Enrol with Mine Training SolutionsEnrolmentsQueensland, Australia build your career, enrol today!Enrolment Form Please complete all details on this enrolment form. This information will be used to enrol you in the course or qualification you are seeking. Some of the information contained on this form may be keyed into the national database and used for statistical purposes only. If you require assistance to fill out this form, please ask your training facilitator for help. Course DetailsTraining Type*Unit of CompetencyRefresher TrainingUpload your statement of attainment for the refresher training course* Drop files here or Accepted file types: jpg, gif, png, pdf. Name of the Course*Date*Delivery Methods*Blended Learning (self-paced)Face to Face Training. Classroom Training (on-site at the workplace).Learning LocationPersonal DetailsFull Name*Date of Birth* Date Format: DD slash MM slash YYYY Gender*MaleFemaleResidential Address* Street Address Address Line 2 City State / Province / Region Post Code Postal Address* Same as residential Street Address Address Line 2 City State / Province / Region Post Code Email* Enter Email Confirm Email Mobile Number*Employer DetailsEmployerEmployer's Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Employer's PhoneLanguage and Cultural DiversityWhat is your country of birth?*AustraliaWhat language do you speak at home?*EnglishHow well do you speak English?*Very wellWellNot wellNot at allAre you of Aboriginal or Torres Strait Islander origin?*NoYes AboriginalYes Torres Strait IslanderDisabilityDo you consider yourself to have a disability, impairment, or long-term condition?*YesNoIf yes, then please indicate the areas of disability, impairment, or long-term condition:*Hearing/DeafPhysicalIntellectualLearningMental IllnessVisionSchoolingWhat is your highest COMPLETED school level?*Year 12 or equivalentYear 11 or equivalentYear 10 or equivalentYear 9 or equivalentYear 8 or equivalentNever completed senior schoolWhat year did you complete that school level?*Are you still attending secondary school?*YesNoUnique Student IdentifierIt is a mandatory government requirement to have a Unique Student Identifier. If you are a new or continuing student undertaking nationally recognised training, you need a USI to receive your qualification or statement of attainment. If you do not know your USI go to www.usi.gov.au and you can find, verify or if required create your USI. Your USI will give you access to an online record of the training you have done since 1 January 2015. You will also be able to produce a comprehensive transcript of your training.What is your Unique Student Identifier no?*Previous Qualifications AchievedHave you successfully completed any of the following qualifications? If yes, please tick any applicable level. Bachelor Degree or higher Advanced Diploma or Associate Degree Diploma / Associate Certificate IV Certificate III (or Trade Cert) Certificate II Certificate I Other Other qualification*EmploymentWhich BEST describes your current employment status?*Full-time employeePart-time-employyeCasual employeeSelf-employedEmployer of othersUnemployed - seeking workNot employed - not seeking workReason for Undertaking TrainingWhy did you undertake this training?* Professional development - further training Requalification requirement/refresher training Upskilling I am aware that the information in this enrolment form may be provided to the Federal Training Authority for statistical purposes and during audit requirements.*YesNoI give permission for In 4 Training and Mine Training Solutions to use my photograph taken during my training for marketing and advertising purposes only.*YesNoI understand that my photo may be used for reference material of my competency during an audit.*YesNoI give permission for Mine Training Solutions and In 4 Training to use my feedback comments for marketing and advertising purposes.*YesNoMine Training Solutions and In 4 Training will provide access to student's personal files and will not disclose information to a third party without my written permission from the student (RRTO courses exempt).*YesNoCertificate IssuanceI require my certificate to be sent to the following address* Same as Residential Address Street Address Address Line 2 City State / Province / Region Post Code Validation This iframe contains the logic required to handle Ajax powered Gravity Forms.
