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!
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
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.
YesNo
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
AustraliaOther
No, English OnlyOther
NoYes, AboriginalYes, Torres Strait Islander
YesNo
Hearing/deafPhysicalIntellectualLearningAcquired brain impairmentVisionMedical conditionMental Health ConditionOther
Schooling
Completed Year 12Completed Year 11Completed Year 10Completed Year 9 or equivalentCompleted Year 8 or lowerNever attended 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.
Yes
AustraliaInternational, and recognised as Equivalent to AustralianInternational
Yes
AustraliaInternational, and recognised as Equivalent to AustralianInternational
Yes
AustraliaInternational, and recognised as Equivalent to AustralianInternational
Yes
AustraliaInternational, and recognised as Equivalent to AustralianInternational
Yes
AustraliaInternational, and recognised as Equivalent to AustralianInternational
Yes
AustraliaInternational, and recognised as Equivalent to AustralianInternational
Yes
AustraliaInternational, and recognised as Equivalent to AustralianInternational
Yes
AustraliaInternational, and recognised as Equivalent to AustralianInternational
Employment
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
1 - Managers2 - Professionals3 - Technicians and Trade Workers4 - Community and Personal Service Workers5 - Clerical and Administrative Workers6 - Sales Workers7 - Machinery Operators and Drivers8 – Labourers9 - Other
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
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
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
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?*
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!
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.
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.
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.
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.
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.
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.
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*

Clear
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

Clear
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*

Clear
Date*

DayMonthYear
Date
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