Diploma
enrolment
form

Please fill out the below form to enroll in the Diploma course.

Course Code

Course Name

This course is co-run with Australis College – RTO 31518

Personal Details

(Important - the details given must MATCH details of the ID provided)

Prefix

First Name *

Middle Name *

Last Name *

Date of Birth *

Sex *MaleFemale

City/Town of Birth

Proof of Identification *

No file chosen

Address

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country

Postal Address

(if different from above)

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Telephone and Email

Work phone

Mobile phone

Home Phone

Personal Email

Cultural Diversity

In which country were you born?

Are you of Aboriginal or Torres Strait Islander origin? *Yes (Aborginal)Yes (Torres Strait Islander)No

Language, Literacy and Numeracy

Do you speak a language other than English at home? (If so, please specify)

Disability

Do you consider yourself to have a disability, impairment or long-term condition? *YesNo

Other impairment:

Schooling and Previous Qualification Achieved

Are you still attending secondary school? *YesNo

In which year did you complete that school level? *

Have you successfully completed any of the following qualifications? Check all that apply.Bachelor Degree or Higher DegreeAdvanced Diploma or Associate DegreeDiploma (or Associate Diploma)Certificate IV (or Advanced Certificate/TechnicianCertificate III (or Trade Certificate)Certificate IICertificate ICertificate other than the ones mentionedNote: Qualifications obtained overseas do not apply unless equivalency has been formally established in Australia

Employment Status

Full time employeePart time employeeSelf employed - not employing othersEmployerEmployed - unpaid worker in the family businessUnemployed – seeking full-time workUnemployed – seeking part-time workNot employed – not seeking employment

Study Reason

Unique Student Identifier (USI)

Australian Residents Only

Do you have a USI? *YesNo

USI Number *0 / 10

You need to register at www.usi.gov.au and return with your USI number

Privacy Notice and Applicant Declaration

I understand that:
The information provided by you in this application will be used by Rii Skills Centre for the purpose of general participant administration, planning and communication. The information contained herein may be provided to government al agencies that fund and/or accredit this course and owners of a registered course for tracking purposes. The provision of this information is essential to determine your eligibility for a place in the course. Your consent to Rii Skills Centre obtaining personal information necessary for the purpose of your application and course. Information provided will be held securely. Refer to the Student privacy section in the Student Handbook for further information. By signing this form you understand and will adhere to Rii Skills Centre and the relevant state Department of Education and Training policies.

I have been advised I can access the Student Handbook at the Rii Skills Centre website, the handbook advises me of:

Assessment and issuance of qualification
Cancellation & Refund Policy
Fees
Welfare and guidance services

Complaints and appeals process
Access and equity
Privacy and management of students records

I acknowledge that the following has been fully explained to me:

Qualification / course
Units of competence
Duration of Training
Unique Student Identifier (USI)

I acknowledge that the information provided by in the enrolment application is true and correct to the best of my knowledge. I understand that providing false or misleading information may result in my removal from the course and render me ineligible to receive the stated qualification.

I acknowledge that I have been notified of location of, or supplied with, and accept the terms of the Privacy Notice.

Student Name *

Date

This course is co-run with Australis College – RTO 31518

Diploma
enrolment
form

Personal Details

(Important - the details given must MATCH details of the ID provided)

Address

Postal Address

(if different from above)

Telephone and Email

Cultural Diversity

Language, Literacy and Numeracy

Disability

Schooling and Previous Qualification Achieved

Employment Status

Study Reason

Unique Student Identifier (USI)

Australian Residents Only

Privacy Notice and Applicant Declaration

Contact:

Get Social with Us

Diplomaenrolmentform

Personal Details

(Important - the details given must MATCH details of the ID provided)

Address

Postal Address

(if different from above)

Telephone and Email

Cultural Diversity

Language, Literacy and Numeracy

Disability

Schooling and Previous Qualification Achieved

Employment Status

Study Reason

Unique Student Identifier (USI)

Australian Residents Only

Privacy Notice and Applicant Declaration

Diploma
enrolment
form