Enrolment Form

Which of the below are you enrolling into?

I have read and understand I will need to bring 100 points of original ID with me on the day of training
Proof of Identification

Are you already enrolled in one of the qualifications below with us?

DO NOT CONTINUE WITH THIS ENROLMENT FORM

Please complete your enrolment in the below link instead

https://kiamacommunitycollege.snapforms.com.au/form/first-aid-unit-enrolment

Which Campus would you like to enrol?

KiamaNowraOther

Start date if known?

Select the item below which best describes the main reason you are undertaking this course?

Personal Details

Preferred pronoun?

SheHeTheyOther

Given Names *

Family Name *

Gender *

MaleFemaleNon-binaryDifferent identity

Date of Birth *

Street address *

Town/Suburb *

State *

Post Code *

Contact Information

Email Address *

Alternative email address

Mobile number *

Home phone

Work phone

Emergency contact's name and relation to you

Emergency contact's number

How did you find out about this course? *

Are you applying for Recognition of Prior Learning or Credit Transfer for any units?

YesNo

Please indicate if you feel you may need assistance during your course?

Anything you would like us to know?

Statistical Information

The AVETMISS Data is sent to NCVER (National Centre for Vocational Education Research) and helps Registered Training Organisations like ourselves deliver courses which would better suit our students.

NCVER will collect, hold, use and disclose your personal information in accordance with the law, including the Privacy Act1988(Cth) (Privacy Act) and the NVETR Act. For more information about how NCVER will handle your personal information please refer to the NCVER’s Privacy Policy at www.ncver.edu.au/privacy.

In which country were you born? *

AustraliaOther

If you where born outside of Australia; which country where you born? *

What is your citizenship status *

Check this box to give Kiama Community College permission to search your Citizenship status on the VEVO website.

What town/city where you born? *

I am of aboriginal or Torres Strait Islander descent? *

NoAboriginalTorres Strait IslanderBoth

Do you have a disability? *

YesNo

What is your disability?

Do you require assistance?

YesNo

What is your highest completed school level? *

Are you still enrolled in high school? *

YesNo

Have you successfully completed any of the qualifications listed below? *

Which best describes your current employment status? *

Unique student identifier (USI)

From 1 January 2015, Kiama Community College can be prevented from issuing you with a nationally recognised VET qualification or statementof attainment when you complete your course if you do not have a Unique Student Identifier (USI). In addition, we are required to include yourUSI in the data we submit to NCVER. If you have not yet obtained a USI you can apply for it directly at https://www.usi.gov.au/your-usi/create-usi on your computer or mobile device.

Do you have a USI number? *

YesYes, but I will need Kiama Community College to look it up for meNo

What is your USI number? *

If you would like Kiama Community College to apply for a USI or search for your existing USI on your behalf you must authorise us to do so and declare that you have read the privacy information.

You will also need to upload some identification, preferably your licence or medicare card.

I have read and I consent to the collection, use and disclosure of my personal information (which may include sensitive information) pursuant to the information detailed at https://www.usi.gov.au/documents/privacy-notice-when-rto-applies-their-behalf

I authorise Kiama Community College to apply pursuant to sub-section 9(2) of the Student Identifiers Act 2014, for a USI on my behalf

PAYMENT OPTIONS

Options *

Apply for a FEE-FREE funded position - (You will be contacted within 2 business days to determine your eligibility)Invoice my employer/organisationMake full payment now

I am an employee of Bluehaven - The course will be invoiced to Blue Haven for a discounted rate of $140

Please confirm your course preference? *

$175 - Provide First Aid (CPR included)$90 - CPR only$150 - Introduction to Barista$165 - White Card

Employer/Organisation contact name, number and email address

Credit Card Details *

Pay

Student Declaration and Consent

Would you like to receive course marketing emails? *

I confirm I have read and agree to the Terms and Conditions

I confirm I have been provided with and have read this linked Privacy Notice

https://kcc.nsw.edu.au/doc/Enrolment_Privacy_Notice_v2.pdf

I declare I have been provided with the student information (student handbook linked below)
http://kcc.nsw.edu.au/doc/KSCC_Student_Handbook_2024-WEB.pdf

I consent to the collection, use and disclosure of my Personal Information in the manner outlined in this link.
Consent to Use & Disclosure of Personal Information *

I have read and agree with the linked photo/image consent statement

Please upload your drivers license or another document confirming your identity

Browse

You will not be enrolled until the required documentation and Identification has been received by our enrolment team

You have chosen to enrol in the White Card unit:

CPCWHS1001 - Prepare to work safely in the construction industry

Proof of identification for the Construction 'White Card' course

You must bring the ORIGINAL documents with you to the course.
You CANNOT do the course unless you bring 100 points of identification on the day.

Please read here for ID requirements

Signature: *

Draw signature|Type signatureClear

Date: *

*Parent/Guardian consent is required for all students under the age of 18

Parent/Guardian full name

Parent/Guardian signature

Draw signature|Type signatureClear

Enrolment Form

Personal Details

Contact Information

Statistical Information

Unique student identifier (USI)

PAYMENT OPTIONS

Student Declaration and Consent

Enrolment Terms and Conditions