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Selected Course:	BSB51915 - Diploma of Leadership and Management
Selected Training Plan:	Diploma of Leadership and Management

Title: *	Title
First Name: *
Middle Name:
Last Name: *
Gender: *
Date of Birth: *
Country of Birth: *
City/Town of Birth: *
Origin: *	I am applying from within Australia?

Do you have a USI: *	What is a USI?
USI Number: *
We can apply for a Unique Student Identifier on your behalf. Please indicate below whether you would like us to do so.
Obtain a USI?: *
Please provide a means of identification that we can use.
You will need to get a USI from the USI Website and provide it to us, before commencing this course.
Identification Type? *
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Drivers Licence Number: *
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Medicare Number: *
Individual Ref Number: *
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Expiry Date: *
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Name Line 3: *
Name Line 4: *
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Passport Number: *
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Registration Number: *
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Date Printed:
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Acquisition Date: *
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Unit or Flat Number:
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Email Address: *
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Note: Please specify at least one of the above contact numbers.

What is your highest COMPLETED school level? *
Year Completed: *	(e.g. 2010)
Are you currently at school? *
What is your CURRENT school level? *
Have you completed any other qualifications? *
Select all that apply
Bachelor 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
Are you applying for credit transfer? *
Which best describes your reason for this study? *

You may upload documents in support of your application.
Select Files	Note: These files will be sent via email, so please limit their size to less than 10MB in total.

In applying for this training, you are advised that Commonwealth Departments are entitled to collect enrolment and training activity information about you for the purpose of monitoring training quality and reporting on training activity. The information you provide will be accessed to support the ongoing statistical analysis of the Australian vocational training sector. We will not disclose your personal information to any unauthorised persons or organisations. The information collected in this form is required to facilitate your enrolment and will be handled and stored in line with our Privacy Procedures. We reserve the right to verify any of the details you have provided on this form in order to process your application. By submitting this form, I certify that:
	I have reviewed the Student Information Booklet available on this website and have been informed about my rights and obligations.
	I have reviewed the course fees and payment arrangements and have been informed of the refund policy.
	I have reviewed the relevant course brochure and have been informed of the training and assessment services to be provided.
	The information provided is true and correct. I further certify that I have been provided sufficient information about my rights and obligations to make an informed decision about enrolment and I agree to the services being provided.

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Which best describes your employment status? *
Are you an Aboriginal or Torres Strait Islander? *
Select an option
Yes, Aboriginal Yes, Torres Strait Islander Yes, Aboriginal AND Torres Strait Islander
Do you speak a language other than English at home? *
Please specify which language:
How well do you speak English? *
Do you have a disability or impairment? *
Select all that apply
Hearing/deaf Physical Intellectual Learning Mental illness Acquired brain impairment Vision Medical condition Other Not specified
Do you have any individual needs we should know about?
Please specify: