BSB30121 Certificate III Business Pre-Enrolment Form 1. BSB30121 Certificate III Business Pre-Enrolment Form Please complete your details below to Pre-enrol. By completing this enrolment form you understand that you are enrolling in the course. OK Question Title * 1. Your status Mr Miss Ms Other OK Question Title * 2. First Name OK Question Title * 3. Surname OK Question Title * 4. I would like to enrol as A funded student in QLD and I do not have a health care card A funded student in QLD and I do have a health care card I am a NSW student looking to enrol in this course I am a trainee enrolling under User Choice in QLD OK Question Title * 5. I am not eligible for funding and will be paying full fees for my course of $2500. I would like to pay my $100 deposit today and enter into a payment plan for the rest of my fees. Leave blank if you are funded student. $ You’ll enter payment info after the survey. OK Question Title * 6. Have you ever been known by any other surname? Add surname below if this applies. OK Question Title * 7. Email address OK Question Title * 8. Residential Address OK Question Title * 9. Suburb OK Question Title * 10. Postcode OK Question Title * 11. Contact number (mobile) OK Question Title * 12. Contact number (home) OK Question Title * 13. Gender Male Female OK Question Title * 14. Date of Birth OK Question Title * 15. Were you born in Australia Yes No OK Question Title * 16. If you were not born in Australia please specify country of birth OK Question Title * 17. Do you speak a language other that english at home Yes No OK Question Title * 18. How well do you speak english Very well Well Not well Not at all OK Question Title * 19. Are you of aboriginal or torres strait islander origin No Yes aboriginal Yes torres strait islander OK Question Title * 20. Do you consider yourself to have a disability, impairment or long term condition Yes No OK Question Title * 21. If yes please indicate below Vision Learning Hearing Physical Medical condition Other OK Question Title * 22. What is your highest completed school level (tick one box only) Year 12 Year 11 Year 10 Year 9 Year 8 or below OK Question Title * 23. In what year did you complete that school level OK Question Title * 24. Are you still attending secondary school OK Question Title * 25. Have you successfully completed any other qualifications Yes No OK Question Title * 26. What qualifications have you completed (if any) Certificate II Certificate I Certificate other than above OK Question Title * 27. What is your employment status Full time employee Part time employee Casual employee Employer Not employed and not seeking work Unemployed seeking full time work Unemployed seeking part time work Employed unpaid, working in a family business OK Question Title * 28. Study reason To get a job To develop my existing business To start my own business To try for a different career To get a better job or promotion It was a requirement of my job I wanted extra skills for my job To get into another course of study For personal interest or self development other reason OK Question Title * 29. Unique student identifier number (if known) If you do not have a USI please visit usi.gov.au and generate your USI. OK Question Title * 30. I would like to book into the following course 100% online course OK Question Title * 31. Are you currently enrolled in any other course - Please answer Yes, No or add the name of the course (example - Diploma of Business BSB50515. OK Question Title * 32. Please acknowledge the below privacy notice Under the Data Provision Requirements 2012, Gold Coast Training College is required to collect personal information about you and to disclose that personal information to the National Centre for Vocational Education Research Ltd (NCVER). Your personal information (including the personal information contained on this enrolment form and your training activity data) may be used or disclosed by Gold Coast Training College for statistical, regulatory and research and advertising purposes. Gold Coast Training College may disclose your personal information for these purposes to third parties, including: School – if you are a secondary student undertaking VET, including a school-based apprenticeship or traineeship; Employer – if you are enrolled in training paid by your employer; Commonwealth and State or Territory government departments and authorised agencies; NCVER; National Centre for Vocational Education and Research. Organisations conducting student surveys; and Researchers. Personal information disclosed to NCVER may be used or disclosed for the following purposes: Issuing a VET Statement of Attainment or VET Qualification, and populating Authenticated VET Transcripts; facilitating statistics and research relating to education, including surveys; understanding how the VET market operates, for policy, workforce planning and consumer information; and administering VET, including program administration, regulation, monitoring and evaluation. You may receive an NCVER student survey which may be administered by an NCVER employee, agent or third party contractor. You may opt out of the survey at the time of being contacted. NCVER will collect, hold, use and disclose your personal information in accordance with the Privacy Act 1988 (Cth), the VET Data Policy and all NCVER policies and protocols (including those published on NCVER’s website at www.ncver.edu.au). Student Declaration and ConsentI declare that the information I have provided to the best of my knowledge is true and correct. I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above. Yes, I agree OK DONE