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* 1. First Name

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* 2. Last Name

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* 3. Employment Status

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* 4. Residency Status

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* 5. Centre

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* 6. Select your qualification code from the dropdown menu.
If you qualification code is CHC30712, upgrading your Certificate III is required.

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* 7. Additional comments

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* 8. Mobile

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* 9. How did you find out about this course?

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