WMTC New Student Enrolment Form

Personal Details

Please write the name that you used when you applied for your Unique Student Identifier (USI), including any middle names names, exactly as written in the identity document you choose to use for this purpose

Family name (surname)

Required

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Given name(s)

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Required

Gender

Male

Female

Other

Required

Date of birth

Required

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Contact Details

Email address

Required

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Phone

Required

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Emergency contact name

Required

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Emergency contact phone

Required

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Residential address (where you usually reside)

Required

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Suburb

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State

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Postcode

Required

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Postal address (if different from above)

Required

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Suburb

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State

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Postcode

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Language and cultural diversity

In which country were you born?

Australia

Other, please specify

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Do you speak a language other than English at home?

No, English only

Yes, please specify

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Are you of Aboriginal or Torres Strait Islander origin?

Required

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Employment

Of the following categories, which best describes your current employment status (for casual, seasonal, contract and shift work, use the current numbers of hours worked per week to determine whether full time (35 hours or more per week) or part-time employed (less than 35 hours per week)

Full time employee

Self-employed not employing others

Unemployed - seeking full time work

Not employed - not seeking employment

Employed - unpaid worker in a family business

Part time employee

Self-employed employing others

Unemployed - seeking part time work

Required

Unique Student Identifier (USI)

From 1 January 2015, we WMTC can be prevented from issuing you with a nationally recognised VET qualification or statement of attainment when you complete your course if you do not have a Unique Student Identifier (USI). In addition, we are required to include your USI in the data we submit to NCVER. If you have not yet obtained a USI you can apply for it directly at https://www.usi.gov.au/students/create-your-usi on computer or mobile device.

Enter your Unique Student Identifier (USI) (if you already have one)

‘Forgotten USI’ link on the USI website at https://www.usi.gov.au/faqs/i-have-forgotten-my-usi/.

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Student Acknowledgement and Declaration

Whilst every endeavor will be made to conduct all advertised courses offered, Whitsunday Maritime Training Centre (WMTC) reserves the right to change or otherwise revise any course related matters including courses offered, class timetables, class locations. The WMTC will make every effort to advise students of any changes.

I agree to abide by the Whitsunday Maritime Training Centre Policies and Procedures relevant to My enrolment and acknowledge that facilities made available for my use will be used only in accordance with the principles of proper use and rules.

Required

I am aware of the WMTC Privacy Notice and consent to the collection, use and disclosure of my personal information in accordance with the Privacy notice (refer over page) and WSC/WMTC privacy policy https://maritimetrainingcentre.com.au/policies/privacy-policy

Required

I consent to photos being taken for marketing purposes.

Required

I participate in any training activity at my own risk and I acknowledge that Whitsunday Maritime Training accepts no responsibility for any claim or demand.

Required

Student Full Name

Required

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Date

Required

Student Signature

Required

Parent/Guardian Full Name

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Date

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Parent/Guardian Signature

Parent or guardian consent required for all students under the age of 18

Clear Signature

I declare that the above information that I have provided to the best of my knowledge is true and correct.

Required

Please complete the required fields

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