Page 1 of 5 TMT F5.1-1 Enrolment and Training Agreement V13 2020 06 (ID 470277) | 14 July 2020 Total Management & Training, 30 Minnie Street, Cairns Q 4870

ENROLMENT & TRAINING AGREEMENT

COURSE OR TRAINING INFORMATION

Course - Enter course names and codes (if known). Course Date - Enter the date of training course or online only

1st Course Course Date

2nd Course Course Date 3rd Course Course Date

PERSONAL DETAILS Clearly print your full given names and surname (this will appear on your certificate). No nick names, or shortened versions of your name.

Title MR MRS MISS MS OTHER

Given Name* Middle Name Surname* Preferred Name Position Date of Birth* Work Phone Mobile Phone Home Phone Email Address **

*Information required for Accredited Courses ** Certificates will be emailed to this address

Residential Address Building Name/Unit Street Number/Name Suburb Postcode Postal Address* Same as street address Street Number/Name PO Box Suburb Postcode

*Qualification certificates only will have a printed copy posted to the above postal address

Unique Student Identifier (USI) Unique Student Identifier (USI): Use CAPITALS ONLY

Cannot remember your USI number – visit www.usi.gov.au

Check this option to instruct TMT not to access your USI details on the Government Portal.

Please only complete this section if you do not have a USI and you would like TMT to create one for you

Drivers Licence number State

Learner Unique Identifier (LUI) (secondary school students):

Emergency Contact Details Full Name of Contact Relationship to You Contact Number

Page 2 of 5 TMT F5.1-1 Enrolment and Training Agreement V13 2020 06 (ID 470277) | 14 July 2020 Total Management & Training, 30 Minnie Street, Cairns Q 4870

AUTHORISATION AND PAYMENT

Please note your enrolment cannot be accepted if the payment area is left blank. Please refer to the Student Handbook for further information on financial responsibility, payment of fees, refunds and a list of TMT’s Fee and Charges. For all transactions over $1500 a split payment will be required.1

I am paying for myself I am accessing funded training

Amount Payable (up to a maximum of $1500)1 $

Balance Payable (if cost of course is over $1500) $ Individuals who wish to pay above $1500 in pre-payment fees must speak to a management representative.

My employer is paying for me I am accessing funded training Authorising Person’s Name

Signature Contact Number

Email Address

Full Amount Payable $

PLEASE CHOOSE ONE PAYMENT METHOD

Purchase Order Purchase Order Number

Direct Deposit A tax invoice will be issued with direct deposit details

Payment Plan We have payment plans available for courses over $500. Please note there are additional fees and charges associated with payment plans. TMT will contact you directly with more details.

Cash Credit Card Please charge the above amount to my credit card – see below

Card Type VISA MasterCard (only Visa or MasterCard accepted)

Cardholder’s Name Signature

Card Number Expiry Date

CCV Number2 Transaction Authority Expiry Date3

Please contact me for Credit Card Details

1 As an RTO we are prohibited to hold more than $1500 of prepaid student fees for individuals (Note: this does not apply to companies or organisations). We ensure this does not occur through the following ways:

1. We only charge a deposit of $1500 prior to the delivery of any training or providing any support services.2. If the individual undertakes classroom or self-paced study – we charge the balance when you are halfway through

your enrolment.2 CCV number is the 3 digit number on the back of the card. 3 Transaction Authority Expiry Date means we can debit your credit card up to a specific date you specify, after that we no longer have authority to debit your card.

We encourage you to read our Student Handbook which outlines your rights and responsibilities.

Page 3 of 5 TMT F5.1-1 Enrolment and Training Agreement V13 2020 06 (ID 470277) | 14 July 2020 Total Management & Training, 30 Minnie Street, Cairns Q 4870

Employer Information Employed (complete information below) Not Employed (move onto next section)

Company Name

Street Address Suburb Postcode Postal Address* Same as street address Street Number/Name PO Box Suburb Postcode

Contact Person Mobile Phone Work Phone Company ABN Fax Number Email Address Do you provide permission for us to contact your employer to discuss the progression of your studies if they are paid for by your employer? YES NO

Would your employer like to subscribe to our update service? YES NO

STUDENT STATISTICAL DATA

As a Registered Training Organisation in Queensland, we must comply with the Standards for Registered Training Organisations (RTOs) 2015. In particular, we must ensure we collect appropriate statistical data on behalf of our National VET Regulator, the Australian Skills Quality Authority (www.asqa.gov.au) and the National Centre for Vocational Education Research (www.ncver.edu.au).

We as an RTO cannot issue your certificate unless this information has been collected. The information collected will not be provided to any recipient other than the registering body as required by the Standards for Registered Training Organisations (RTOs) 2015.

Citizenship and Cultural Diversity Gender Male Female Indeterminate / Intersex / Unspecified

What is your country of birth? Australia Other –

What is your city of birth?

Country of Citizenship

Australian Citizenship Status Australian citizen New Zealand citizen Visa Holder

Australian permanent resident Overseas – no visa or citizenship

Circle your visa type Student / Temporary Resident / Visitors / Business / Holiday / Other

Do you identify as Aboriginal or Torres Strait Islander?

No Aboriginal Torres Strait Islander

Page 4 of 5 TMT F5.1-1 Enrolment and Training Agreement V13 2020 06 (ID 470277) | 14 July 2020 Total Management & Training, 30 Minnie Street, Cairns Q 4870

Employment Status Of the following categories, please tick ONE only which BEST describes your current employment status?

Full-time Employee Part-time Employee/Casual Self-employed, not employing others Employer Employed – unpaid worker in a family business

Unemployed – seeking full-time work Unemployed – seeking part-time work Unemployed – not seeking employment

Language Proficiency, Language Literacy and Numeracy Support Do you speak a language other than English at home?

No, English only

Other

How well do you speak English?

Very well Well Not well Not at all

Do you require assistance to read, write, do math or speak with people? If you ticked yes, please tick which area below.

YES NO

Reading Writing Numbers Communication

Highest Completed School Level Are you still attending school? Yes No

If yes, name of school

Please tick only one

What is your highest COMPLETED school level?

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?

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

Yes – please indicate below No Not Specified

If yes, please indicate the area of disability, impairment, or long-term condition.

You may tick more than one.

Hearing/Deaf Physical Intellectual Learning Mental Illness

Acquired Brain Impairment Vision Medical Condition Other

Previous Qualifications Achieved Have you SUCCESSFULLY completed any qualifications listed?

Yes - please tick all that apply below No

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 Certificate I Certificates other than the above

Page 5 of 5 TMT F5.1-1 Enrolment and Training Agreement V13 2020 06 (ID 470277) | 14 July 2020 Total Management & Training, 30 Minnie Street, Cairns Q 4870

Study Reason – Please tick one box only To get a job It was a requirement of my job

To develop my existing business I wanted extra skills for my job

To start my own business To get into another course of study

To try for a different career For personal interest or self-development

To get a better job or promotion Other reasons

MARKETING INFORMATION

TMT may take photos of students undertaking training and assessment for Good News Stories. Please indicate below consent to your photo being taken and used in social media and other advertising. Please note if NEITHER box is ticked, consent will be implied.

Yes, happy to be in photo opportunity No, do not want to be in the photos

Please let us know how you found out about this course.

Word of mouth Internet search Social media Existing client/student Employer arranged Referral ______________________ Other ____________________

TMT likes to keep students updated on safety issues, market and legislative changes and interesting news from the safety and training industries. We would like to subscribe you to this service. Please provide your permission below:

Yes, please keep me up to date No thank you

TERMS AND CONDITIONS Our Student Handbook sets out your rights and responsibilities under this training agreement and can be accessed online here or in hard copy from your trainer or from Reception staff. The Handbook explains in detail our commitment to you and your obligations under our training agreement. Areas of highlight include legislative requirements, health and safety, recognition of existing qualifications, access and equity, assessment procedures, recognition of prior learning, literacy and numeracy assistance, client support, appeals processes and conduct expectations, payment of fees, student support, refunds, extensions and deferrals.

We encourage you to seek clarification on any issues which are important to you, and please ensure you familiarise yourself with the contents of the Student Handbook prior to enrolling in training.

STUDENT’S AGREEMENT AND DECLARATION • I declare that to the best of my knowledge the information in this application and the documentation

supporting my application is correct and complete.• I acknowledge that I have read, understood and accepted my rights and obligations, and the policies and

procedures in the Student Handbook.• I have read all the terms and conditions above; I fully understand every item, and I agree to all terms and

conditions.

Sign Here Participant Signature Date Parent/Guardian Signature (if student is under the age of 18) Date

Please email your enrolment to enrolments@totalmantra.com.au