1.

Course Applying For

Non- Mode
Course Tuition Materials
Course Name Tuition Location Of
Code Fee Fee
Fees Study

Which intake month would you prefer?

Are you applying for Recognised Prior Learning (RPL)? ☐ Yes ☐ No

2. Agent Information

Has an Agent or Representative of AIBTGlobal assisted with this application? Yes ☐ No ☐

If Yes, please specify

Name of Agent / Company

3. Personal Details
Gender ☐ Male ☐ Female

Title ☐ Mr ☐ Mrs ☐ Ms ☐ Miss ☐ Dr

Family Name (Surname)

Given Names

Former Family Name Date of Birth / / _(DD/MM/YYYY)

Do you have a Unique Student Identifier (USI)?

If yes, please provide USI details

If no, please refer to section 14 of this enrolment application to apply for a USI.

Do you currently hold a visa? If yes, what type? ☐ Student ☐ Working ☐ Tourist ☐ Other

Are you currently enrolled with another Australian education provider? ☐ Yes ☐ No

If yes, please provide the following details:

Name of the education provider

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 Name of course/s you are currently enrolled in

4. Residential Address
Flat/Unit Number _Street Number
Street Name Suburb/Locality or Town
State Postcode Country
Contact

5. Postal Address (if different to above)

PO Box (if applicable) Flat/Unit Number Street Number

Street Name

Suburb/Locality or Town State Postcode

Country

6. Student Contact
Phone Mobile

Email

7. Emergency Contact
Name Relationship

Phone Mobile

**Please advise AIBTGlobal of any changes to any of your contact details within 7 days of the change**

8. Language and Cultural Diversity

1. In which country were you born? ☐ Australia ☐ Other, please specify

2. In which city were you born?

Non-Australian Passport No Country of Passport

3. Do you speak a language other than English at home? ☐ Yes ☐ No

If Yes, please specify

4. How well do you speak English?

☐ Very well ☐ Well ☐ Not well ☐ Not at all

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 5. English language proficiency – ☐ IELTS ☐ PTE ☐ TOEFL ☐ other

9. Disability and Mental Health

1. Do you consider yourself to have a disability, impairment or long-term condition?

☐ Yes ☐ No (If No, go to 10 Schooling Section)

2. If Yes, then please indicate the area of disability, impairment or long-term condition. You can
select more than one area.

☐ Hearing/Deaf ☐ Physical ☐ Intellectual Learning

☐ Mental illness ☐ Acquired brain impairment
☐ Vision ☐ Medical condition ☐ Other, please specify

3. Do you require special assistance? ☐ Yes ☐ No

4. If yes, please explain the special assistance required

10. Schooling
1. What is your highest COMPLETED secondary school level? (tick ONE box only)

☐ Year 12 ☐ Year 11 ☐ Year 10 ☐ Year 9 ☐ Year 8 or below ☐ Never attended

school

2. Which year did you complete that secondary school?

level? Year

3. Are you still attending secondary school? ☐ Yes ☐ No

4. If yes. What secondary school are you attending?

11. Previous Qualifications Achieved

1. Have you SUCCESSFULLY completed any of the following qualifications? ☐ Yes ☐ No

(If No, go to 12 Employment section)

2. If Yes, tick ANY applicable boxes

☐ Bachelor’s degree or higher degree
☐ Advanced diploma or associate degree
☐ Diploma (or Associate Diploma)
☐ Certificate IV (or advanced certificate / technician)
☐ Certificate III (or trade certificate)
☐ Certificate II
☐ Certificate I
☐ Certificates other than the above

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Name of Qualification Year completed Name of training or academic organisation

**Please complete Authority and Release – Previous Qualifications **

12. Employment
Of the following categories, which BEST describes your current employment status? (Tick ONE box
only)
☐ Full-time employee
☐ Part-time employee
☐ Self-employed (not 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)
☐ Other

13 Reason for Study

Of the following categories, which BEST describes your main reason for undertaking this course?

☐ To get a job
☐ To develop my existing business
☐ To start my own business
☐ To try for a different career
☐ To get a better job or promotion
☐ 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
☐ Other reasons, please specify

14. Unique Student Identifier

If you already have a Unique Student Identifier (USI), please provide this USI at section 3 in this
enrolment application.
If you would like us (AIBTGlobal) to apply for a USI on your behalf you must authorise us to do so and
declare that you have read the privacy information at http://www.usi.gov.au/Training-

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 Organisations/Pages/Privacy-Notice.aspx.

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

☐ I have read and I consent to the collection, use and disclosure of my personal information pursuant
to the information detailed at
http://www.usi.gov.au/Training- Organisations/Pages/Privacy-Notice.aspx.

Please note that in accordance with section 11 of the Student Identifiers Act 2014, AIBTGlobal will
securely destroy personal information which we collect from individuals solely for the purpose of applying
for a USI on their behalf as soon as practicable after we have made the application, or the information is
no longer needed for that purpose unless we are required by or under any law to retain it.

15. Declaration
In signing or emailing this form I acknowledge and declare that:
1. I am over the age of 18 years.
2. If I am under 18 years of age, my parent(s) or guardian(s) have signed permission for this enrolment
and have arranged/will arrange for my accommodation, support and welfare arrangements, whilst
studying in Australia until I turn 18 years of age.
3. I have read, understood and completed all questions and details on the enrolment form.
4. I agree that the information provided in the enrolment form is to the best of my knowledge true,
correct and complete at the time of my enrolment (including information provided to assess my
eligibility).
5. I agree that arrangements have been made to pay all fees and charges applicable to this enrolment.
6. I have read, understand and agree to follow the Information, Rules, Regulations, Policies
and Procedures located in the Important Enrolment Information.
7. I agree that my participation in this course/s is subject to the right of AIBTGlobal to cancel or
amalgamate courses or classes. I agree to abide by all rules and regulations of AIBTGlobal.
8. I confirm I have been informed about the training, assessment and support services to be provided
and about my rights and obligations as a student at AIBTGlobal.
9. I authorise AIBTGlobal or its agent, in the event of illness or accident during any AIBTGlobal
organised activity, and where emergency contact or next of kin cannot be contacted within a
reasonable time, to seek ambulance, medical or surgical treatment at my cost.
10. I agree that my academic results will be withheld until my debt is fully paid and any property
belonging to AIBTGlobal has been returned.
11. I am responsible for keeping a copy of this document and any receipts for payment of tuition or
non-tuition fees.

Name (please print)

Signature

Date / / (DD/MM/YYYY)

**Authority and Release – Previous Qualifications **

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I hereby

authorise AIBTGlobal to contact

(name of training/academic organisation) listed in this enrolment form, where I have obtained previous

qualifications and I authorise

(name of training/academic organisation) to release any details relating to these previous qualifications to
AIBTGlobal.

Name (please print)

Signature

Date / / (DD/MM/YYYY)

Please complete if qualifications obtained at more than one (1) training/academic organisation

Qualification Year Name of training/academic organisation

Completed

Consent - Under 18 years of age

I/We (Name of Parent(s) or Guardian(s), consent to

(Name of student)

enrolling in the course outlined in this enrolment form and I/we understand and agree that because

(Name of student)

is under the age of 18 years of age that I/we are required to organise appropriate accommodation, support and

welfare arrangements for (Name of student)

whilst he/she is studying in Australia and until he/she turns 18 years of age.

Signatures
Parent(s) or Guardian(s)

Date / / (DD/MM/YYYY)

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