Cert IV Allied Health Assistance EOI

1
Completing this EOI

Complete all parts of this EOI. Incomplete EOIs will not be processed.

The application has three sections:

Contact information of the student;

Contact information of the student's parent or guardian;

Contact information for the school staff member responsible for the student whilst they are training with RuralMeded.
2
Contact Information - Student* This field is required.Please provide contact information for the Student
First Name
Surname
Mobile Number
Email address
3
Contact Information - Parent/Guardian* This field is required.Please provide contact information for the Student's Parent/Guardian
First Name
Surname
Mobile Number
Email Address
4
Contact Information - School Contact* This field is required.Please provide contact information for the Student's School Contact
First Name
Surname
Mobile Number
Email Address
5
Confirmation of expression of interest* This field is required.
6
Privacy* This field is required.
7
Signature of parent or guardian to confirm their consent to begin the enrolment process for the studentPlease complete this EOI by signing
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Completing this EOI