ITS Enrolment Form Step 1 of 8 - STUDENT INFORMATION 12% Student InformationFirst Name*Surname*Date of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender*MaleFemale Residential AddressBuilding/ property nameFlat / unit details:Street number:*Street name:*Suburb / town*Postcode*State*Select StateQueenslandACTNew South WalesNorthern TerritorySouth AustraliaTasmaniaVictoriaWestern AustraliaPostal AddressSame as Residential Address?If yes, please go to next question NoBuilding/ property nameFlat / unit details:Street number:Street name:Suburb / townPostcodeState Contact InformationHome PhWork PhMobile*Email* Do you give ITS permission to email you as needed for the purposes of the course's conduct?* Yes Enrol | Qualification / unit of competency* SITXFSA Use Hygienic practices for Food Safety SITHFAB002 Provide Responsible Service of Alcohol SITHGAM001 Provide Responsible Gambling Services USI Number*** IF YOU WRITE THE USI INCORRECTLY IT WILL DELAY YOUR CERTIFICATEPlease tick the box below to authorise ITS to validate your USI number*You must provide your USI number to ITS or we will be unable to issue your Statement of Attainment. Be aware also that ITS will need to verify your USI number on the USI database. Please sign here to authorise ITS to validate your USI number. If you don't have an USI number, create one here Pre-Course Evaluation ChecklistCountry of birth*Language other than English spoken at homeProficiency in English*Very wellWellNot wellNot at allDisability*No disabilityYesPlease Specify:Indigenous status*AboriginalAboriginal and Torres Strait IslanderTorres Strait IslanderNeither Aboriginal nor Torres StraitHighest school level completed*Did not go to schoolCompleted Year 8 or belowCompleted Year 9 or equivalentCompleted Year 10 or equivalentCompleted Year 12 or equivalentPrior qualifications* No previous qualifications Bachelor degree or higher degree level Advanced diploma or associate degree level Diploma level Certificate IV Certificate III Certificate II Certificate I Miscellaneous Education Employment category / status*Full time employeePart time employeeEmployerSelf-employed – not employing othersEmployed – unpaid work in a family businessUnemployed – seeking part time workUnemployed – seeking full time workNot employed – not seeking workStudy reason* 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 Please write briefly about your reasons for study and how they relate to your personal goals and career path*Do you have any skills or work experience relevant to your chosen course of study*YesNoIf yes, please describe.Have you previously undertaken this style of training?*YesNoIf yes, was it successful? Why / why not?How did you find ITS?* Word of mouth Forum Print Ad Trained with previously Search Engine Website Link Employer Other Would you like ITS to contact you to further discuss your enrolment?* No Yes, via phone Yes, via email STUDENT INDEMNITY AGREEMENT IN CONSIDERATION of the Organiser permitting me to participate in the training course I agree with it as follows: I UNDERSTAND that participating in any type of training or course or activity may be present varying forms of RISK and possible hazards and I voluntarily ACCEPT the risk of damage consequent upon or arising from my entry as a student, and the use of the Organiser's facilities. I WILL NOT SUE the Organisers for any negligence, tort, breach of contractual or any other legal or equitable rights howsoever caused, and this indemnity will extend to and include any damage arising from my participation in a training course and from my use of the Organiser's facilities and I INDEMNIFY the Organisers in respect of the same. I WILL abide by the Rules and Regulations of the Organisers as to the training and to the use of the Organiser's facilities and the directions of the Organiser's officials including the right to terminate or cancel my training and the use of the Organiser's facilities at any time and for any reason. THE PERSONAL INFORMATION I have supplied to the Organiser regarding my qualifications, experience and any other matter associated with the training is true and correct and I have READ AND UNDERSTOOD all of the clauses of this agreement before accepting the same and before my use of the Organiser's facilities or before any participation in training. IN THIS AGREEMENT the following words shall respectively mean: "The Student" - the person named as such on this application form on this paper over the page. "The Organiser" – RTO Name (any campus or organisation associated with a RTO Name school, Registered Training Organisation or company), RTO Name and any teachers, lecturers, instructors, directors, officers, managers, advisors, employees, agents, licensees, subcontractors, subsidiaries, holding companies, associates and assignees, or any person associated with the company in any way; the course participation venue, company in control of the venue or any company or person authorising the use of the training venue, its directors, officers, managers, advisors, employees, agents, licensees, subcontractors, subsidiaries, holding companies, associates and assignees or any person or company associated with the company or person in any way. "The Organiser's facilities" - the land and buildings associated with any training or any part of the training, training resources, accommodation or training venue. "use of the Organiser's facilities" - the use by the student or his / her attempted use of the Organiser's facilities whether such use or access is in breach of this agreement or the Organiser's Rules and Regulations or authorised or otherwise and whether intended to be so used or not. "damage" - all loss or damage, costs or expenses, whether direct or indirect flowing from any legal liability, claim, demand, right of action, proceedings or judgment of whatever nature and whether arising at law or in equity and whether suffered to the person or property of the Organiser, the Student, or any other person or corporation and whether arising out of or consequent upon the negligence of the Organiser, the Student or otherwise. "Rules and Regulations" - the Rules and Regulations are the Rules and Regulations relating to any Training which is available from the Organiser, and includes all amendments or alterations to the Rules and Regulations made from time to time. I have read and understood the Student Indemnity Agreement (above). Privacy Notice Under the Data Provision Requirements 2012, ITS 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 and your training activity data) may be used or disclosed by ITS for statistical, regulatory and research purposes. ITS may disclose your personal information for these purposes to third parties, including: School – if you are a secondary student undertaking VET, including a school-based apprenticeship or traineeship; Employer – if you are enrolled in training paid by your employer; Commonwealth and State or Territory government departments and authorised agencies; NCVER; Organisations conducting student surveys; and Researchers. Personal information disclosed to NCVER may be used or disclosed for the following purposes: Issuing a VET Statement of Attainment or VET Qualification, and populating Authenticated VET Transcripts; facilitating statistics and research relating to education, including surveys; 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 an NCVER student survey which may be administered by an NCVER employee, agent or third party contractor. 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 VET Data Policy and all NCVER policies and protocols (including those published on NCVER’s website at www.ncver.edu.au).PhoneThis field is for validation purposes and should be left unchanged.