Student Enrolment Form A2 New

Do you speak a language other than English at home?

Yes No (English only)

Please specify:

How well do you speak English?

Are you of Aboriginal or Torres Strait Islander Origin?

No Yes - Aboriginal Yes - Torres Strait Islande

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

Yes No

Please indicate areas of disability, impairment or long-term condition. You may indicate more than one option:

Hearing/Deaf Physical Intellectual Learning Mental Illness Acquired Brain Impairment Vision Medical Condition Other

Emergency Contact Person

If you require any form of additional support or have any special learning needs then please outline below, so that assistance can be provided on the day: (the information provided will be dealt with discretion and in strict confidence only for the purpose for providing additional support during training and assessment by EXELTrain) example - any language, literacy, numeracy issues and or other support.

What is your highest COMPLETED school level?

Are you still enrolled in secondary or senior secondary education?

Have you SUCCESSFULLY completed any of the following qualifications?

Yes No

Bachelor Degree or Higher Degree Advanced Diploma or Associate Degree Diploma (or Associate Diploma) Certificate IV (or advanced Certificate Certificate III (or Trade Certificate) Certificate II Certificate I Certificates other than the above

Of the following categories, which BEST describes your current employment status?

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

I have read and agree with the privacy statement and student declaration I have read and agree to the enrolment privacy notice I have read and agree to the cancellation and refund policy I have read the terms and conditions

Student Declaration and Consent

I declare that the information I have provided to the best of my knowledge is true and correct. I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice.

Parent / Guardian Signature

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

Quick Course Finder

Student Enrolment Form

AVETMISS Information Collection (RTO Compliance Requirement)

Student Declaration and Consent

Electronic Signature

Parent / Guardian Signature