Please enable JavaScript in your browser to complete this form.Email *EmailConfirm EmailTitle *Mr.Mr.Mrs.Miss1) First Name *2) Middle name3) Last Name *4) Date of Birth *5) Residential Address – Number *Street Name *Street Type *StreetStreetRoadAvenueBoulevardCourtCrescentDriveOtherSuburb *StateNSWNSWVICQLDSAWATASNTACTPostcode *CountryIs the Student's Postal Address is same as their Residential Address?NoYes6) Postal Address – NumberPLEASE LEAVE BLANK IF POSTAL ADDRESS IS THE SAME AS THE RESIDENTIAL ADDRESS Street Name *Street TypeStreetRoadAvenueCourtDriveBoulevardCrescentOtherSuburb *StateNSWVICQLDSAWATASNTACTPostcode *Country7) Mobile Phone Number *8) Landline Phone Number9) Unique Student Identifier *If you do not have a USI number, you may obtain one from the USI website which can be located here: www.usi.gov.au.10) Evolation Learning will be required to access the USI system to validate your USI number. Sometimes Evolation Learning will be required to access the system to find, create or perform another function on the system. This may require Evolation Learning using your details to undertake these functions. Do you provide Consent to Evolation Learning to use your details to perform functions on the USI system as required to support your enrolment?YesNo11) Gender MaleFemale12) Course *Choose from one of the optionsCHCPRT025 (Upgrade) – Identify and report children and young people at riskCHCPRT025 – Identify and report children and young people at riskHLTAID012 – Provide First Aid in an education and care settingHLTAID009 – Provide cardiopulmonary resuscitationTAE40122 – Certificate IV in Training and Assessment10741NAT – Certificate III in Christian Ministry and TheologyPlease note if you are enrolling in the CHCPRT025 upgrade option you will need to provide evident of completing the unit of competency CHCPRT001 – Identify and respond to children and young people at risk. This either needs to be a verified transcript or a verified USI record. This MUST be an transcript issued by an RTO and does not include professional development courses that have a certificate of completion. If you are unsure please email [email protected]. 13) Are you an Australian Aboriginal or Torres Strait Islander? YES, ABORIGINALYES, TORRES STRAIT ISLANDERYES, ABORIGINAL AND TORRES STRAIT ISLANDERNO, NEITHER ABORIGINAL OR TORRES STRAIT ISLANDER14) Were your born in Australia? *YesNoWhat is your country of birth? 15) What is the language you mainly speak at home? *EnglishOtherWhat is other language you mainly speak at home? 16) How well do you speak this language?Very WellWellNot wellNot at all17) Do you consider yourself to have a disability, impairment or long-term condition? *YesNo18) If yes to Question 17, please specify. *Hearing/DeafPhysicalIntellectualLearningMental IllnessAcquired Brain ImpairmentVisionMedical ConditionOther – Please specify in additional comments19) What is your highest COMPLETED school level? *YEAR 12 OR EQUIVALENTYEAR 11 OR EQUIVALENTYEAR 10 OR EQUIVALENTYEAR 9 OR EQUIVALENTDID NOT GO TO SCHOOL20) In which YEAR did you complete that school level? *21) Are you still attending secondary school? *YesNo22) Have you successfully completed any other qualifications? *YesNo23) If yes to Question 22, please indicate which qualifications you have completed:Bachelor Degree or Higher DegreeAdvanced Diploma or Associate DegreeDiploma or Associate DiplomaCertificate IV (or Advanced Certificate/Technician)Certificate III (or Trade Certificate)Certificate IICertificate IOther – please specify in additional comments24) Of the following categories, which BEST describes your current employment status? *Full-time employeePart-time employeeSelf-employed – not employing othersSelf-employed – employing othersEmployed – unpaid family worker in a family businessUnemployed – seeking full-time workUnemployed – seeking part-time workNot employed – not seeking employment25) Of the following categories, which BEST describes your main reason for undertaking this course / qualification? *To get a jobTo develop my existing businessTo start my own businessTo try for a different careerIt was a requirement of my jobI wanted extra skills for my jobTo get into another course of studyFor personal interest or self-developmentOther reasons26) Is there any assistance that you would require to complete your course? *27) Would you like to undertake an assessment of your Language, Literacy and Numeracy Skills prior to commencing your course?YesNoPlease note, you may be required to part take in one of these assessments when enrolling into a Qualification. If you have completed prior study and don’t wish to do this LLN assessment, please notify your Trainer who will speak with you or gather some further information. We do this to ensure that we can provide the best support to you in order for you to complete your course.28) Would you like to be considered for Recognition of Prior Learning? *YesNoI am not sure – please contact me with more information29) Are you on a student Visa to be in Australia? *NoYesPlease note if you are on a student visa you need to let us know as we are not CRICOS registered and cannot take enrolments if you are currently in Australia on a student visa.30) Have you read and understood the Student Handbook which can be accessed here:Yes (proceed with your enrolment)No (do not proceed with the enrolment, or contact Evolation Learning for further assistance)Student Handbook 31) Have you understood the Terms & Conditions in the student handbook including but not limited to payment of fee's and the refund policy, privacy and confidentiality? *Yes (proceed with your enrolment)No (do not proceed with the enrolment, or contact Evolation Learning for further assistance)32) I understood that I will be required to provide Evolation Learning with a certified copy of my photo identification. yesNo33) Have you read to Evolation Learning's Privacy Statement and I declare that the information I have provided to the best of my knowledge is true and correct and that you consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above.YesNoPrivacy Statement can be accessed here: https://drive.google.com/file/d/1LEzsS62ogKD4w-CKsGG9KZJccmbk9Rfj/view?usp=sharing34) By signing your name below, you are agreeing that you have read, understood and willing to comply with the terms and conditions, and that you are aware of your rights as a student with Evolation Learning. I understand that submitting the enrolment form will act as an agreement to undertaking by the above conditions.35) Date of Signing and Acknowledgement 36) Discount code (If applicable)37) Were you referred to Evolation Learning by a person or organisation? Please name the person or the organisation.You are only requested to answer this question if you have been referred by another person or organisation; or through any advertisement from a person or organisation other than Evolation Learning.Submit