ENROLMENT FORM

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Personal Details

Please write the name that you used when you applied for your Unique Student Identifier (USI), including any middle names.
Unique Student Identifier (USI)

Entity Data - AVETMISS - Unique Student Identifier (USI)
Title
Entity Data - Profile - Title
First Name
Entity Data - Profile - First Name
Middle Name
Entity Data - Profile - Middle Name
Surname
Entity Data - Profile - Surname
Birth Date
Entity Data - Profile - Birth Date
Gender
Entity Data - Profile - Gender
E-mail Address
Please make sure to provide an accurate email address that you can access, as this will be used to create your login credentials for the learning portal
Entity Data - Contact - Home - E-mail Address
Mobile Number
Entity Data - Contact - Home - Mobile Number
Address
Entity Data - Address - Home - Lookup
Address - Home - Unit/Flat Number
Entity Data - Address - Home - Unit/Flat Number
Address - Home - Street/Lot number
Entity Data - Address - Home - Street/Lot number
Address - Home - Street Name
Entity Data - Address - Home - Street Name
Address - Home - Suburb
Entity Data - Address - Home - Suburb
Address - Home - Post Code
Entity Data - Address - Home - Post Code
Address - Home - State
Entity Data - Address - Home - State
Address - Home - Country
Entity Data - Address - Home - Country

AVETMISS Information

Please complete all required fields below

Employment Status
Entity Data - AVETMISS - Labour Force Status
Country of Birth
Entity Data - Profile - Country of Birth
Town/City of Birth
Entity Data - Profile - Town/City of Birth
Citizenship Status
Entity Data - Profile - Citizenship Status
Indigenous Status - Are you of Aboriginal or Torres Strait Islander descent?
Entity Data - AVETMISS - Indigenous Status
Main Language - what is your primary language?
Entity Data - AVETMISS - Main Language
Disability - do you consider yourself to have a disability?
Entity Data - AVETMISS - Disability Flag
Disability Type
Entity Data - AVETMISS - Disability Type
At School - do you still attend school?
Entity Data - AVETMISS - At School
Highest School Level - what is the highest school level you have completed?
Entity Data - AVETMISS - Highest School Level
Year Completed - what year did you complete your highest school level? e.g. 1999
Entity Data - AVETMISS - Year Completed (Highest School)
Prior Education - have you completed any prior qualifications?
Entity Data - AVETMISS - Prior Education Flag
Prior Education Type
Entity Data - AVETMISS - Prior Education Type
Study Reason
Entity Data - AVETMISS - Study Reason

Declaration

Terms and Conditions

Please read our Student Handbook here
Basic - Checkboxes
Identification - Drivers Licence (Front)
Basic - File
Identification - Drivers Licence (Back)
Basic - File
Signature
Basic - Digital Signature
Date
Basic - Date

Payment

Is your employer paying?
Basic - Checkboxes
Employer Name
Basic - Text
Employer Phone
Basic - Text
Employer Email
Basic - Text
Employer Address
Basic - Text
Payment Options

Select a Payment Option


Pay Now

Select this option if you want to pay now.
You'll be redirected to the Payment Gateway.

Pay Later

Select this option to pay later. An invoice will
be provided to you, or your sponsor, post
submission.

Please select from the following options:

Invoice me - I would like to pay in full
Invoice me - My employer is paying
Pay in Full (Pay in Full ) 		$3,900.00
$3,900.00
$0.00
$3,900.00