Enrolment Application Simply fill out the below form to apply for enrolment 1. Course to be enrolled in Course Commencement Date Course 2. Personal Details Title (Mr, Miss, Mrs, Other) MrMissMsMrsOther Sex Male Female Surname (Family Name) Given Name (Legal Name) Preferred Name Address Suburb State Post Code Contact Number Email Address Emergency Contact Emergency Contact Number Relationship to You ( e.g. Mother, Friend ) 3. Residence Number Street Address Suburb State Post Code 4. Postal Address (if different from residential address) Details 5. Employment Section 1 Are you currently employed Yes No (Go to section 2) Employment Status Full TimePart TimeCasualVolunteer Employer Employer Address Employer Suburb Employer State Employer Postcode 6. Do you have any medical condition we should be aware of? YesNo Please list any relevant workshops, courses you have attended Details Privacy statement & student declaration I understand that: CONSENT FOR PUBLICATION OF PHOTOGRAPHS AND STUDENT WORK From time to time, photographs or video tapes of students and their learning are taken in a classroom or at places where the student is involved in an activity. These photo/s/images/videos may be used in a classroom or on the job work activities or could be published by THE RTO in documents, newsletters, displays, journals, professional development materials for trainers and teachers or on the THE RTO website. In addition some outstanding student work may be also published. CONSENT/AUTHORITY TO RELEASE INFORMATION AND VIEW DOCUMENTS (In accordance with the Privacy Act 1988, which incorporates the Privacy Amendment (Private Sector) Act 2000) while you are undertaking your training program, there may be times when The RTO and/or its Training Representative, will need to discuss your situation with others. This could be with your workplace manager/ supervisor, employer or another trainer. As part of our work theremayl also be a need to observe & examine workplace practices to help assess your work. Please be assured that any discussions held with this representative will be for the purposes of your assessment and for your skills development. During the process we do not plan to discuss your evidence or work practices with other trainees, unless we have your written permission to do so. You are required to give permission in writing for any of these discussions or viewing of evidence to occur.