Enrolment Form

Course Details

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What course do you wish to study?*

Mode of Study*

Have you previously completed any qualifications?*

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Learner Details

Full Name*

Email Address*

Phone*

Date of Birth*

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Month

Year

Town/City of Birth

Country of Birth

Home Address*

Unique Student Identifier (USI)*

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What is your employment status?

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Are you an Aboriginal or Torres Strait Islander?*

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Is English your first language*

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Emergency Contact Details

Emergency Contact Name*

Emergency Contact Phone*

Do you have any medical conditions we need to be aware of?*

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