Enrol - 1 Stop Driving School

Course Details

Please select your chosen course *

Scheduled Course Date *

Have you previously undertaken training with 1 Stop Driving School? *

Yes
No

Personal Details

Name *

First

Last

Title *

Mr
Mrs
Ms
Miss

Gender *

Male
Female
Other

Date of Birth *

Town / Suburb of Birth *

Country of Birth *

Indigenous Status *

Neither
Both
Aboriginal
Torres Straight Islander

Identification *

Driver's Licence
Medicare Card
Passport
Birth Certificate

Drivers Licence

Medicare Card

Passport

Birth Certificate

If you are 25 or under, you would have been provided with a VSN at school. Do you have a VSN number? *

Yes, but unsure of it
Yes, please specify below
No

Contact Details

Address *

Address Line 1

Address Line 2

City

State / Territory

Postcode

Postal Address (if different from above)

Specify

Postal Address

Address Line 1

Address Line 2

City

State / Territory

Postcode

*** At least one mobile and one email MUST be supplied ***

Mobile

Email 1 *

Home

Email 2

Work

Preferred Contact Method

Mobile
Email
Mail

Emergency Contact Name

Relationship

Mobile

Home / Work

Education history

What is your highest completed year level? *

Name of school *

Year completed (i.e. 1990) *

Are you still attending school? *

Yes
No

Have you completed any other qualifications? *

Yes
No

Checkboxes *

Was this obtained in Australia? *

Yes
No

Language

Do you speak a language other than English? *

Yes
No

Please specify

How well do you speak and understand English? *

Very Well
Well
Not Well
Not At All

Disabilities

Do you consider you have a disability, impairment or long term condition? *

Yes
No

Please select the area/s *

Please specify

Citizenship Status

What is your current citizen/residency status? *

Australian Citizen
Permanent Resident
Overseas Resident

Passport Number *

Visa Number *

Visa Type *

Expiry Date *

Employment Status

Which of the following best describes your current employment? *

What industry are you currently employed in? *

What is your current occupation? *

Course Payment Details

Who is paying for this course? *

Self
Employer
Jog Agency
Other

Company or Agency Name

Company or Agency Address *

Address Line 1

Address Line 2

City

State / Territory

Postcode

Contact Person

Contact Phone

Contact Email

Unique Student Identifier

From January 1, 2015, we 1 Stop Driving School 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).

If you have not yet obtained a USI you can apply for it directly at http://www.usi.gov.ua/create-your-usi/ on computer or mobile device. Please note that if you would like to specify your gender as “other” you will need to contact the USI office for assistance.

Do you have a Unique Student Identifier (USI)? *

Yes
No
Yes, not sure of the number

My USI Number *

Check this box to give permission to 1 Stop Driving School to obtain a USI on my behalf. Please complete the USI Form on our website.

Yes

How did you hear about us? *

Which best describes your reason for doing the course? *

Student Enrolment Agreement & Declaration (please read thoroughly)

Due to the high-risk nature of the training conducted by 1 Stop Driving School it is a requirement of enrolment that all participants strictly adhere to the instructions provided by the trainer at all times. I understand 1 Stop Driving School reserves the right to suspend training or remove participants from the course if:

• Any unacceptable or inappropriate behaviour towards the trainer/staff or other participants
• Deliberate failure to follow instructions provided by the trainer
• In the trainer’s opinion the participant is under the influence of drugs or alcohol Any actions that may result in injury to other course participants, staff or general public.

A1 *

Agree
Disagree

I acknowledge that providing false information on this enrolment form, or failing to disclose any relevant information, may result in the withdrawal of any course offer or cancellation of my enrolment.

B1 *

Agree
Disagree

I have been advised 1 Stop Driving School may require taking photos or videos of me as evidence of my assessment.

C1 *

Agree
Disagree

I understand 1 Stop Driving School is required to provide Australian Skills Quality Authority (ASQA) with student and training activity data which may include information provided in this enrolment form. Information is provided in accordance with Data Provision Requirements Legislation.

C1 *

Agree
Disagree

I agree to disclose any impairments, disabilities or medical conditions that may impact the safety of persons during the course of training.

D1 *

Agree
Disagree

I consent in the event of injury or illness for the appropriate person/s or medical assistance can be contacted.

E1 *

Agree
Disagree

I acknowledge that I have been provided with information regarding my rights and responsibilities and sufficient information to determine that the services being provided meet with my expectations to enter into this training agreement.

F1 *

Agree
Disagree

I give 1 Stop Driving School permission to use photos taken of me for marketing and promotion purposes. (Optional)

H1 *

Agree
Disagree

TRUCK LICENSING STUDENTS ONLY - I am liable for any fines or penalties that I incur during driving instruction training.

I1

Agree
Disagree

TRUCK LICENSING STUDENTS ONLY - I give consent for the FCA/CT to be filmed and have been advised all records of assessment will be securely archived by the RTO and will only be released to VicRoads on request for audit purposes. The FCA/CT will not proceed if the applicant does not provide consent to be filmed.

J1

Agree
Disagree

By clicking agree, I agree to the above terms and conditions of this enrolment. *

Agree

Date *

Privacy Notice

Under the Data Provision Requirements 2012, 1 Stop Driving School is required to collect personal information about you and to disclose that personal information to the National Centre for Vocational Education Research Ltd (NCVER).

Your personal information (including the personal information contained on this enrolment form and your training activity data may be used or disclosed by 1 Stop Driving School for statistical, regulatory and research purposes. 1 Stop Driving School may disclose your personal information for these purposes to:

• Commonwealth and State or Territory government departments and authorised agencies; and
• NCVER Personal information disclosed to NCVER may be used or disclosed for the following purposes:
• Populating authenticated VET (Vocational Education and Training) transcripts;
• Facilitating statistics and research relating to education, including surveys and data linkage;
• Pre-populating RTO student enrolment forms;
• Understanding how the VET market operates, for policy, workforce planning and consumer information; and
• Administering VET, including program administration, regulation, monitoring and evaluation.

You may receive a NCVER student survey which may be administered by a NCVER employee, agent or third-party contractor.

You may opt out of the survey at the time of being contacted.

NCVER will collect, hold use and disclose your personal information in accordance with the Privacy Act 1988 (Cth), the VET Data Policy and all NCVER policies and protocols (including those published on NCVER’s website at www.ncver.edu.au)

STUDENT DECLARATION AND CONSENT

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

Yes

I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above. *

Yes

Date *