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RTO No. 70220
Participant Enrolment Form
Complete the form for the specific course in which you are interested
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Learner ID (office use only):
Course Title:
TLI41222 - Certificate IV in Motor Vehicle Driver Training (Car)
TLI41222 - Certificate IV in Motor Vehicle Driver Training (Car - Upgrade)
TLISS00162 - Driving Instructor Skill Set
Ten Digit Unique Student Identifier (USI):
If you already have a USI, please insert it in the field above, otherwise go to
Unique Student Identifier Website
and follow the instructions to obtain one. Please note that your enrolment will not be registered unless you include your USI Number.
Personal Details
First Name:
Middle Name:
Family Name:
Date of Birth:
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Town/City of Birth:
Country of Birth:
Email Address:
Gender:
Male
Female
Contact Details
Mobile Phone:
Emergency Contact:
Address:
Suburb:
State & Postcode:
Education Information
Are you currently attending secondary school?
Yes
No
What is/was your highest level completed?
Year 8 or below
Year 9
Year 10
Year 11
Year 12
Did not go to school
In which year did you complete that school level?
Have you successfully completed any post-secondary education?
Yes
No
If yes, select all that apply
Bachelor or higher
Advanced Diploma
Diploma
Certificate IV
Certificate III
Certificate II
Certificate I
Miscellaneous
ONLY if you reside in Victoria, please select all that apply
Australian Qualification
Australian Equivalent
International
Individual Needs
Do you consider yourself to have a disability, impairment, or long-term condition?
Yes
No
Are you of Aboriginal or Torres Strait Islander origin? (Optional)
Yes, Aboriginal
Yes, Torres Strait Islander
Yes, Aboriginal and Torres Strait Islander
No, neither Aboriginal nor Torres Strait Islander
Which BEST describes your current employment status?
Full-time Employee
Part-time Employee
Self-employed (not employing others)
Self-employed (employing others)
Employed (unpaid worker in a family business)
Unemployed (seeking full-time work)
Unemployed (seeking part-time work)
Not employed (not seeking employment)
Do you speak a language other than English at home?
Yes
No
What is your main language?
How well do you speak English?
Very Well
Well
Not Well
Not at all
Do you have any other needs that we should be aware of?
Drivers Licence Number:
Licence Expiry Date:
Day
Month
Year
What is your reason for completing this course? (Optional)
Get a job
Develop my existing business
Start my own business
Try for a different career
Get a better job or promotion
It was a requirement of my job
I wanted extra skills for my job
Get into another course
For personal interest or self-development
To get skills for community/Voluntary Work
Other reasons
By clicking submit you confirm that you have read our Student Handbook.
(Required)
I have read and understood the
Student Handbook.
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