Academy of Career Training
101 North St., Toowoomba, Qld 4350 Phone: (07) 4659 5062, Fax: (07) 46391009
ENROLMENT FORM
Print Name_________________________________________________ Date of Birth ___________________ Current Address____________________________________________________________________________ Phone Contact__(home) _________________(work) ______________ (mobile) ________________________ Email ____________________________________________________________________________________ Course name _______________________________Course Date(s) ___________________________________
Vocational Education and Training Information
1. Born in Australia and speaks English at home Yes ____ No _____ (If yes, proceed to question 5) 2. Country of birth __________________________________________________________________ 3. How well do you speak English? very well _____ well ______ not well ______ not at all ______ 4. Language spoken at home __________________________________________________________ 5. Do you require Language or Literacy assistance? ________________________________________ 6. Prior Educational Achievements _____________________________________________________ 7. Highest School Level ______________________________________ Year completed __________ 8. Attending secondary school currently? Yes _____ No ________ 9. Employment category: Part time _____ Full time _____ Self-employed ____ Employer ______ Unemployed seeking part time ____ Unemployed seeking full time _____ Not employed and not seeking work ______ 10. Indigenous status: Aboriginal _______ TSI ________ Both ________ Neither _________ Yes / No Disability? ______________________________
11. Do you have special requirements?
12. Please comment on how we may assist your learning process._____________________________ __________________________________________________________________________________ __________________________________________________________________________________
Please return a copy of this letter to Academy of Career Training by mail or fax with your choice of course and dates clearly marked and include appropriate payment. If responding by mail, please allow sufficient time for receipt prior to your chosen course or workshop date. Your instructor will be contacting you to confirm exact times, location, and materials required. A deposit of 20% is required to secure your place in each course. Full payment is required before start of term. Payment options are available. Please contact Academy of Career Training for further details.
Office use only: Date received
Invoice number
Payment received
-1-
Conf of Enrolment
Student number
Revised 25 November, 2005 To be Reviewed 5 June, 2006
Academy Application Form, V2.1 Authorised by Kimberly Halter, Director
Academy of Career Training
101 North St., Toowoomba, Qld 4350 Phone: (07) 4659 5062, Fax: (07) 46391009
ENROLMENT FORM
Re: Certificate IV in Training and Assessment (TAA 40104)
Return a copy of this letter to Academy of Career Training by mail or fax with appropriate payment. The course costs are: • Full Course $1450.00 upon course commencement or $1600.00 with a payment plan. • Recognition of Prior Learning. $595.00. • Upgrade from Certificate IV in Assessment and Workplace Training $795.00 for prompt payment or $850.00 with a payment plan. Your instructor will contact you to arrange an interview. At that time they will confirm with you exact times, location, and course materials required. Recommended length of time for Certificate IV in Training and Assessment (TAA40104) is 360 nominal hours.
On successful completion of the course participants will receive TAA 40104 Certificate IV in Training and Assessment
Payment Options All Fees are per person, payable in Australian Dollars (Minimum 20%) Payment Method (Check only one) Cheque Amount __________________ Deposit 20% non-refundable Credit Card Visa Master Card American Express
Card number___________________________________________Exp Date__________________ Cardholder Name____________________________________________________________________ Cardholder's signature:_______________________________________________________________
Academy Application Form, V2.1 Authorised by Kimberly Halter, Director
-2-
Revised 25 November, 2005 To be Reviewed 5 June, 2006