Enrolment In: 22578VIC Course in First Aid Management of Anaphylaxis @ Keilor East – Wednesday 24th May 2023

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Enrolment Form

EMAIL: ENROLMENT@ITS.EDU.AU | CALL: 1300 585 866 | WEB: WWW.ITS.EDU.AU

SECTION A - COURSE ENROLMENT CONFIRMATION

22578VIC Course in First Aid Management of Anaphylaxis*

PLEASE NOTE: This enrolment form is for one person only. If you wish to add additional people to this course you will need to complete this enrolment form for each person.

Price:

Would you like to add the '22556VIC Course in the Management of Asthma Risks and Emergencies in the Workplace course' to this enrolment?

Add the 22556VIC Course to this enrolment? Reduced from $65, Now $52

By enrolling on both courses now, you will receive a 20% discount on the 22556VIC course.

SECTION B - PREVIOUS APPLICATIONS AND/OR ENROLMENTS

Have you previously applied to, or been enrolled at Intelligent Training Solutions?*

If Yes, please state your I.T.S Student ID number (If known)

example: ITS000123X

Has your name changed since your last enrolment with us?

If Yes, you must provide documentary evidence (Marriage Certificate etc...)

If Yes, please enter your previous name

Please enter your previous FULL legal name

SECTION C - PERSONAL DETAILS

Single Name Only

Tick this box if you have one name only that cannot be written in the traditional format (example, Name, Middle Name, Surname)

*Please provide us with the name that you used when you applied for your Unique Student Identifier (USI), including any middle names.

Title

First Name*

Enter your first legal given name

Middle Name

Family Name (Surname)*

Enter your legal family name (surname)

Date of birth*

DD slash MM slash YYYY

Select your date of birth using the calendar to avoid formatting errors

What is your gender?*

CONTACT DETAILS

If possible, provide us with your home (landline) and mobile number.

As this course requires the coordination of yourself and our trainers, it may become important for our team to contact you should the need arise.

Telephone: Mobile*

Telephone: Home

Telephone: Work

Your preferred email address*

Enter Email Confirm Email

What is your citizenship status? - Please tick one*

Australian Citizen

New Zealand Citizen

Overseas Resident

Permanent Humanitarian Visa

Permanent Non-Humanitarian Visa

Permanent Visa Holder

Other

RESIDENTIAL ADDRESS

Please provide the physical address of where you usually reside - street number and name, not post office box. Do not provide any temporary address at which you reside for training, work or other purposes. If you are from a rural area, use the address from your state or territory's rural addressing or numbering system as your residential street.

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

MAILING ADDRESS

Is your mailing address the same as your residential address?*

YES

Please enter your mailing address below.

Please enter your mailing address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

NOTE: This will be the address our team will send out your Certificate should you choose to have a printed copy sent to you

UNIQUE STUDENT IDENTIFIER (USI)

From 1 January 2015, Intelligent Training Solutions can be prevented from issuing you with a nationally recognised VET qualification or statement of attainment when you complete your course if you do not have a Unique Student Identifier (USI). In addition, we are required to include your USI in the data we submit to NCVER. If you have not yet obtained a USI you can apply for it directly at https://www.usi.gov.au/providers/create-usi-student on a computer or mobile device.

Please note: You will not need a USI to enrol or attend this course, only to receive a Certificate.

Do you have a Unique Student Identifier (USI)?*

Please enter your USI below*

Please note, your USI will be case sensitive and will need to match the name you provided on this enrolment form.

SECTION D - EMERGENCY CONTACT DETAILS

This course may require you to participate in classroom activities, which may or may not involve outdoor training activities. In the unlikely event of a medical emergency such as a heart attack, asthma or anaphylaxis attack, or any other major or minor emergency, we would like to know who in your family or circle of friends to contact to gather some background medical information on you. This information may be shared with the emergency services team. You are not obligated to provide us with this information; however:

PLEASE NOTE - If you choose not to provide us with your emergency contact details, be aware that in the event of a medical emergency, regardless of how minor, our staff are instructed to call 000 for the emergency services. Any associated costs will be at your expense.

Would you like to provide us with your preferred emergency contact?*

YES

Emergency Contact - Full Name*

Prefix First Middle Last

Telephone: Mobile*

Telephone: Other

Relationship: How this is person related to you?*

SECTION E - AVETMISS DATA COLLECTION & PRE-TRAINING REVIEW (PTR) DATA

Intelligent Training Solutions is required to collect the following information for NCVER. For learn about the AVETMISS data collection process or the NCVER please visit the NCVER website.

For those interested in a quick overview of why Registered Training Organisations such as Intelligent Training Solutions needs to collect AVETMISS data, watch the following NCVER video: https://www.youtube.com/watch?v=hveBYeuGee4.

Please remember, you are entitled to view your own personal information held by Intelligent Training Solutions Pty Ltd at any stage by appointment. If you wish to view your records please our administration office.

RECOGNITION OF PRIOR LEARNING (RPL) OR DIRECT CREDIT TRANSFER (DCT)

Have you enrolled in a similar course elsewhere?*

YES

If Yes, please provide us with the name and course title of the course you completed*

Have you been employed in the area covered by this course?*

YES

If Yes, what was the industry you worked in and the Job title you held?*

LANGUAGE AND CULTURAL DIVERSITY

In which country were you born?*

Country

What was the name of the town you were born in?*

City

Do you speak a language other than English at home?*

YES

If Yes, please specify*

Are you a permanent Australian Resident?*

YES

How well do you speak English?*

Very Well

Well

Not Well

Not at all

Are you of an Aboriginal or Torres Strait Islander origin?*

Aboriginal

Torres Strait Islander

Both

Neither

DISABILITY

Click here to view the Department of Education's Disability Type Identifier / Disability Supplement Information. This information has been provided to assist you with the definitions and requirements for each of the following disabilities.

Do you consider yourself to have a disability, impairment or long-term condition?*

YES

NOTE: STUDENTS WITH A DISABILITY OR CHRONIC MEDICAL CONDITION Intelligent Training Solutions provides advice and assistance for students with accessibility and/or medical requirements. This may include short-term conditions like a broken hand or something more permanent like a hearing or vision impairment. Each student is assessed on an individual basis for appropriate support services. Support services may include alternative assessment arrangements, special equipment or the use of assistive technology

As you indicated 'Yes', please specify the nature of your condition below. Please note you may select more than one.*

Hearing / deaf

Physical

Intellectual

Learning

Mental illness

Acquired brain impairment

Vision

Medical Condition

Other

If other, please specify*

Do you require special assistance because of your disability?*

What can we do to support you during this course?

EMPLOYMENT STATUS - AVETMISS & PTR REQUIREMENT

Of the following categories, which BEST describes your current employment status?*

If unemployed, are you registered as a Jobseeker?*

YES

Of the following categories, which BEST describes your occupation?*

Other? Please specify*

Of the following categories, which BEST describes the industry you work in?*

Other? Please specify*

EDUCATION HISTORY - AVETMISS & PTR REQUIREMENT

Are you still attending secondary school?*

Please provide us with your Victrorian Student Number (VSN)*

What is your highest COMPLETED school level?*

In which YEAR did you complete your highest level of schooling?*

SPECIFIC AQTF EDUCATIONAL HISTORY - AVETMISS & PTR REQUIREMENT

Have you ever SUCCESSFULLY completed a qualification in AUSTRALIA?*

Please tick ANY applicable boxes.*

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

Miscellaneous Education

STUDY REASON - AVETMISS REQUIREMENT

Of the following categories, which BEST describes your main reason for undertaking this course?*

If other reasons, please specify

SECTION F - NOMINATE A THIRD PARTY TO PAY FOR THIS COURSE

Is this course being paid for by a third party such as an employer, school, employment agency or other organisation?*

YES

If Yes, please complete the details below

Organisation Name*

Organisation ABN (Australian Business Number)

Contact Person*

Prefix First Last

Organisation | Contact Telephone*

Organisation | Contact Email Address*

Enter Email Confirm Email

Organisation Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

SECTION G - ENROLMENT PRIVACY NOTICE & TERMS AND CONDITIONS

CLICK HERE TO VIEW THE NCVER VET DATA POLICY | PRIVACY NOTICE - 2ND NOVEMBER 2021 UPDATE

Why do we collect your personal information

As a registered training organisation (RTO), we collect your personal information so we can process and manage your enrolment in a vocational education and training (VET) course with us. Failure to provide your personal information to us will result in Intelligent Training Solutions being unable to provide you with a Certificate of Completion, a Statement of Attainment (SOA), and or any other nationally accredited award and may exclude you from attending our course.

How we use your personal information

We use your personal information to enable us to deliver VET courses to you, and otherwise, as needed, to comply with our obligations as an RTO.

How we disclose your personal information

We are required by law (under the National Vocational Education and Training Regulator Act 2011 (Cth) (NVETR Act)) to disclose the personal information we collect about you to the National VET Data Collection kept by the National Centre for Vocational Education Research Ltd (NCVER). The NCVER is responsible for collecting, managing, analysing and communicating research and statistics about the Australian VET sector.

We are also authorised by law (under the NVETR Act) to disclose your personal information to the relevant state or territory training authority.

How the NCVER and other bodies handle your personal information

The NCVER will collect, hold, use and disclose your personal information in accordance with the law, including the Privacy Act 1988 (Cth) (Privacy Act) and the NVETR Act. Your personal information may be used and disclosed by NCVER for purposes that include populating authenticated VET transcripts; administration of VET; facilitation of statistics and research relating to education, including surveys and data linkage; and understanding the VET market.

The NCVER is authorised to disclose information to the Australian Government Department of Education, Skills and Employment (DESE), Commonwealth authorities, State and Territory authorities (other than registered training organisations) that deal with matters relating to VET and VET regulators for the purposes of those bodies, including to enable:

administration of VET, including program administration, regulation, monitoring and evaluation
facilitation of statistics and research relating to education, including surveys and data linkage
understanding how the VET market operates, for policy, workforce planning and consumer information.

The NCVER may also disclose personal information to persons engaged by NCVER to conduct research on NCVER’s behalf. The NCVER does not intend to disclose your personal information to any overseas recipients. For more information about how the NCVER will handle your personal information please refer to the NCVER’s Privacy Policy at www.ncver.edu.au/privacy.

If you would like to seek access to or correct your information, in the first instance, please contact us using the contact details listed on our website.

DESE is authorised by law, including the Privacy Act and the NVETR Act, to collect, use and disclose your personal information to fulfil specified functions and activities. For more information about how the DESE will handle your personal information, please refer to the DESE VET Privacy Notice at https://www.dese.gov.au/national-vet-data/vet-privacy-notice.

Surveys

You may receive a student survey which may be run by a government department or an NCVER employee, agent, third-party contractor or another authorised agency. Please note you may opt out of the survey at the time of being contacted.

Contact Information

At any time, you may contact Intelligent Training Solutions to:

request access to your personal information
correct your personal information

You can contact the NCVER to:

make a complaint about how your personal information has been handled
ask a question about this Privacy Notice

INTELLIGENT TRAINING SOLUTIONS STANDARD ENROLMENT TERMS AND CONDITIONS

PLEASE TAKE A MOMENT TO REVIEW OUR ENROLMENT TERMS AND CONDITIONS BY CLICKING THE LINK BELOW.

You can also download, view or print a copy of our terms and conditions, including our refund policy, assessment policy and withdrawal policy to name a few, by clicking the Student Administration link below:

CLICK HERE to view the Terms and Conditions associated with your enrolment

CLICK HERE is visit our Student Administration section

TERMS AND CONDITIONS*

I have read and understood the above privacy notice and the terms and conditions related to my enrolment, including those terms and conditions related to government restrictions and lockdowns due to COVID-19 as found on https://www.its.vic.edu.au/enrolment-terms/.

SECTION H - STUDENT DECLARATION

PLEASE NOTE:

TO SUBMIT THIS ENROLMENT FORM, YOU MUST AGREE TO ALL THE TERMS AND CONDITIONS LISTED BELOW & SIGN YOUR NAME WHEN PROMPTED.

STUDENT DECLARATION*

I declare that the information I have provided, to the best of my knowledge, is true and correct.

I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice listed on the previous page.

I understand the terms and conditions of this written agreement, including the refund policy. I have been advised and understand the fees involved with my enrolment and agree to be a student of Intelligent Training Solutions Pty Ltd (RTO: 22570)

I agree to pay all the fees and charges associated with my enrolment. I understand that if I nominate a third party to make payment for this enrolment, I remain liable for all enrolment fees until such time as the nominated third party has settled the account.

I understand that I must give I.T.S 8-days notice if I cannot attend this course. Should I fail to provide 7-days notice, I understand that I am liable and must pay the FULL course fees. Failure to do so will result in my account being sent to a debt collection agency. I understand that failure to officially withdraw from a course, as stated in the refund clause, will result in a vacant position within the course and will deprive I.T.S and the course from the revenue it would provide.

I give permission for Intelligent Training Solutions to apply or search for my Unique Student Identifier on my behalf if I do not provide one myself within this Enrolment Form and I understand that by providing my USI to Intelligent Training Solutions I give permission for Intelligent Training Solutions to view the course records contained in my USI account.

I understand that I can view my own records held by Intelligent Training Solutions by contacting the administration office.

I have made my own enquiries and believe that this training course is suitable for my personal and/or career purposes. I consider that, based on my educational attainment, capabilities, aspirations and interests, this training is appropriate for me.

You must tick all the boxes above to be presented with the 'SUBMIT YOUR ENROLMENT' button.

If you have any concerns about our terms and conditions, please contact our office on 03 5415 0204 during business hours

STUDENT SIGNATURE*

BEFORE YOU GO - CHECK OUT THESE FIRST AID RELATED PRODUCTS YOU MAY BE INTERESTED IN!

PLEASE NOTE: The following services, products and course options are optional and are not required as part of your enrolment. They serve as optional extras designed to assist you with your career.

A PRINTED A4 Statement of Results (CERTIFICATE) - Optional - Extra $8.00

Add Printed Certificate

Each student will receive a their Statement of Results (Certificate) via PDF. This PDF will be sent directly to the email address on this enrolment form once you have successfully completed your course.

NOTE: Only select this option IF YOU WOULD LIKE to receive a printed copy of your Statement of Results (Certificate). All printed copies will be sent via Australia Post using their standard mail service. Delivery times will vary between 2 to 14 days from successful completion of your course depending on the area in which you live.

SURVIVAL WORKPLACE First Aid Kit - $179.95

Add SURVIVAL Workplace First Aid Kit

Tick off every item on your first aid kit checklist with this SURVIVAL First Aid kit. Suitable for home and compliant for workplaces, this kit contains all the components you need to deal with a First Aid emergency.

NOTE: This kit is Nationally compliant with Safe Work Australia's Health and Safety Code of Practice and is therefore approved for use within a workplace.

For more information on this kit or to see a full list of the items included, visit: SURVIVAL EMERGENCY SOLUTIONS

SURVIVAL Snake Bite Kit - $84.95

Add SURVIVAL Snake Bite Kit

Designed in Australia by leading first aid experts and developed in conjunction with snake safety experts (SSSafe), the SURVIVAL Snake Bite Kit is built around the success of SURVIVAL's revolutionary smart bandage to effectively manage potentially deadly snake and funnel-web spider bites. This kit also contains life-saving instructions on correct snake bite bandage techniques.

For more information on this kit or to see a full list of the items included, visit: SURVIVAL EMERGENCY SOLUTIONS

SURVIVAL Pet First Aid Kit - $139.95

Add SURVIVAL Pet First Aid

If you’ve got four-legged friends in your family, or know that certain someone who loves Fido more than life itself, SURVIVAL’s radical new Pet First Aid KIT is the must-have pet product for everyday and emergency use.

Expertly designed to sit perfectly on your hip with a clever waist belt attachment, this pet powerhouse provides easy access to every accessory, treat and first aid tool your favourite furry friend will ever need.

Never again will you need to search through your belongings for a pet poo bag -- swiftly dispose of your doggy doo-doo, with eco-friendly disposal bags located in an easily accessible exterior pocket.

And a zippered pouch for treats means you can reward your favourite fur balls quickly and easily, while keeping all canine goodies safe and secure whenever you’re on the go.

Perfect for the home, car or daily ‘walkies’ adventures, this ground-breaking Pet First Aid KIT features everything you need to keep your beloved furry friends satisfied and safe - and their humans, too!

For more information on this kit or to see a full list of the items included, visit our webpage: SURVIVAL Pet First Aid Kit

LivCor - CellAED - Your Personal Defibrillator (Pre-Order) - $382.95

Pre-Order Only - CellAED

The CellAED® is the smallest, most portable, and most accessible AED ever invented. The CellAED® is an inexpensive, lightweight, easy-to-use AED for homes, offices, and workplaces around the world. CellAED® is designed to save lives from sudden cardiac arrest. An arrest can happen to anyone, anywhere, anytime. Be prepared and confident to act quickly to save a life. CellAED® can be applied in seconds.

For more information on this AED or to see a full list of the items included, visit: LivCor

PREFERRED PAYMENT METHOD

PLEASE SELECT YOUR PREFERRED PAYMENT METHOD*

PAY ON INVOICE - DUE IN 7 DAYS

PAY VIA PAYPAL - ADDITIONAL 3%

PAY VIA CREDIT CARD - ADDITIONAL 3%

By selecting 'PAY VIA PAYPAL' you will be transferred to the PayPal system upon submitting your enrolment form. You do not need a PayPal account to complete your purchase.

By selecting 'PAY VIA CREDIT CARD' you will be transferred to our STRIPE system upon submitting your enrolment form. From here you will be able to securely complete your purchase using your credit card.

TOTAL ENROLMENT FEE

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