eLearn Enrollment FormPlease enable JavaScript in your browser to complete this form.Title *SelectMrMrsMissDrName *FirstMiddleLastEnter your name as it you would like it to appear on your certificate.Email *Type of training you are signing up for? *SelectAccredited / QualificationNon Accredited / QualificationShort courseOtherPlease provide the type of training *To be issued with your certificate on successful completion of this nationally recognised course, please complete the following form ensuring your details match your current USI.Don't have a USI? Secure your free USI here.Date of Birth *Gender *SelectFemaleMaleOtherUnique Student Identifier(Apply for/find your USI. or leave blank if unknown)Mobile *Home PhonePreferred Contact *SelectEmailPhoneCompanyAddress *Address Line 1Address Line 2CityState / Province / RegionPostal CodeLang. spoken at home *Indigenous Status *SelectYes, AboriginalYes, Torres Straits IslanderYes, Aboriginal & Torres Straits IslanderNo, Neither Aboriginal & Torres Straits IslanderDisability *SelectNo disabilityHearing/DeafPhysicalIntellectualLearningMental IllnessAcquired Brain ImpairmentVisionMedical ConditionOtherSchool Level completed *SelectCompleted year 12Completed year 11Completed year 10Completed year 9Completed year 8Did not go to schoolCurrently at High School *YesYesNoBE JOB READY detailsParent/Guardian NameParent/Guardian Contact NumberSchool LUI (QLD students only)*SchoolPrior Qualifications *SelectNoneBachelor Degree or Higher DegreeAdvanced Diploma or Associated DegreeDiploma (or Associated Degree)Certificate IV (or Advanced Certificate/Technician)Certificate III (or Trade Certificate)Certificate IICertificate ICertificates other than the aboveEmployment Status *SelectFull-time employeePart-time employeeSelf employed - not employing othersEmployerEmployed - unpaid worker in a family businessUnemployed - seeking full-time workUnemployed - seeking part-time workNot employed - not seeking employmentStudy Reason *SelectTo get a jobTo develop my existing businessTo start my own businessTo try for a different careerTo get a better job or promotionIt was a requirement of my jobI wanted extra skills for my jobTo get into another course of studyFor personal interest or self-developmentTo get skills for community/voluntary workOther reasonsLLN Assistance *SelectYes pleaseNo thanksI require Language, Literacy and Numeracy assistance.To assist us with this, please complete the LLN Quiz at LLN RobotAdditional NotesHow did you hear about us?SelectEmployer/ColleaguesThe ProForum CommunityCourses.comSkills.orgInternet or Search EngineReturning StudentLinkedInFacebookWalk-insWord of MouthView Privacy Notice *SelectYesPrivacy NoticeUnder the Data Provision Requirements 2012, Pro Leaders Academy 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 Pro Leaders Academy for statistical, administrative, regulatory and research purposes. Pro Leaders Academy 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 programme administration, regulation, monitoring and evaluation. You may receive an NCVER 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).Enrol
