you SUCCESSFULLY completed any of the following qualifications?
If YES, then tick ANY applicable boxes.
(If more than one language, indicate the one that is spoken most often)
Do you consider yourself to have a disability, impairment or long-term condition?
If you indicated the presence of a disability, impairment or long-term condition, please select the area(s) in the following list: (You may indicate more than one area)
Cultural diversity
Are you of Aboriginal or Torres Strait Islander origin?
For persons of both Aboriginal and Torres Strait Islander origin, mark both ‘Yes’ boxes
Unique Student Identifier
From 1 January 2015, all students completing nationally recognised training need to have a Unique Student Identifier (USI).
You can create your own USI at http://www.usi.gov.au/create-your-USI/Pages/default.aspx