STUDENT ENROLMENT APPLICATION RTO

STUDENT ENROLMENT APPLICATION

Student Pack Cat c - V1.3 July 2022 - Gold Coast Pistol Club Ltd - RTO 45819
To complete this form you must have a UNIQUE STUDENT IDENTIFIER (USI)

If you do not have one yet please follow this link and follow the prompts:

https://www.usi.gov.au/students/get-a-usi

1. STUDENT DETAILS
Name*

SurnameGiven names
Title*
Gender*
Birth Date*

MonthDayYear
Email Address*

Confirmation Emailtwice entry will help to ensure your address is correct
Home Phone
Mobile Phone*

3. UNIQUE STUDENT IDENTIFIER (USI)
USI No:*
4. CULTURAL DIVERSITY AND CITIZENSHIP
Are you of Aboriginal or Torres Strait Islander Origin?*

NoYes AboriginalYes - Torres Strait Islander
Are you an Australian or New Zealand citizen?*

YesNo
What country were you born in?

5. EMPLOYMENT STATUS
Please tick your most appropriate employment status:*

Full Time employeeEmployed - unpaid worker in family businessPart time employeeUnemployed - seeking full time workSelf-employed (not employing others)Unemployed - seeking part time workEmployerUnemployed - not seeking employment

9. REASON FOR STUDY
To get a better jobIt was a requirement of my jobTo develop my existing businessTo try for a different careerTo start my own businessFor personal interest or self-developmentI want extra skills for my jobOther

11. MARKETING AND IMAGES
How did you hear about us?*

Existing ClientConsultantInternetEmployerOther
GCPC may from time to time send you details about future training opportunities or offers. , please indicate below.*

I DO NOT wish to be contactedI DO wish to be contacted
During training, photos or footage may be taken of you. Do you give GCPC permission to use these photos or footage for such things as improving training resources, promotional documents and reports?*

YesNo

12. STUDENT DECLARATION

By signing this form, I certify that the information provided is true and correct.

I further certify that:

I have reviewed the Learner Handbook supplied to me and have been informed about and accept my rights and obligations.

I have reviewed and accept the Schedule of Fees and Payments and have been informed of the refund policy.

I have reviewed the Course Brochure and have been informed of and accept the training and assessment services to be provided and the units of competency to be completed

I have reviewed the National VET Data Privacy Policy Notice provided in the Learner Handbook and acknowledge that Commonwealth and State or Territory government departments and authorised agencies will use my personal information in accordance with this notice.
Signature*

Clear
Date*

DayMonthYear
Date
RTO use only:
Is learner support indicated?

YesNo
Referred to:
Details entered into system?Enrolment confirmation sent?Has Payment been received
Amount paid
Receipt no.
USI verified?

YesNo
Training scheduled to commence on the following date

DayMonthYear
Date
Notes:
Full Name
Date

MonthDayYear
Date
Student Pack Cat c - V1.3 July 2022 - Gold Coast Pistol Club Ltd - RTO 45819
Should be Empty: