Short Course Enrolment Form APPLICANT INFORMATIONFamily Name (Surname):*Given Name:*Date of Birth (dd/mm/yy):* Date Format: DD slash MM slash YYYY Gender:*MaleFemaleOtherProvide your Unique Student Identifier Number (USI)?:*If your USI is not known or you have forgotten then please visit: https://www.usi.gov.au/faqs/i-have-forgotten-my-usiE-mail Address:* Mobile Phone:*Work Phone:*Home Phone:*Unit Number:*Street Number:*Street Name:*Suburb or Town:*State:*Postcode:*EMERGENCY CONTACTName:*Relationship*Mobile Phone:*COURSE DETAILSCampus Location:*BrisbaneParramattaAdelaideCourses*BaristaRSAFirst AidManual HandlingSITHFAB005 Prepare and serve espresso coffee SITXFSA001 Use hygienic practices for food safetyStart Date:* Date Format: DD slash MM slash YYYY Fee:*SITHFAB002 Provide responsible service of alcohoStart Date:* Date Format: DD slash MM slash YYYY Fee:*HLTAID001 Provide cardiopulmonary resuscitation HLTAID003 Provide first aid* HLTAID004 Provide an emergency first aid response in an education and care setting**Start Date:* Date Format: DD slash MM slash YYYY Fee:*HLTWHS005 Conduct manual tasks safelyStart Date:* Date Format: DD slash MM slash YYYY Fee:**This unit incorporates the content of units: HLTAID001 Provide cardiopulmonary resuscitation and HLTAID002 Provide basic emergency life support ** This unit include units HLTAID001 Provide cardiopulmonary resuscitation, HLTAID002 Provide basic emergency life support, HLTAID003 Provide first aidTERMS AND CONDITIONS Queensford College reserves the right to cancel classes at any time prior to their commencement. If a class is cancelled, students will be advised by SMS and email no later than two days prior to its scheduled commencement date. We require a current mobile and email address to communicate details relating to your application. If the training date selected is not available, you will be contacted via email and/or phone to confirm your availability and enrolment into the next available training date/s. If alternative dates are not available, fees paid will remain in the students account. Course Cancellation and Refund Information: If you wish to cancel your enrolment, you must provide us with written notification to info@queensford.edu.au stating your full name, course details and reason for cancellation. Please note there will be NO REFUNDS granted before, on or after commencement date of a course. Students will be enrolled into the next class session if they have notified the college they cannot attend and wish to attend the next class session. By enrolling in this course you are agreeing you have the minimum entry requirements for this course. Minimum age for enrolment is 16 years unless authorised by the Business Area Manager. A USI number is required for assessed courses otherwise Statement cannot be issued. Statement of Attendance or Statement of Attainment will be issued to the student two to four weeks after successful completion of course. Information on our privacy policy is available on our website: https://queensford.edu.au/privacy-policy Due to privacy compliance we cannot issue student details or outcomes to employers. Consent* I declare that I have read and understand the above terms and conditions.*Name:*Signature:*Date* Date Format: DD slash MM slash YYYY FEE PAYMENTFees paid by:*StudentCompanyParent/GuardianIf paid by company:Business Name:*Business Address:*PAYMENT OPTIONPayment option by:*EFTPOSCheque/Money OrderCompany Purchase OrderCredit Card – Please note that a 2.5% surcharge applies:*Card Type:*MastercardVISAExpiry Date:* Date Format: DD slash MM slash YYYY Card Number:*Card Holder:*I hereby authorise Queensford College to debit the amount of AUD$*from my credit card.Signature:*Date* Date Format: DD slash MM slash YYYY OFFICE USE ONLYPayment Amount: AUD$Processed By:Date Date Format: DD slash MM slash YYYY This iframe contains the logic required to handle Ajax powered Gravity Forms.
