How to Enrol

	Please complete the form below, accept the Terms and Conditions and press the Submit button. By accepting the Terms and Conditions and submitting this form you agree that you may be contacted by the Department of Education and Training and asked to participate in one or more surveys about this training program.


	Student Enrolment Form

	Course to enrol: *
	Funding: *

	Name: *
	Surname: *
	Address: *
	Suburb: *
	State: *
	Post Code: *
	Country: *

	Phone: *	Include Area Code, Ex. 0894503311
	E-mail: *

	Birth Date: *
	Gender: *	Male Female

	Country of Origin: *

	Do you mainly speak english at home? *
		Yes No
	Do you speak a language other than English at home? *
		No, English only Yes, other Please specify
	How well do you speak English? *

	Are you of Aboriginal or Torres Strait Islander origin? *

	Do you consider yourself to have a disability, imapairment or long term condition? *
		No Yes Please indicate the areas of disability below
		Hearing/Deaf Physical Intellectual Learning Mental Illness Aquired brain impairment Vision Medical condition Other
	What is your highest completed school year? *

	In which year did you complete that school level? *

	Are you still attending secondary school? *
		No Yes
	Have you successfully completed any of the following qualifications? *
		No Yes Please indicate below
		Bachelor Degree or higher Advanced Diploma or Associate Degree Diploma (or Associated Diploma) Certificate IV (or Advanced Certificate/Technician) Certificate III (or Trade Certificate) Certificate II Certificate I Pre-Apprenticeship/Pre-Vocational Certificates other than the above
	Which best describes your current employment status? *

	What is your main reason for undertaking this course/traineeship/apprenticeship? *

	Do you accept the Terms and Conditions? *
		YES

		() All fields are mandatory.*