FIRST AID & CPR COURSE TOWNSVILLE CPR ONLY course $60 SAVE $10 HLTAID009 (1 yr) FIRST AID + CPR course $120 SAVE $30 HLTAID009 (1 yr)HLTAID010 (3 yr)HLTAID011 (3 yr) 1COURSE SELECTION2PERSONAL DETAILS 3ENROLMENT DETAILS4COMPLIANCE QUESTIONS5TERMS & CONDITIONS6PAYMENT Select Course* CPR Only - Tuesday 30th April 2024 - 5:30pm-7:30pm CPR & FIRST AID - Tuesday 30th April 2024 - 5:30pm-8:30pm Total $ 0.00 Enter Coupon Code Personal DetailsName* First Last Date of Birth* DD slash MM slash YYYY Gender* Male Female Other USI Contact DetailsEmail* Telephone*Mobile*Address* Street Address Address Line 2 City State Postcode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Address Same? My Postal Address Is the Same Postal Address Postal Address Line 1 Postal Address Line 2 Postal Suburb Postal State Postal Postcode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Postal Country Next of Kin Next of Kin Contact No.* In which country were you born?*AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweTown of Birth* Do you give Fitness Institute permission to do a USI search on your behalf (if required)?* Yes No Are you of Aboriginal or Torres Strait Islander origin?* Yes No Main Language Spoken at Home*1201 - English8998 - Aboriginal English, so described6513 - Acehnese9201 - Acholi8901 - Adnymathanha9299 - African Languages, nec1403 - Afrikaans9203 - Akan8121 - Alawa3901 - Albanian8315 - Alngith8603 - Alyawarr9101 - American Languages9214 - Amharic8156 - Amurdak8101 - Anindilyakwa8610 - Anmatyerr8619 - Anmatyerr, nec8607 - Antekerrepenh8703 - Antikarinya9241 - Anuak8902 - Arabana4202 - Arabic8699 - Arandic, nec4901 - Armenian8199 - Arnhem Land and Daly River Region Languages, nec3903 - Aromunian (Macedo-Romanian)8620 - Arrernte8629 - Arrernte, nec5213 - Assamese4206 - Assyrian Neo-Aramaic9701 - Auslan4302 - Azeri8946 - Baanbay8947 - Badimaya6514 - Balinese4104 - Balochi8903 - Bandjalang8904 - Banyjima8948 - Barababaraba8801 - Bardi9242 - Bari2901 - Basque9243 - Bassa8905 - Batjala3401 - Belorussian9215 - Bemba5201 - Bengali8906 - Bidjara6515 - Bikol8504 - Bilinarra6501 - Bisaya9402 - Bislama3501 - Bosnian3502 - Bulgarian8802 - Bunuba8181 - Burarra8180 - Burarran8189 - Burarran, nec6101 - Burmese6199 - Burmese and Related Languages, nec7101 - Cantonese8399 - Cape York Peninsula Languages, nec2301 - Catalan6502 - Cebuano1199 - Celtic, nec8611 - Central Anmatyerr4207 - Chaldean Neo-Aramaic6102 - Chin Haka7199 - Chinese, nec3503 - Croatian3601 - Czech3604 - Czechoslovakian, so described8233 - Daatiwuy8951 - Dadi Dadi8122 - Dalabon9244 - Dan (Gio-Dan)1501 - Danish4105 - Dari8221 - Dhalwangu8907 - Dhanggatti8210 - Dhangu8219 - Dhangu, nec8952 - Dharawal8220 - Dhay'yi8229 - Dhay'yi, nec5214 - Dhivehi8230 - Dhuwal8239 - Dhuwal, nec8240 - Dhuwala8249 - Dhuwala, nec8291 - Dhuwaya9216 - Dinka8908 - Diyari8305 - Djabugay8953 - Djabwurrung8231 - Djambarrpuyngu8292 - Djangu8232 - Djapu8222 - Djarrwark8250 - Djinang8259 - Djinang, nec8260 - Djinba8262 - Djinba8269 - Djinba, nec5199 - Dravidian, nec1401 - Dutch8306 - Dyirbal8612 - Eastern Anmatyerr8621 - Eastern Arrernte1601 - Estonian9217 - Ewe9301 - Fijian5217 - Fijian Hindustani6512 - Filipino1602 - Finnish1699 - Finnish and Related Languages, nec2101 - French1402 - Frisian9245 - Fulfulde9218 - Ga1101 - Gaelic (Scotland)8211 - Galpu8813 - Gambera8911 - Gamilaraay8261 - Ganalbingu8157 - Garrwa8913 - Garuwali4902 - Georgian1301 - German9302 - Gilbertese8307 - Girramay8914 - Githabul8212 - Golumala8803 - Gooniyandi2201 - Greek8123 - Gudanji8954 - Gudjal5202 - Gujarati8242 - Gumatj8915 - Gumbaynggir8171 - Gundjeihmi8182 - Gun-nartpa8243 - Gupapuyngu8505 - Gurindji8506 - Gurindji Kriol8183 - Gurr-goni8302 - Guugu Yimidhirr8244 - Guyamirrilili7102 - Hakka9221 - Harari9222 - Hausa9403 - Hawaiian English4107 - Hazaraghi4204 - Hebrew5203 - Hindi6201 - Hmong6299 - Hmong-Mien, nec3301 - Hungarian6516 - Iban2399 - Iberian Romance, nec1502 - Icelandic9223 - Igbo6503 - IIokano6517 - Ilonggo (Hiligaynon)5299 - Indo-Aryan, nec6504 - Indonesian9601 - Invented Languages4199 - Iranic, nec1102 - Irish2401 - Italian8127 - Iwaidja8128 - Jaminjung7201 - Japanese8507 - Jaru6518 - Javanese8814 - Jawi8131 - Jawoyn8132 - Jingulu8401 - Kalaw Kawaw Ya/Kalaw Lagaw Ya8916 - Kanai5101 - Kannada8917 - Karajarri6103 - Karen8918 - Kariyarra8704 - Kartujarra5215 - Kashmiri8921 - Kaurna8922 - Kayardild8606 - Kaytetye8955 - Keerray-Woorroong9702 - Key Word Sign Australia6301 - Khmer8815 - Kija9224 - Kikuyu8899 - Kimberley Area Languages, nec9246 - Kinyarwanda (Rwanda)9247 - Kirundi (Rundi)9502 - Kiwai8308 - Koko-Bera5204 - Konkani7301 - Korean9248 - Kpelle9251 - Krahn9225 - Krio8924 - Kriol8316 - Kugu Muminh8705 - Kukatha8706 - Kukatja8301 - Kuku Yalanji8133 - Kunbarlang8172 - Kune8173 - Kuninjku8174 - Kunwinjku8170 - Kunwinjkuan8179 - Kunwinjkuan, nec4101 - Kurdish8311 - Kuuk Thayorre8303 - Kuuku-Ya'u8158 - Kuwema8956 - Ladji Ladji8312 - Lamalama6401 - Lao8925 - Lardil8136 - Larrakiya2902 - Latin3101 - Latvian1302 - Letzeburgish9252 - Liberian (Liberian English)8508 - Light Warlpiri9262 - Lingala3102 - Lithuanian8235 - Liyagalawumirr8236 - Liyagawumirr9253 - Loma (Lorma)9226 - Luganda9254 - Lumun (Kuku Lumun)9227 - Luo8707 - Luritja3504 - Macedonian8293 - Madarrpa9255 - Madi8137 - Malak Malak6505 - Malay5102 - Malayalam8511 - Malngin2501 - Maltese4208 - Mandaean (Mandaic)7104 - Mandarin9256 - Mandinka8926 - Mangala8138 - Mangarrayi8246 - Manggalili9257 - Mann8263 - Manyjalpingu8708 - Manyjilyjarra9303 - Maori (Cook Island)9304 - Maori (New Zealand)5205 - Marathi8141 - Maringarr8142 - Marra8161 - Marramaninyshi8234 - Marrangu8166 - Marridan (Maridan)8143 - Marrithiyel8711 - Martu Wangka8144 - Matngala8111 - Maung9205 - Mauritian Creole8175 - Mayali8402 - Meriam Mir4299 - Middle Eastern Semitic Languages, nec7107 - Min Nan8804 - Miriwoong8957 - Mirning6303 - Mon7902 - Mongolian6399 - Mon-Khmer, nec9258 - Moro (Nuba Moro)8317 - Morrobalama9503 - Motu (HiriMotu)8512 - Mudburra8146 - Murrinh Patha8927 - Muruwari8147 - Na-kara8928 - Narungga9306 - Nauruan9228 - Ndebele8148 - Ndjébbana (Gunavidji)5206 - Nepali8712 - Ngaanyatjarra8151 - Ngalakgan8152 - Ngaliwurru8162 - Ngandi8113 - Ngan'gikurunggurr8514 - Ngardi8805 - Ngarinyin8515 - Ngarinyman8931 - Ngarluma8932 - Ngarrindjeri8958 - Ngatjumaya8280 - Nhangu8281 - Nhangu8289 - Nhangu, nec9307 - Niue9404 - Norf’k-Pitcairn8599 - Northern Desert Fringe Area Languages, nec1503 - Norwegian9231 - Nuer8153 - Nungali8114 - Nunggubuyu8933 - Nyamal8934 - Nyangumarta9232 - Nyanja (Chichewa)8806 - Nyikina8935 - Nyungar9499 - Oceanian Pidgins and Creoles, nec5216 - Oriya9206 - Oromo8999 - Other Australian Indigenous Languages, nec7999 - Other Eastern Asian Languages, nec3999 - Other Eastern European Languages, nec6999 - Other Southeast Asian Languages5999 - Other Southern Asian Languages2999 - Other Southern European Languages, nec4999 - Other Southwest and Central Asian Languages, nec8290 - Other Yolngu Matha8299 - Other Yolngu Matha, nec8936 - Paakantyi9399 - Pacific Austronesian Languages, nec8937 - Palyku/Nyiyaparli6521 - Pampangan9599 - Papua New Guinea Languages, nec4102 - Pashto4106 - Persian (excluding Dari)8713 - Pintupi8714 - Pitjantjatjara3602 - Polish2302 - Portuguese5207 - Punjabi8115 - Rembarrnga8295 - Rirratjingu8271 - Ritharrngu6104 - Rohingya3904 - Romanian3905 - Romany9312 - Rotuman3402 - Russian9308 - Samoan1599 - Scandinavian, nec3505 - Serbian3507 - Serbo-Croatian/Yugoslavian, so described9238 - Seychelles Creole9233 - Shilluk9207 - Shona9799 - Sign Languages, nec5208 - Sindhi5211 - Sinhalese3603 - Slovak3506 - Slovene9405 - Solomon Islands Pijin9208 - Somali6599 - Southeast Asian Austronesian Languages, nec2303 - Spanish9211 - Swahili1504 - Swedish6511 - Tagalog6499 - Tai, nec5103 - Tamil4303 - Tatar5104 - Telugu6507 - Tetum6402 - Thai8318 - Thaynakwith9261 - Themne7901 - Tibetan9234 - Tigré9235 - Tigrinya6508 - Timorese8117 - Tiwi8322 - Tjungundji8722 - Tjupany9504 - Tok Pisin (Neomelanesian)9313 - Tokelauan9311 - Tongan9236 - Tswana5105 - Tulu4399 - Turkic, nec4301 - Turkish4304 - Turkmen9314 - Tuvaluan3403 - Ukrainian5212 - Urdu4305 - Uygur4306 - Uzbek6302 - Vietnamese8163 - Waanyi8272 - Wagilak8164 - Wagiman8938 - Wajarri8516 - Walmajarri8961 - Waluwarra8154 - Wambaya8715 - Wangkajunga8962 - Wangkangurru8716 - Wangkatha8213 - Wangurri8517 - Wanyjirra8155 - Wardaman8963 - Wargamay8518 - Warlmanpa8521 - Warlpiri8717 - Warnman8294 - Warramiri8522 - Warumungu1103 - Welsh8964 - Wergaia8622 - Western Arrarnta8799 - Western Desert Language, nec8304 - Wik Mungkan8314 - Wik Ngathan8941 - Wiradjuri8807 - Worla8808 - Worrorra7106 - Wu8247 - Wubulkarra8811 - Wunambal8251 - Wurlaki9237 - Xhosa8270 - Yakuy8279 - Yakuy, nec8718 - Yankunytjatjara8282 - Yan-Nhangu8165 - Yanyuwa9315 - Yapese8812 - Yawuru1303 - Yiddish8313 - Yidiny8943 - Yindjibarndi8944 - Yinhawangka8945 - Yorta Yorta9212 - Yoruba8965 - Yugambeh8721 - Yulparija8403 - Yumplatok (Torres Strait Creole)8321 - Yupangathi6105 - Zomi9213 - ZuluHow well do you speak English?*Not StatedVery WellWellNot WellNot at AllOf the following categories, which BEST describes your current employment status?*Not StatedFull-time employeePart-time employeeSelf-employed - not employing othersEmployerEmployed - unpaid worker in a family businessUnemployed - seeking full-time workUnemployed - seeking part-time workNot employed - not seeking employmentOf the following categories, which BEST describes your main reason for undertaking this course/traineeship/apprenticeship?*Not StatedTo get a jobTo develop my existing businessTo start my own businessTo try for a different careerTo get a better job or promotionIt was a requirement of my jobI wanted extra skills for my jobTo get into another course of studyOther reasonsFor personal interest or self-developmentTo get skills for community/voluntary workHighest School Level Completed*Not StatedDid not go to schoolYear 8 or belowYear 9 or equivalentCompleted Year 10Completed Year 11Completed Year 12In which year did you complete that school level?*2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Are you still attending secondary school? (Yes / No)* Yes No Survey Contact Status*Available for survey useCorrectional facility (address or enrolment)Deceased studentExcludedInvalid address / Itinerant student (very low likelihood of response)Minor - under age of 15 (not to be surveyed)Overseas (address or enrolment)Do you consider yourself to have a disability, impairment or long-term condition? if Yes, please indicate the areas of disability, impairment or long-term condition: Hearing/Deaf Physical Intellectual Learning Mental Illness Acquired Brain Impairment Vision Medical Condition Other (Only use when previous options are not applicable) Not Stated If you have SUCCESSFULLY completed any of the following qualifications, tick ANY applicable boxes.* No Previous Qualifications Bachelor Degree or higher Degree Level Advanced Diploma or Associate Degree Level Diploma Level Certificate IV Certificate III Certificate II Certificate I Miscellaneous Education Multiple Qualifications Age* I am at least 18 years old I am under 18 years old (parent/guardian signature required) *Parental/guardian consent is required for all students under the age of 18.Student Declaration and Consent* I understand and agree to the Fitness Institute Terms & Conditions. In signing this agreement, I understand and agree to abide by the Fitness Institute Terms and Conditions of Enrolment. I declare the information I have provided to Fitness Institute is to the best of my knowledge, true and correct. I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above. I understand access to the learning materials will be provided following the receipt of: 1. Payment clearing 2. Fitness Institute terms & conditions of enrolment acknowledgment (signatures required below) 3. Identification being provided Parent/Guardian Declaration & Consent* I understand and agree to the Fitness Institute Terms & Conditions. In signing this agreement, I consent to the above-named student participating in this training program and agree to the fee agreement. I also agree to be responsible for any default payments and other costs which may become payable.Parent/Guardian Name* Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Last Australian Residency Check* Drop files here or Select files Max. file size: 40 MB. • Australian Government Pensioner Concession Card (showing state address) • Australian Government Health Care Card (showing state address) • Commonwealth Seniors Card • Australian Passport • Australian Citizenship certificate • Australian Birth Certificate • Medicare Card either: - A Green Card - A Blue Card with accompanying Australian Government Department of Immigration and Border Protection / Department of Home Affairs documentation, visa and work permits on the pathway to permanent residency. Upload front of card picture (must be a colour copy).State Residency & Date of Birth Check* Drop files here or Select files Max. file size: 40 MB. Please upload both the front and back of a state issued card with your address. This could be either a: • State Issued Driver License • State Issued Proof of Age Card • State Issued Heavy or Marine License Note: If Address on card differs from current residential address, please upload additional information such as an electricity, gas, bank statement or telephone account issued in the last 6 months. Maximum 2 file upload limit for this space. Credit Card*Card Details Cardholder Name Total $ 0.00 For support, contact our Fitness Institute Careers Team on 1300 434 863