Certificate Enrolment Form 2011
 

 
Before completing this enrolment form, Clients should familiarise themselves with the following documentation available on our website under the Certificate Course Information link on the home page.-

Client Information Handbook
Fees and Charges Policy
Refund Policy

Please note KeyboardConcepts recognises qualifications issued by other RTOs.

1. Date

 MM DD YYYY 
Today's Date
/
/
 

2. First Name

3. Surname:

4. Date of Birth

 DD MM YYYY 
Use format dd/mm/yyyy
/
/
 

5. If you are aged 24 or below at time of enrolment, please provide your Victorian Student Number.

6. Are you new to the Victorian Education system or do you not have your Victorian Student Number?

7. Sex

8. Email address

9. Postal Address

10. Emergency Contact

11. Postcode?

12. Choose State/Territory:

13. Contact Details

14. LANGUAGE AND CULTURAL DIVERSITY

In which country were you born?

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

16. How well do you speak English?

17. Are you of Aboriginal or Torres Strait Islander origin?

18. DISABILITY

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

19. If yes, Please indicate the areas of disability, impairment or long-term conditon. (You may indicate more than one area)

20. SCHOOLING

What is your highest COMPLETED school level? (Select one option only)

21. In which YEAR did you complete that school level?

22. Are you still attending secondary school?

23. PREVIOUS QUALIFICATION ACHIEVED

Have you SUCCESSFULLY completed any of the following? (You may select more than one option)

24. EMPLOYMENT

Of the following categories, which BEST describes your current employment status? (Select ONE option only)

25. STUDY REASON

Of the following categories, which BEST describes your main reason for undertaking this course/traineeship/apprenticeship?(Select ONE option only.)

26. COURSE YOU ARE ENROLLING FOR

Select the course you are enrolling for.

27. Citizenship and Residence status for Government Funding Eligibility

Please select option applicable to you. You may be eligible for funds under the Victorian Training Guarantee made available by the Victorian and Commonwealth Government. You will be asked to provide proof of your residence status and age (eg; birth certificate/passport) Further details available on the home page of our website - www.keyboardconcepts.com.au.

28. Do you have a qualification higher than the one you are enrolling for?

29. Do you hold an overseas qualification

30. Do you require additional Language, Literacy or Numeracy support to help you complete the course you are applying for?

31. Please identify anything that might prevent you from progressing through the training and assessement program, (eg physical ability, cultural backround or educational background).

Privacy Statement

I understand that: Keyboard Concepts is required to provide the Victorian Government, through Skills Victoria, with student and training activity data which may include information I provide in this enrolment form. Information is required to be provided in accordance with the Victorian VET Student Statistical Collection Guidelines (which are available at www.skills.vic.gov.au/corporate/statistics/submit_data).

Skills Victoria may use the information provided to it for planning, administration, policy development, program
evaluation, communication, resource allocation, reporting and/or research activities. For these and other lawful purposes, Skills Victoria may also disclose information to its consultants, advisers, other government agencies, professional bodies and/or other organisations.

Please contact Keyboard Concepts’s on phone 03 95929919 or email training@keyboardconcepts.com if you require any further information.



32. Please Tick to confirm the following:-

Please contact Keyboard Concepts (03 95929919) to arrange payment.
Please click the DONE button below.