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Student Enrolment Form
Student Enrolment form
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Step
1
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Personal Details
Title
*
Mr
Mrs.
Ms.
Miss
Other:
Name
*
First
Middle
Last
Maiden Name (if applicable)
Date of Birth
*
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1925
1924
1923
1922
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1920
Gender
*
Male
Female
Other
Which qualification are you enrolling into?
Certificate II in Business
Certificate III in Business
Certificate III in Business Administration
Certificate IV in Business
Certificate IV in Leadership and Management
Certificate IV in Small Business Management
The Goondiwindi Best in Business Program
Diploma of Business
Diploma of Leadership and Management
Graduate Certificate of Management (Learning)
Graduate Diploma of Strategic Leadership
Certificate II in Hospitality
Certificate III in Hospitality
Certificate III in Commercial Cookery
Certificate IV in Hospitality
Certificate IV in Commercial Cookery
Diploma of Hospitality Management
Certificate II in Tourism
Certificate II in Community Services
Certificate III in Individual Support (Ageing)
Certificate III in Individual Support (Disability)
Certificate III in Individual Support (Home and Community)
Certificate II in Health Support Services
Certificate III in Health Support Services (Food Services)
Certificate IV in Health Administration
Certificate II in Retail Services
Certificate III in Retail
Certificate IV in Retail Management
Workplace Details (if applicable)
Are you currently employed?
*
Yes
No
Company Name
Job Role
Workplace Address
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Manager/Supervisor Name
Employer/Supervisor Email Address
Work Number
Personal Details
Email Address
*
Mobile Number
*
Phone (home)
*
If you do not have a home phone number, please enter your best contact number
Home Address
*
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Is your postal address different to your home address?
*
Yes
No
Postal Address (if different from above)
*
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Province of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Citizenship/Visa Details
Country of Birth
*
City of Birth
*
Are you an Australian or New Zealand citizen/resident?
*
Yes
No
Visa Type
*
Student Visa
Temporary Resident Visa
Business Visa
Permanent Humanitarian Visa
Holiday Visa
No Visa or Citizenship
Visitor's Visa
Other Visa
Other Visa (please specify)
*
Visa Number
*
Passport Number
*
Indigenous Status
*
Yes, Aboriginal
Yes, Aboriginal and Torres Strait Islander
Yes, Torres Strait Islander
No, neither Aboriginal or Torres Strait Islander
Next
Employment Status
*
Full-time Employee
Full-time Employee
Employed – unpaid worker in a family business
Part-time Employee
Self-employed – employing others
Unemployed – Seeking full-time work
Unemployed – Seeking part-time work
Unemployed – Not seeking employment
What language do you speak most often?
*
Do you require English Assistance?
*
Yes
No
Proficiency in spoken English
*
Very Well
Well
Not Well
Not at All
Schooling
If you are currently enrolled in secondary education, the Highest school level completed refers to the highest school level you have completed and not the level you are currently undertaking. For example, if you are currently in Year 10, the highest school level completed is Year 9.
Highest Level of Secondary Schooling completed
*
Never Attended School
Year 8 or below
Year 9 or equivalent
Year 10 or equivalent
Year 11 or equivalent
Year 12 or equivalent
Year of highest level of secondary school completed: (e.g. 1996)
*
Are you currently attending secondary school?
*
Yes
No
Name of school you are currently attending
*
Do you hold any Qualifications? (E.g. Certificate III, IV, Diploma, Bachelor. Masters etc.)
*
Yes
No
Qualification Level(s)
*
Certificate I
Diploma
Certificate II
Advanced Diploma or Associate degree
Certificate III
Bachelor's degree
Certificate IV
Master's degree or higher
Qualification Recognition
*
Australian Qualification
Australian Equivalent Qualification
International Qualification
Other
Recognition of Prior Learning
Are you intersted in RPL? (Recognition of Prior Learning)
*
Yes
No
Approximately, how many years/months experience do you have?
*
Experience is in relation to the vocation of your qualification you are enrolling into. E.g. Individual Support (Aged Care) or Hospitality
Disability Status
Do you consider that you have a disability, impairment / long term condition that may affect your participation in the course?
*
Yes
No
Disability, Impairment, or long-term condition
Hearing / Deafness
Physical
Medical Condition
Vision
Intellectual
Mental Illness
Acquired Brain Impairment
Learning
Not Specified
Other
Next
We are required, by law, to verify your Unique Student Identifier (USI) upon enrolment
We are required, by law, to verify your Unique Student Identifier (USI) upon enrolment
What is your USI? ( Unique Student Identifier)
We are required, by law, to verify your Unique Student Identifier (USI) upon enrolment From 1 January 2015, we College Australia can be prevented from issuing you with a nationally recognised VET qualification or statement of attainment when you complete your course if you do not have a Unique Student Identifier (USI). In addition, we are required to include your USI in the data we submit to NCVER. If you have not yet obtained a USI you can apply for it directly at https://www.usi.gov.au/students/create-your-usi/ on computer or mobile device. Enter your Unique Student Identifier (USI) below (if you already have one). You may already have a USI if you have done any nationally recognised training, which could include training at work, completing a first aid course or RSA (Responsible Service of Alcohol) course, getting a white card, or studying at a TAFE or training organisation. It is important that you try to find out whether you already have a USI before attempting to create a new one. You should not have more than one USI. To check if you already have a USI, use the ‘Forgotten USI’ link on the USI website at https://www.usi.gov.au/faqs/i-have-forgotten-my-usi/
Your USI
*
I authorise Real Group to create or obtain a USI on my behalf.
(If you do not have a USI, please complete these details) Town/City of Birth
(please write the name of the Australian or overseas town or city where you were born) If you would like us Real Group to apply for a USI on your behalf you must authorise us to do so and declare that you have read the privacy information at: http://www.usi.gov.au/Documents/Student-Identifiers-Registrar-privacy-policy-v1.1.pdf
I have read and I consent to the collection, use and disclosure of my personal information (which may include sensitive information) pursuant to the information detailed at https://www.usi.gov.au/documents/privacy-notice-when-rto-applies-their-behalf.
In accordance with section 11 of the Student Identifiers Act 2014, College Australia will securely destroy personal information which we collect from individuals solely for the purpose of applying for a USI on their behalf as soon as practicable after we have made the application or the information is no longer needed for that purpose.
LUI (QLD School Students Only)
Learner Unique Identifier - usually located on your school ID. Please leave blank if not applicable to you.
Emergency Contact Details
Contact Name
*
Contact Number
*
Relationship
*
Email
*
Qualification / Course Details
Which of the following statements best describes your reason for enrolling in this course?
Personal Interest or self-development
To start my own business
To get a job
To develop my existing business
To get a better job or promotion
To try another career
I want extra skills for my job
Meet CPD / licence / vocational requirements
Requirement of my job
To gain a qualification
To get skills for community/voluntary work
To get into another course of study
Fees
Do you hold a concessional Card? (E.g. Pensioner or Health Care Card)
*
Yes
No
Who is responsible for arranging payment for your enrolment?
*
Self
Employer
Other
• Invoices/receipts will be raised and sent within 7 days of enrolment date. • Payment must be made before commencement of course. • The course fees are payable immediately. If applicable. • Cancellation fees may apply, refer to refund policy.
Do you require a payment plan?
*
Yes (student services will contact you for further information)
No
Section Marketing Feedback
How did you hear about us?
Email received
Job Services Agency
Advertisement
My Skills
Internet Search
Employer
Word of mouth
I am a Past Student
Other
Please provide how you heard about us below
File Upload
Click or drag files to this area to upload.
You can upload up to 99 files.
If possible, please provide forms of identification - such as Driver licence, Medicare Card, Concessional Card etc. If you are unable to provide these at this point in time, please email a clear, coloured photograph of your identification to info@collegeaustralia.edu.au
Signature
*
Clear Signature
By signing this form, I agree that all the information provided is true and correct and any untrue information may delay my enrolment process.
Submit
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