MSTS Course Registration Form + Pre-Course + Acknowledgement

MSTS Course Registration Form

Please complete this form prior to your course date. RTO 50343
Course Name*
Course Date*

DayMonthYear
ENTER YOUR COURSE DATE
MandurahPort HedlandOther
Learners Name*

First NameMiddle NameLast Name
First Name:*
Middle Name:
Last Name:*
Birth Date*

DayMonthYear
Gender*
She/HerHe/HimThey/ThemName OnlyPrefer not to discloseNot Listed (please specify):
Residential Address*

Street Address

Street Address Line 2

CityState

PostCodeCountry
Postal Address - If different to above

Street Address or PO BOX

Street Address Line 2

CityState

PostCode
Mobile Number*
Format: 0000 000 000.
E-Mail*
example@example.com.au
USI - Unique Student Identifier*
You will require a USI - Unique Student Identifier - visit https://www.usi.gov.au/ Please Note: This is not your School/Tafe number.
Employer
Emergency Contact Details*

NameRelationship to youContact Number
AustraliaOther
No, English onlyYes, please specify
NoYes, AboriginalYes, Torres Strait IslanderI prefer not to say
NoYes, if so, please select from the below:VisionHearing/DeafPhysicalMedical ConditionLearningIntellectualMental IllnessAcquired Brain ImpairmentOther
If you selected ‘Yes’ above, please let us know anything you’d like your trainer to understand so we can better support your learning journey with MSTS.
Your response is confidential, and will only be shared with the relevant staff who need to be aware
Year 8 or equivalentYear 9 or equivalentYear 10 or equivalentYear 11 or equivalentYear 12 or equivalentNever attended school
YesNo
Certificate ICertificate IICertificate III (or Trade Certificate)Certificate IV (or Advanced Certificate/Technician)Diploma (or Associate Diploma)Advanced Diploma or Associate DegreeBachelor degree or Higher degreeCertificates other than the aboveN/A
Full-Time Employee (more than 35 hours per week)Part-Time Employee (less than 35 hours per week)Casual EmployeeSelf Employed - Not employing othersEmployed - unpaid worker in a family businessUnemployed - seeking Part-Time workUnemployed - seeking Full-Time workNot Employed - Not Seeking EmploymentI am an Employer
Traineeship/ApprenticeshipTo get a jobTo get a better job or promotionIt was a requirement of my jobI wanted extra skills for my jobTo get into another course or studyFor personal interest or self-developmentTo try for a different careerTo develop my existing businessTo start my own businessOther reasons
I declare that the information I have provided to the best of my knowledge is true and correct.

I understand that my RTO Mandurah Safety and Training Services (MSTS) are required to submit data sourced from this enrolment form to the National Centre for Vocational Education Research Ltd (NCVER) as a regulatory reporting requirement. The information contained on my enrolment form may be used by my RTO or the following third parties, for administrative, regulatory and/or research purposes:
- School – if I am a secondary student undertaking VET, including a school-based apprenticeship or traineeship.
- Employer – if I am enrolled in training paid by my employer.
- Government departments and authorised agencies.
- NCVER.
- Organisations conducting student surveys.
- Researchers.
You may receive an NCVER student survey which may be administered by an NCVER employee, agent or third party contractor. Please note you may opt out of the survey at the time of being contacted.
I chose to OPT OUT of this marketing and usage consent
I acknowledge that the information being collected on this form is required by the Australian Government, and that I cannot be awarded any course qualifications until it has been fully completed and provided to MSTS.
PRE-COURSE QUESTIONNAIRE

In relation to the course you are currently enrolled in:
Do you have any prior experience in performing tasks or operating the machinery relevant to this course?*
If Yes, please provide details of your experience, including:
The type of work performed:
Specific duties or responsibilities:
How these relate to the learning outcomes outlined in the course handout (the handout is attached to your booking email):
LEARNER ACKNOWLEDGEMENT

Learners are to indicate that you have read and understood important information about your enrolled training course. Please read the MSTS Code of Practice that is available on our website for the details listed below.
Payments, Refunds and CancellationsRights and ResponsibilitiesComplaints and Appeals ProcessLearner SupportNot Yet CompetentPrivacy
By signing this form you also acknowledge that MSTS does not guarantee that attendance alone on this training course will lead to issuance of a Statement of Attainment.

Fulfillment of a Statement of Attainment is only if you are deemed competent by an MSTS Trainer/Assessor in the applicable assessment instruments.
Enter your FULL NAME to acknowledge the above:*
Parental/Guardian Consent is required for all students under the age of 18.
Parental/Guardian - Enter Your full name
Photos & Social Media

We love sharing what our students are up to! Sometimes we take photos during training to post on our social media pages and website.

Please let us know what you are comfortable with:
Consent is completely your choice.*
YesNo
YesNo
Thank you, we will see you soon at MSTS.
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