Online Enrolment Form – Non-Accredited Courses

Personal Details

Title:

Name

First

Middle

Last

Date of Birth:

Gender

Male
Female
Prefer not to specify

Home Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Mobile/Telephone:

Email

Emergency Contact

Contact Name

First

Last

Relationship:

Contact Number

How did you hear about us?

Course Information

Course Name

Course Fee:

Price: $ 390.00

Hospitality Professional Workshop

Course Fee:

Price: $ 295.00

WorkSmart Program

Course Fee:

Price: $ 300.00

WorkSmart: Hospitality

Course Fee:

Price: $ 595.00

WorkSmart: Construction

Course Fee:

Price: $ 695.00

WorkSmart: Hospitality & Construction

Consent *

CONSENT

I have read and understand BIA’s Privacy Notice and agree to the Disclosure of Personal Information to the Department of Education and Other Government Agencies.

CONSENT 2

I authorise Brighten Institute Australia and the Department of Education to have appropriate access to my USI records.

Student Declaration

The information I have provided is true, accurate, complete, and not misleading in any way.

Under the Data Provision Requirements 2012, Brighten Institute Australia is required to collect personal information about you and to disclose that personal information to the National Centre for Vocational Education Research Ltd (NCVER). More information regarding this is found on the Enrolment Application form, and in our Privacy Policy.

I have completed and signed this Enrolment Form.

I have read and understood the Student Handbook.

Student Name

Signature

Total

$ 0.00

Stripe Credit Card

Card

Name on Card