Enrolment Form
1. Course *
2. Products *
3. Start Month? *
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4. How did you find us? *
Personal Details
5. Family Name (Surname) *
Your answer
6. Given Name *
Your answer
7. Birth Date *
MM
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YYYY
8. Gender *
9. Email Address *
Your answer
10. Phone Number (10 Digits exactly) *
Your answer
11. Unique Student Identifier (USI) *
Your answer
Don’t have a USI yet? You need one to enrol so click here and follow the prompts: https://www.usi.gov.au/students/create-your-usi
Residential Address
12. Building/Property Name
Your answer
13. Flat/Unit Number/Street Number *
Your answer
14. Street Name *
Your answer
15. PO Box or Roadside Delivery Box
Your answer
16. Suburb, Locality, or Town *
Your answer
17. State/Territory *
18. Postcode *
Your answer
19. Country *
Postal Address
Same as Residential?
20. Building/Property Name
Your answer
21. Flat/Unit Number/Street Number
Your answer
22. Street Name
Your answer
23. PO Box or Roadside Delivery Box
Your answer
24. Suburb, Locality, or Town
Your answer
25. State/Territory
26. Postcode
Your answer
27. Country
Language and Cultural Diversity
28. Where were you born? *
29. What language do you prefer to speak? *
30. How well do you speak English? *
31. Are you of Aboriginal or Torres Strait Islander origin? *
Disability
32. Do you consider yourself to have a disability, impairment or long-term condition? *
If YES, then please indicate the areas of disability, impairment or long-term condition: (You may indicate more than one area.)
Support
33. Is there anything related to your learning that you would like support with? *
Schooling
34. What is the highest level of school you have SUCCESSFULLY completed? *
35. In which YEAR did you complete that school level? *
36. Are you still attending secondary school? *
Previous Qualifications Achieved
37. Have you SUCCESSFULLY completed any of the following qualifications? *
Required
Employment
38. Of the following categories, which BEST describes your current employment status? *
If you are working, what organisation do you work for?
Your answer
Reason for Study
39. Of the following categories, which BEST describes your main reason for undertaking this course/traineeship/apprenticeship? *
Other Details
40. Would you like to do a short evaluation of your literacy & numeracy skills before starting the course?
41. Would you like further information about Recognition of Prior Learning/Credit Transfer for this course?
Testimonials
42. I give permission for any testimonial comments to be used for marketing purposes for 12 months following my completion of the course *
43. Print advertising *
44. Online advertising *
Want to sign up to Total Management Training eNews to keep up to date with what’s happening safety and training? *
Payment Options
Partner Organisation will be in contact with you directly to confirm your payment options?
45. I would like the invoice to be made out to *
46. I would like the invoice to be emailed to *
Terms and Conditions
I am aware that this qualification is being delivered in partnership, with credentials being issued by Fortress Learning RTO # 31974.

I have completed the Suitability Self-Assessment and am satisfied that this program of study is suitable for me and that I have access to the resources and environments that it will require. https://fortresslearning.com.au/how-to-enrol/suitability-self-assessment-partners/

I acknowledge that I have read, understood and accept the fees associated with commencing, extending and withdrawing from this course, as outlined in the handbook.

I acknowledge that I have read the Student Handbook and am aware of my rights and obligations.

I declare that the information I have provided to the best of my knowledge is true and correct.

I understand that Fortress Learning is required to submit data sourced from this enrolment form to the National Centre for Vocational Education Research Ltd (NCVER) as a regulatory reporting requirement. The information contained on my enrolment form may be used or the following third parties for administrative, regulatory and/or research purposes:

• School – if I am a secondary student undertaking VET, including a school-based
apprenticeship or traineeship.

• Employer – if I am enrolled in training paid by my employer.

• Government departments and authorised agencies.

• NCVER.

• Organisations conducting student surveys.

• Researchers.

You may receive an NCVER student survey which may be administered by an NCVER employee, agent or third party contractor. Please note you may opt out of the survey at the time of being contacted.

*Parental/guardian consent is required for all students under the age of 18.

NCVER will use, secure, disclose, and retain your data in accordance with the VET Data Protocol and all NCVER policies and protocols (including those published on NCVER’s website at www.ncver.edu.au).

Acknowledgement
I have read all the terms and conditions above. I fully understand each and every item. I agree to all terms and conditions. *
Required
Signature
Name *
Your answer
Date Signed *
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16 February 2018 | V1
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