KneeDeep Office Use Only
Student ID No: /
STUDENT ENROLMENT FORM
DIPLOMA OF LEADERSHIP AND MANAGEMENT (BSB51915)
Please provide all applicable information. Some of the information requested in this form is for statistical purposes according to the Australian Vocational Education and Training Management Information Statistical Standard (AVETMISS).
Please send completed form to: / Email:
/
OR
Student Registrations
KneeDeep
Suite 203, Level 2
33 Pirie Street
Adelaide SA 5000
Personal Details
  1. Surname:
/ Given Names:
  1. Date of Birth:
/ // / (DD/MM/YYYY) / Sex: / Male / Female
  1. Residential Address:

State: / Post Code:
  1. Postal Address:

State: / Post Code:
  1. Home Phone:
/ Mobile No:
  1. Email Home:
/ Email Work:
Organisation Details
  1. Business Name:

  1. Position Held:

  1. Business Address:

State: / Post Code:
  1. Business Phone:
/ Fax No:
Emergency Contact Details
  1. Full Name:
/ Relationship to you:
  1. Home Address:

State: / Post Code:
  1. Home Phone:
/ Mobile No:
Language and Cultural Diversity
  1. Country of Birth:
/ Australia / Other – Please Specify
  1. Language Spoken at Home:
/ English – Go to Question 17 / Other – Please Specify
  1. English speaking capability:
/ Very Well / Not Well
Well / Not at All
  1. Australian Aboriginal or Torres Strait Islander status:
/ No
Yes, Australian Aboriginal / Yes, Torres Strait Islander
Language, Literacy & Numeracy
  1. Our training takes into account the language skills required by people wishing to increase their skills. We will take into account the needs of clients who require additional assistance with language, literacy and numeracy. If you believe you need further assistance please contact us and enquire about our LLN referral programs.

Enrolment Form - Dip Ldr & Mgt BSB51915Page 1 of 6

Special Needs
  1. Is there any information we need to be aware of that will assist us in delivering the best learning experience for you as an individual? You may choose to contact us direct on (08) 7127 4885 to discuss.

No – Please go to Question 20
Yes – please specify
  1. Do you have a long term disability, impairment or dietary requirement?

No – Please go to Question 21
Yes – please specify – Note:We may also contact you for further information
Hearing / Intellectual / Acquired Brain Impairment
Vision / Learning / Medical Condition
Physical / Mental Illness / Other
Food Allergy/Dietary need – Please specify
Schooling
  1. Are you still attending high school:
/ No / Yes
  1. Highest COMPLETED school level:

Year 12 or equivalent / Year 11 or equivalent
Year 10 or equivalent / Year 9 or equivalent
Year 8 or below / Never attended school
– Please go to Question 24
  1. Year in which you completed school:

Previous Qualifications
  1. Have you SUCCESSFULLY completed any of the below?

No – Please go to Question 26 / Yes – Please go to Question 25
  1. If YES, tick all applicable qualifications:

Bachelor Degree or Higher / Certificate III (or Trade Certificate)
Advanced Diploma or Associate Degree / Certificate II
Diploma (or Associate Diploma) / Certificate I
Certificate IV (or Advanced Certificate/ Technician) / Certificates other than those listed
Employment
  1. Which BEST describes your current employment status?

Full time employee / Part time employee
Employer / Self employed – not employing others
Unemployed – seeking full time work / Unemployed – seeking part time work
Employed – unpaid worker in a family business / Unemployed – not seeking employment
Study Reason
  1. What BEST describes the main reason for undertaking this course?

To get a job / It is a requirement of my job
To develop my existing business / I wanted extra skills for my job
To start my own business / To get into another course of study
To try for a different career / For personal interest or self-development
To get a better job or promotion / Other reasons
Enrolment
  1. Are you applying for recognition of prior learning?

Yes, I am applying for recognition of prior learning. Please go to Question 29
No, I am registering to participate in the whole program. Please select 12 units of competency as detailed in Question 30.
If you answered yes to Question 28 please contact KneeDeep on (08) 7127 4885 to discuss your eligibility.
Enrolment Subject Details – Diploma of Leadership andManagement
  1. What are the Units you are applying for RPL:

BSBLDR501 / Develop and use emotional intelligence
BSBMGT517 / Manage operational plan
BSBLDR502 / Lead and manage effective workplace relationships
BSBWOR502 / Lead and manage team effectiveness
BSBCUS501 / Manage quality customer service
BSBMGT516 / Facilitate continuous improvement
BSBWOR501 / Manage personal work priorities and professional development
BSBPMG522 / Undertake project work
BSBWHS501 / Ensure a safe workplace
BSBADM502 / Manage meetings
BSBINN502 / Build and sustain an innovative work environment
BSBMGT502 / Manage people performance
BSBHRM506 / Manage recruitment selection and induction processes
  1. Please choose the units of competency in which you wish to enrol:

BSBLDR501 / Develop and use emotional intelligence
BSBMGT517 / Manage operational plan
BSBLDR502 / Lead and manage effective workplace relationships
BSBWOR502 / Lead and manage team effectiveness
BSBCUS501 / Manage quality customer service
BSBMGT516 / Facilitate continuous improvement
BSBWOR501 / Manage personal work priorities and professional development
BSBPMG522 / Undertake project work
BSBWHS501 / Ensure a safe workplace
BSBADM502 / Manage meetings
BSBINN502 / Build and sustain an innovative work environment
BSBMGT502 / Manage people performance
BSBHRM506 / Manage recruitment selection and induction processes
Unique Student Identifier
As of 2015 January 1st, all students enroling for nationally recognised training are required to have a Unique Student Identifier.
If you already have a USI, please enter into the field below.
If you do not already have a USI, please visit to create a USI, and enter into the field below.
If you are unable to obtain a USI please contact us on (08) 7127 4885 for assistance.
  1. USI:

Terms & Conditions
  • An enrolment fee of $1,000 is payable at the enrolment stage, unless a request for an instalment plan is nominated.
  • Upon receiving the completed enrolment form, KneeDeep will issue a tax invoice for the enrolment fee. Invoices are to be paid in full within 14 days and prior to course commencement.
  • In case of a Recognition of Prior Learning, KneeDeep will raise an invoice after the applicant has agreed on the path to pursue.
  • Payment plans can be negotiated on mutual agreement by both parties.
  • Invoices are to be paid in full within 14 days and prior to the issuance of Statement of Attainment and Certificate of Completion.
  • Cancellations notified more than 5 working days prior to course commencement date will NOT incur any fees.
  • Cancellations notified less than 5 working days prior to course commencement date will incur the total enrolment fee as the cancellation fee.
  • No refunds will be issued after course commencement unless a medical certificate is provided.
  • KneeDeep will refund the total enrolment fee if the company cancels a program or reschedules a program to a date that is not suitable to the candidate.
  • If any fees are not paid and the company deems necessary to engage a debt collector agency to collect the outstanding amount, all costs associated with debt recovery will be added to the outstanding debt of the candidate.
  • All complaints about the provision of training or assessment services will be dealt with in accordance with our Complaints Policy as detailed below.

Complaints Policy
All complaints about the provision of training or assessment services will be dealt with efficiently, effectively, transparently and fairly and all quality issues identified will be addressed.
The Company seeks to:
  • Listen to the views of all our clients and stakeholders
  • Address any concerns that they may have
  • Constantly improve the quality of our services and processes.
If a participant has a complaint or problem with one of the Company’s programs or processes, he/she may also report it to any staff member. Staff members will encourage complainants to lodge their complaints using the Complaint Form.
All forms received will be referred to the Training Manager so they can be dealt with confidentially and promptly.
We will provide complainants with the opportunity to present their case and they can also bring a support person if consider necessary and/or have access to an independent arbiter if needed.
We will keep the complainants informed of the progress of their complaints and will also give them the option to contact us at any time to find out the current status of their complaint.
If the complaint has an origin in company policy, the Training Manager will escalate the complaint to the Managing Director.
If the complainants are not satisfied with the outcome of the process they should be referred to the Department of Further Education, Employment, Science and Technology, Quality Branch (08) 8241 8000, the National Training Complaints Hotline (1800 000 674) or the Office of the Training Advocate (1800 006 488).
For a minimum of 5 years, we will keep all supporting evidence of:
  • Data about complaints and appeals
  • Records of actions taken to address the root cause of complaints
  • Minutes of staff meetings at which actions arising from complaints were agreed on
  • Documented changes to our systems

I accept these Terms & Conditions
Signature: / Date:

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