ACFE Registration and Enrolment - All Abilities Creative Writing Only

Learn Local Short Course Registration

Thank you for choosing to enrol in one of our short courses, Creative Writing for People with a Disability.

As a Learn Local provider funded by the Adult Community and Further Education Board, we’re required to collect some additional information as part of the enrolment process. This helps us meet funding requirements and continue offering affordable community courses.

We understand there are quite a few questions — please don’t feel overwhelmed. If you’re unsure about anything, we’re happy to help.

📞 Call us on 9876 4381 during business hours
📧 Email enrol@parkorchards.org.au

Once you submit this form, a staff member will be in touch to confirm your enrolment.
Is your course sold out? Click here to go to our Waitlist form instead!
To qualify for a funded place, you must be over 18, an Australian citizen, Permanent resident, New Zealand citizen or part of Asylum Seeker VET program and complete all required paperwork provided.*

I confirm I meet the above requirements.I do not meet the above requirements.
It looks as though you do not meet the funding requirements.

You may still be able to attend this course at a non-funded fee, please contact the office on 9876 4381 or email us at enrol@parkorchards.org.au to discuss with a member of staff.
1. Family Name:*
Given Name:*
Middle Name:
Preferred Name: (optional)
Town/City of birth:*
2. Date of Birth:*

DayMonthYear
Date
3. Gender:*

F FemaleM MaleX Indeterminate/Intersex/Unspecified
4. Mobile Phone*
Email:*
example@example.com
5. House Number and Street Name: (e.g.: 572 Park Road) *
e.g.: 572 Park Road
Suburb:*
State:*
Postcode:*
6. Postal Address (if different from above):
Suburb:
State:
Postcode:
Emergency Contact's Name:*
Emergency Contact's Phone Number:*
Emergency Contact Relationship:
Course Name:
Concession

Concession rates apply for holders of a Pensioner Concession Card, Commonwealth Health Care Card and/or Veterans Gold Card (pictured below). Additionally, if you are a dependent spouse or dependent child of a card holder you may be eligible for a concession rate.
*A copy of the concession card is required at enrolment. Please send a picture of the card to enrol@parkorchards.org.au upon enrolment if you claim concession. We do not store any information regarding the card, one sighted it is deleted from our server.
Are you claiming a concession? (A copy of the concession card is required at enrolment)*

YesNo
What type of concession card do you have?*

Asylum SeekerHealth Care CardPensioner Concession CardVeterans Gold CardAny dependent spouse or dependent child of one of the above cardholders
Name on Concession Card*
Language and Cultural Diversity
7. In which country were you born?*

AustraliaOther
8. Do you speak a language other than English at home?(If more than one language, indicate the one that is spoken most often)*

No, English OnlyOther
9. Are you of Aboriginal or Torres Strait Islander origin? (For persons of both Aboriginal and Torres Strait Islander origin, mark both ‘Yes’ boxes.)*

NoYes, AboriginalYes, Torres Strait Islander
10. Do you consider yourself to have a disability, impairment or long-term condition? No – Go to Question 12*

YesNo
11. If yes, please indicate the areas of disability, impairment or long-term condition:(You may indicate more than one area.)

Hearing/deafPhysicalIntellectualLearningAcquired brain impairmentVisionMedical conditionMental Health ConditionOther
Schooling
12. What is your highest COMPLETED school level? (Tick ONE box only) If you never attended school – Go to Question 14*

Completed Year 12Completed Year 11Completed Year 10Completed Year 9 or equivalentCompleted Year 8 or lowerNever attended school
13. Are you still attending secondary school?*

YesNo
Previous Qualifications Achieved

14. Have you SUCCESSFULLY completed any of the qualifications listed in question 15? Yes - go to question 15. No- go to question 16.
Bachelor’s degree or Higher Degree

Yes
If Yes, where did you complete your course

AustraliaInternational, and recognised as Equivalent to AustralianInternational
Advanced Diploma or Associate Degree

Yes
If Yes, where did you complete your course

AustraliaInternational, and recognised as Equivalent to AustralianInternational
Diploma or Associate Diploma

Yes
If Yes, where did you complete your course

AustraliaInternational, and recognised as Equivalent to AustralianInternational
Cert. IV or advanced. Certificate/Technician I

Yes
If Yes, where did you complete your course

AustraliaInternational, and recognised as Equivalent to AustralianInternational
Certificate III or Trade Certificate

Yes
If Yes, where did you complete your course

AustraliaInternational, and recognised as Equivalent to AustralianInternational
Certificate II

Yes
If Yes, where did you complete your course

AustraliaInternational, and recognised as Equivalent to AustralianInternational
Certificate

Yes
If Yes, where did you complete your course

AustraliaInternational, and recognised as Equivalent to AustralianInternational
Certificates other than above

Yes
If Yes, where did you complete your course

AustraliaInternational, and recognised as Equivalent to AustralianInternational
Employment
16. Of the following categories, which BEST describes your current employment status? (Tick ONE box only)*

01 - Full-time employee02 - Part-time employee03 - Self-employed - not employing others04 - Self-employed - employing others05 - Employed - unpaid worker in a family business06 - Unemployed - seeking full-time work07 - Unemployed - seeking part-time work08 - Not employed - not seeking employment
17. Which of the following classifications BEST describes your current or recent occupation? (Tick ONE box only)If never employed go to Question 19.

1 - Managers2 - Professionals3 - Technicians and Trade Workers4 - Community and Personal Service Workers5 - Clerical and Administrative Workers6 - Sales Workers7 - Machinery Operators and Drivers8 – Labourers9 - Other
18. Which of the following classifications BEST describes the industry of your current or previous Employer?

Agriculture, Forestry and FishingMiningManufacturingElectricity, Gas, Water and Waste ServicesConstructionWholesale TradeRetail TradeAccommodation and Food ServicesInformation Media and telecommunicationsTransport, Postal and WarehousingRental, Hiring and real Estate ServicesProfessional, Scientific and Technical ServicesAdministrative and Support ServicesPublic Administration and SafetyEducation and TrainingHealth Care and Social AssistanceArts and recreation ServicesFinancial and Insurance ServicesOther
19. Of the following categories, which BEST describes your main reason for undertaking this course? (Tick ONE box only)*

To get a jobIt is a requirement of my jobI want extra skills for my jobTo get a better job or promotionTo try for a different careerTo develop my existing businessTo start my own businessTo get into another course of studyFor personal interest or self-developmentTo get skills for community/voluntary workOther reasons
19. Cohort*

Asylum seekerHead start apprentice/traineeLearner facing financial stressRetrenched workerWoman returning to workA learner with literacy, numeracy, and digital literacy needsJobs Victoria Employment Network ClientReconnect program studentVeteranNo specific cohort
Photo Release
Do you consent to Park Orchards Community House & Learning Centre Inc. publishing photos of yourself for the purpose of marketing and advertising?*

YesNo
Feedback
Where Did You Find Out About This Course?*
Tell us more about why you have chosen this course
What inspired you to enrol in this course?*
What specific skills are you hoping to develop in this course?*
How do you plan to apply what you learn in this course?*
Select any of the skills listed below you would like to improve.*

Self-management (Taking responsibility, organising self)Learning (Learning new things, learning how to do newthings)Teamwork (Connecting and working with others for a sharedgoal)Planning and organising (Making decisions, organising things and people to achieve an outcome)Problem-solving (Working out ways to do things for an outcome)Initiative and enterprise (Trying new things, being creative, following up ideasfor an outcome)
Your Digital Skills

You have enrolled in a course that uses technology. Please choose the answer that best matches your current skills and confidence. There are no right or wrong answers, it just helps us understand how to best support you!
How confident are you using a laptop or desktop computer?*

I’m just getting started.I can do this with some help.I can just about do this on my own.I feel very confident doing this.
How confident are you using a tablet? (for example, an iPad)*

I’m just getting started.I can do this with some help.I can just about do this on my own.I feel very confident doing this.
How confident are you using a smartphone? (a mobile phone)*

I’m just getting started.I can do this with some help.I can just about do this on my own.I feel very confident doing this.
How confident are you finding information online (for example, using Google)?*

I’m just getting started.I can do this with some help.I can just about do this on my own.I feel very confident doing this.
How confident are you checking if information online is true and reliable?*

I’m just getting started.I can do this with some help.I can just about do this on my own.I feel very confident doing this.
How confident are you saving files like photos, documents or videos?*

I’m just getting started.I can do this with some help.I can just about do this on my own.I feel very confident doing this.
How confident are you finding files you have saved before?*

I’m just getting started.I can do this with some help.I can just about do this on my own.I feel very confident doing this.
Victorian Government VET Student Enrolment Privacy Notice

Please read, accept sign and date the attached Victorian Government VET Student Enrolment Privacy Notice and Student Declaration and Consent.
Signature*
DATE*

DayMonthYear
Date
If Student is under 18

PARENT/GUARDIAN SIGNATURE [or electronic acknowledgement]* *Parental/guardian consent is required for all students under the age of 18.
Signature
DATE

DayMonthYear
Date
EVIDENCE OF ELIGIBILITY AND STUDENT DECLARATION FORM

STUDENT SCHOOL ATTENDANCE STATUS DECLARATION

STUDENT DECLARATION
In seeking to enrol in one or more pre-accredited modules with this Learn Local provider, declare the following to be true and accurate statements:

• I AM NOT enrolled in a school, including government, non-government, independent, Catholic or home school, and:

• I am aged 17 years of age or over, or

• I am under 17 years of age and have provided Evidence of Exemption by a school principal or the Department of Education and Training Regional Director.

• I acknowledge and understand that I may be contacted by the Department of Education and Training or their agent to participate in a survey, interview or other questionnaire
Full Name*
Full Name*
Signature*
Date*

DayMonthYear
Date
Would you like to stay in the loop?*

Yes, please send me helpful reminders about courses, news and opportunities (email/SMS).No thanks, I don’t want to receive marketing messages(please note you will still receive communication about current enrolments).
Should be Empty:

It looks as though you do not meet the funding requirements.

Concession

Language and Cultural Diversity

Schooling

Previous Qualifications Achieved

Employment

Photo Release

Feedback

Tell us more about why you have chosen this course

Your Digital Skills

Victorian Government VET Student Enrolment Privacy Notice