Enrolment Form

Enrolment Details

Are you applying for Recognition of Prior Learning (RPL)?

Yes No

Course Name

Assistant Agent Course CPP41419 - Certificate IV in Real Estate Practice CPP51122 - Diploma of Property (Agency Management)

Student Details

Title

Gender

Male Female Non-Binary

USI (Unique Student Number) Forgotten your USI? Find it here. Need a USI? Create one here.

First Name Middle Name Surname I have only one legal name Former Name (if applicable) Date of Birth City of Birth Country of Birth

Contact Details

Residential Address Suburb / State Postcode Postal Address (if different) Postal Suburb / State Postal Postcode Mobile Email

Emergency Contact

Name Phone Mobile

Background & Education

Cultural Background

Born in Australia Aboriginal Torres Strait Islander

Birth Country

Language Spoken at Home

English Other

If other language

Highest Completed School Level

Currently at school?

Yes No

Trade Qualification Trade Year Tertiary Qualification

Employment & Reason for Study

Employment Status

Full-time Part-time Self-employed (not employing others) Self-employed (employing others) Unemployed - seeking full-time work Unemployed - seeking part-time work Not employed - not seeking employment

Employer Name Employer Address

Reason for Study (Select ONE)

Support Requirements

Do you have any disability, impairment or long-term condition?

Yes No

Support Types

Other Support

Declarations & Privacy

Please read our Policies & Forms, Student Handbook and Enrolment Information before proceeding.

Student Declaration

You may sign below to include your signature with the saved application.

Student Signature

Declaration Date