TENTERFIELD COMMUNITY COLLEGE INC

ENROLMENT FORM
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Personal details
Family name (surname)__________________________Given name/s___________________________

Home Phone _____________________ Mobile ___________________________

Email _______________________________

Your birth date _____________________ Male Female

Course Name _____________________________________________________________

What is the address of your usual residence? What is your postal address (if different from residential)?



Sig
nat
ure
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___
___
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_________________ Date
__________________
Your signature on this enrolment form is your consent for this information to be made available for research, statistical
analysis and evaluation by Government and internal management purposes

The questions below are designed to ensure we can accurately assess the learning and course support needs for students
enrolling in vocational courses.
Language and cultural diversity
In which country were you born?
Australia Other Please specify; _____________________________________________


Do you speak a language other than English at home?


(If more than one language, indicate the one that is spoken most often)
No, English only
Yes, please specify which
language


How well do you speak English?
Very well Well Not well Not at all

Are you of Aboriginal or Torres Strait Islander origin?


(For persons of both Aboriginal and Torres Strait Islander origin, mark both Yes boxes)
No Yes, Aboriginal Yes, Torres Strait Islander


The assessment and qualification issued for this course may be in agreement with one of these RTOs


Building/property name
Flat/unit
Street or lot number
Street name
Town
State/territory
Postcode
Building/property name
Flat/unit
Street or lot number
Street name
Postal Box No.
Town
State/territory
Postcode
TENTERFIELD COMMUNITY COLLEGE INC
ENROLMENT FORM
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Disability

Do you consider yourself to have a disability, impairment or long-term condition?
YES NO

If you indicated the presence of a disability, impairment or long-term condition, please select the area(s) in the following
list: (You may indicate more than one area)

Hearing/deaf Hearing/deaf
Physical
Intellectual What type of support do you think would be helpful?
Learning
Mental illness
Acquired brain impairment
Vision
Medical condition
Other
Schooling
Are you still attending secondary school? YES NO

What is your highest COMPLETED school level? (Tick ONE box only)
Year 12 or equivalent Year 11 or equivalent Year 10 or equivalent
Year 9 or equivalent Year 8 or below Never attended school

In which YEAR did you complete that school level? ______________________________

Previous qualifications achieved
Have you successfully completed any of the following qualifications? YES NO
If YES, then tick ANY applicable boxes.
Batchelor Degree or higher Advanced diploma or associate degree
Diploma or associate diploma Certificate IV
Certificate III Certificate II
Certificate I Certificate other that above
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 family business Unemployed-seeking part-time work
Unemployed-seeking full time work Not employed-not seeking work

Of the following categories, which BEST describes your main reason for undertaking this course? (Tick ONE box only)
To get a job To develop my existing business To develop my existing 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
.