Application for Enrolment Form - Aqua Fitness Online

Intended Course of Study
Course Name*
Personal Details
Your Full Name*
Please write the name that you used when you applied for your Unique Student Identifier (USI), including any middle names. If you do not yet have a USI please write your name exactly as written in the identity document you choose to use.
Prefix First Last
Date of Birth*
Day
Month
Year
Gender
- Male
- Female
- Other
Home Phone
Mobile Phone
Email Address*
Alternative Email (optional)
Your Emergency Contact
Emergency Contact Name*
Relationship To You
Emergency Contact Number
Your Address
What is the address of your usual residence?*
Street Address Address Line 2 City State Postcode Country
Is your postal address different from above?*
- Yes
- No
What is your postal address?*
Street Address Address Line 2 City State Postcode Country
Language and Cultural Diversity
In which country were you born?*
- Australia
Do you speak a language other than English at home?*
(If more than one language, indicate the one that is spoken most often)
- No – English Only
Are you of Aboriginal or Torres Strait Islander origin?*
(For persons of both Aboriginal and Torres Strait Islander origin, mark both ‘Yes’ boxes)
- No
- Yes, Aboriginal
- Yes, Torres Strait Islander
Disability
Do you consider yourself to have a disability, impairment or long-term condition?*
- Yes
- No
Please select the areas from the following list
(You may select more than one area)
- Hearing/deaf
- Physical
- Intellectual
- Learning
- Mental illness
- Acquired brain impairment
- Vision
- Medical condition
- Other
Other area*
Do you require any assistance to paricipate in this course?*
- No
- Yes (We’ll arrange a meeting to discuss with you)
Schooling
What is your highest COMPLETED school level?*
If you are currently enrolled in secondary education, the Highest school level completed refers to the highest school level you have actually completed and not the level you are currently undertaking. For example, if you are currently in Year 10 the Highest school level completed is Year 9.
- Completed Year 12
- Completed Year 11
- Completed Year 10
- Completed Year 9 or equivalent
- Completed Year 8 or lower
- Never attended school
In which year did you complete this level?*
Eg, 1995
Are you still enrolled in secondary or senior secondary education?*
- Yes
- No
Employment
Of the following categories, which BEST describes your current employment status?*
For casual, seasonal, contract and shift work, use the current number of hours worked per week to determine whether full time (35 hours or more per week) or part-time employed (less than 35 hours per week).
- Full-time employee
- Part-time employee
- Self-employed – not employing others
- Self-employed – employing others
- Employer
- Employed – unpaid worker in a family business
- Unemployed – seeking full-time work
- Unemployed – seeking part-time work
- Not employed – not seeking employment
Study Reason
Study Reason?*
Of the following categories, which BEST describes your main reason for undertaking this course / traineeship /apprenticeship?
- To get a job
- To develop my business
- To start my own business
- To try for a different career
- To get a better job or promotion
- To get skills for community/volunteer work
- 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
Unique Student Identifier
From 1 January 2015, Active Training can be prevented from issuing you with a nationally recognised VET qualification or statement of attainment when you complete your course if you do not have a Unique Student Identifier (USI). If you have not yet obtained a USI you can apply for it directly at http://www.usi.gov.au/create-your-USI/ on computer or mobile device. Please note that if you would like to specify your gender as ‘other’ you will need to contact the USI Office for assistance.
Enter your Unique Student Identifier (USI) (if you already have one)
Marketing Use Content
Marketing Use Consent
I give Active Training permission to use photos in public material and social media (including any photos where I may be recognised) as may be useful. I authorise images of my participation in training to be used by Active Training for future marketing and business purposes.

I understand that I retain the right to withdraw my consent at any time.
- I choose to opt-out of this marketing and usage consent
Privacy Notice
Under the Data Provision Requirements 2012, Active Training 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), may be used or disclosed by Active Training for statistical, administrative, regulatory and research purposes. Active Training may disclose your personal information for these purposes to:
- Commonwealth and State or Territory government departments and authorised agencies; and
- NCVER;
Personal information that has been disclosed to NCVER may be used or disclosed by NCVER for the following purposes:
- populating authenticated VET transcripts;
- facilitating statistics and research relating to education, including surveys and data linkage;
- pre-populating RTO student enrolment forms;
- 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 a student survey which may be administered by a government department or NCVER employee, agent or third party contractor or other authorised agencies. Please note 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 National VET Data Policy and all NCVER policies and protocols (including those published on NCVER’s website at www.ncver.edu.au).

Active Training retains a record of personal information about all individuals with whom we undertake any form of business activity. Active Training must collect, hold, use and disclose information from our clients and stakeholders for a range of purposes.

As a government registered training organisation, regulated by the Australian Skills Quality Authority, Active Training is required to collect, hold, use and disclose a wide range of personal and sensitive information on Students in nationally recognised training programs. This information requirement is outlined in the National Vocational Education and Training Regulator Act 2011 and associated legislative instruments.

Active Training must require and confirm identification however in services delivery to individuals for nationally recognised course programs. We are authorised by Australian law to deal only with individuals who have appropriately identified themselves. That is, it is a Condition of Registration for all RTOs under the National Vocational Education and Training Regulator Act 2011 that we identify individuals and their specific individual needs on commencement of services delivery, and collect and disclose Australian Vocational Education and Training Management of Information Statistical Standard (AVETMISS) data on all individuals enrolled in nationally recognised training programs. Other legal requirements, as noted earlier in this policy, also require considerable identification arrangements.

For information about how Active Training collects, uses and discloses your personal information generally, including how you can make a complaint about a breach of privacy, please refer to Active Training’s privacy policy which can be found on the web at https://www.activetraining.net.au/policies/policies/

This Privacy Policy contains information about how individuals may access and seek correction of the personal information held by us, and how to complain about a breach of privacy, and how we will deal with such a complaint.

In providing your personal information as requested you are confirming your receipt of, and understanding of these details, and providing your consent for the collection, storage, use and disclosure of your personal information as outlined.
Name
This field is for validation purposes and should be left unchanged.

Intended Course of Study

Personal Details

Your Emergency Contact

Your Address

Language and Cultural Diversity

Disability

Schooling

Employment

Study Reason

Unique Student Identifier

Marketing Use Content

Privacy Notice