VIC Online Enrolment Form

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Your course

PERSONAL DETAILS

Please complete the following information:

Are you living in Australia on a visa? (Tick NO if you are an NZ Special Category Visa Holder)

Yes No

Do you have a USI (Unique Student Identifier)

Yes No

If you have been given an Enrolment Code, please enter it below

Please provide your proper full name below as it will be printed on your Statement of Attainment

Title

First name

Middle name(s)

Surname

Please provide the preferred name you would like us to use when engaging with you

Preferred name (optional)

Gender

Date of birth

Town of birth

Country of birth

Mobile

Landline phone

RESIDENTIAL ADDRESS

Building name

Flat/unit details

Street/Lot number

Street name

Suburb

State/Territory

Postcode

Country

POSTAL ADDRESS:

(if different from residential address above)

Building name

Flat/unit details

Street/Lot number/PO Box

Street name

Suburb

State/Territory

Postcode

Country

How did you hear about us?

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(OPTIONAL) WORK HISTORY

Please briefly tell us about yourself

Current employment

Current qualifications

Work experience (The 2 most recent organisations you worked in and your role there)

LEARNER ACKNOWLEDGEMENT AND DECLARATION

The information provided by me in this ENROLMENT FORM is true and correct.

I have read and understood the information contained in this ENROLMENT FORM, the REFUND POLICY and the LEARNER HANDBOOK.

I consent and authorise Validum Institute to manage any personal information I have provided in the manner described in Validum's PRIVACY POLICY, and the LEARNER HANDBOOK and in particular to verify my identity or my USI.

By typing my name in the space below, I declare that I have read and understood the PRIVACY POLICY, the REFUND POLICY and ENROLMENT TERMS AND CONDITIONS in the LEARNER HANDBOOK and agree that, on acceptance of my enrolment by Validum Institute, the provisions of the PRIVACY POLICY, the REFUND POLICY, the LEARNER HANDBOOK and the ENROLMENT TERMS AND CONDITIONS will govern my relationship with Validum Institute.

Online Enrolment Form

PERSONAL DETAILS

RESIDENTIAL ADDRESS

POSTAL ADDRESS:

STATISTICAL INFORMATION

(OPTIONAL) WORK HISTORY

LEARNER ACKNOWLEDGEMENT AND DECLARATION

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