Enrolment Form for NON-VET Accredited Courses

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

SECTION A - COURSE REGISTRATION CONFIRMATION

AFL Emergency Response Coordinator (ERC) Course

Price:

SECTION B - PREVIOUS APPLICATIONS AND/OR ENROLMENTS

Have you previously applied to, or been enrolled at Intelligent Training Solutions?(Required)

NO

YES

UNSURE

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?(Required)

NO

YES

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

Prefix(Required)

First Name(Required)

Middle Name

Surname(Required)

Date of birth(Required)

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

What is your gender?(Required)

CONTACT DETAILS

If possible, PLEASE provide us with BOTH your home (landline) and mobile numbers.

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(Required)

Would you like to provide with us an alternative number?

NO

YES

Telephone: Home

Your preferred email address(Required)

Enter Email Confirm Email

RESIDENTIAL ADDRESS

Address(Required)

Street Address Address Line 2 City State Post Code Country

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.

MAILING ADDRESS

Is your mailing address the same as your residential address?(Required)

YES

NO

Please enter your mailing address below.

Please enter your mailing address(Required)

Street Address Address Line 2 City State Post 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

Are you completing this course as part of a requirement for a Sports Club or Team(Required)

NO, Self-interest only

YES

Are you completing this course as part of a requirement for a Sports Club or Team(Required)

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 so that we may 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 and all associated costs will be at your expense.

Would you like to provide us with your preferred emergency contact?(Required)

NO

YES

Please ensure that the person you nominate below is aware of your medical history and will be available to contact on the day of your training.

Who would you like us to contact in the unlikely event of an emergency?

Emergency Contact Full Name(Required)

Prefix First Last

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

Is this course being paid for by a third party such as an employer, school, sporting club, employment agency or other organisation?(Required)

NO

YES

If Yes, please complete the details below

Organisation Name

ABN (Australian Business Number)

Contact Person(Required)

Organisation | Contact Telephone(Required)

Organisation | Contact Email Address(Required)

Enter Email Confirm Email

Organisation Address

Street Address Address Line 2 City State Post Code Country

SECTION F - ENROLMENT PRIVACY NOTICE & TERMS AND CONDITIONS

PRIVACY NOTICE (VERSION 2) 2020 UPDATE

Your personal information, which includes the personal information contained within is registration form, may be used or disclosed by Intelligent Training Solutions for statistical, administrative, regulatory and research purposes. Intelligent Training Solutions may disclose your personal information for these purposes to:

Australian Football League (AFL)

Personal information that has been disclosed to the AFL may be used or disclosed by AFL for the following purposes:

populating authenticated transcripts;
facilitating statistics and research relating to AFL and club related activities, including surveys and data linkage;
pre-populating AFL registration / enrolment forms;
understanding how the AFL market operates, for policy, workforce planning and consumer information; and
administering AFL, including program administration, regulation, monitoring and evaluation.

You may receive a student survey which may be administrated by an Australian Football League (AFL) 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.

TERMS AND CONDITIONS FOR ENROLLING INTO THIS COURSE

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

SECTION G - 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(Required)

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 7-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 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(Required)

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

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 Kit

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.

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

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

YOUR PREFERRED PAYMENT METHOD

PAY VIA CREDIT CARD - 3% Surcharge

PAY VIA PAYPAL - 3% Surcharge

PAY ON INVOICE - Due in 7 days

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

Name

This field is for validation purposes and should be left unchanged.

Enrolment In: AFL EMERGENCY RESPONSE COORDINATOR (ERC) COURSE – East Keilor – Tuesday 09th May 2023

Enrolment Form for NON-VET Accredited Courses

SECTION A - COURSE REGISTRATION CONFIRMATION

SECTION B - PREVIOUS APPLICATIONS AND/OR ENROLMENTS

SECTION C - PERSONAL DETAILS

SECTION D - EMERGENCY CONTACT DETAILS

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

SECTION F - ENROLMENT PRIVACY NOTICE & TERMS AND CONDITIONS

SECTION G - STUDENT DECLARATION

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

PREFERRED PAYMENT METHOD