Training Registration Form – FNS40815 Certificate IV in Finance and Mortgage Broking (Recognition of Prior Learning)

Participant Details:

Surname: ______Given Names: ______Title: ______

Preferred Name: ______Date of Birth: _____/_____/_____

Home Address: ______Postcode: ______

Postal Address: ______Postcode: ______

Email Address: ______

Telephone Contact: (Please indicate preferred contact number)

ú (Home) ______ú (Work) ______ú (Mobile) ______

Student: Existing USI Number (Unique Student Identifier): ______

If you would like FARSTA to arrange a USI on your behalf – You will need to complete the USI legislation paperwork available at www.farsta.com.au (under enrolments) or contact FARSTA for a “USI fact sheet”. (This is an Australian Government Requirement from 1 January 2015)

Course Fees: Fees for this program are exempt of the Goods and Services Tax (GST)

Special Fee (RPL Program) $495.00

Payment Option – Please Select either of the following:

o Option 1 Credit Card Type ______(Visa / Mastercard) Amount $ ______

Card Number: ______/______/______/______

Expiry Date: ______/______Name on Card: ______

CVN Number: ______(Last 3 digits on back of card - signature panel)

Signature: ______

o Option 2 Cheque / Money Order for $______payable to: FARSTA Pty Ltd

o Option 3 Payment by Direct Credit - Transfer direct to the following bank account:

FARSTA Pty Ltd

Bank: CBA BSB: 064-121 Account: 10154511

Course Fees: Course fees are generally required prior to the commencement of training.

Cancellations: Will be accepted prior to course commencement with a full refund of any fee paid, less an administration charge of $100.00

Certificates: Course certificates will be mailed to participants upon successful completion of all RPL requirements as outlined in the “Guide to Recognition of Prior Learning” within 14 days of receipt at FARSTA offices.

Examination: No examination required.

Materials: All materials required for the program will be provided by FARSTA. Materials are subject to copyright restrictions and cannot be duplicated or reprinted without the written consent of FARSTA.

Assignments: RPL documentation must be completed and forwarded to FARSTA within 6 months of the date below. Please contact FARSTA for any subsequent request for extension.

I understand and agree to the above terms and conditions:

Name: ______

Signature: ______Date: ______

Forward registration form to: F.A.R.S.T.A.

Scan:

Mail: PO Box 6, Paddington Qld 4064

Fax: (07) 33111598

Telephone enquiries: (07) 33682719 or 0419 655248

Training Registration Information

Personal Details:

1.  In which City and Country were you born?

______

2.  Do you speak a language other than English at home?

ú Yes ú No

Main language other than English spoken at home?

______

3.  How well do you speak English?

ú Very well

ú Well

ú Not well

ú Not at all

4.  Are you Aboriginal or Torres Strait Islander origin?

ú Yes ú No

5.  Do you consider yourself to have a disability, impairment or long-term condition?

ú Yes ú No

6.  If yes to (5) then please indicate the area of disability, impairment or long-term condition:

______

7.  What is your highest COMPLETED school level?

ú Did not go to school

ú Year 8 or below

ú Year 9 or equivalent

ú Completed year 10

ú Completed year 11

ú Completed year 12

8.  In what year did you complete that school level?

______

9.  Are you still attending Secondary School?

ú Yes ú No

10.  Have you successfully COMPLETED any of the following qualifications?

ú Bachelor Degree or Higher Degree

ú Advanced Diploma or Associate Degree

ú Diploma or Associate Diploma

ú Certificate IV (or Advanced Certificate / Technical Qualification)

ú Certificate III (or Trade Certificate)

ú Certificate II

ú Certificate I

ú Certificates other than the above ______

11.  Of the following categories, which BEST describes your current employment status:

ú Full-time employee

ú Part-time employee

ú Self-employed (not employing others)

ú Employer

ú Employed – Unpaid worker in a family business

ú Unemployed – seeking full-time work

ú Unemployed – seeking part-time work

ú Not employed – not seeking employment

12.  Of the following categories, which BEST describes your main reason for undertaking this course:

ú To get a job

ú To develop my existing business

ú To start my own business

ú To try a different career

ú To get a better job or promotion

ú It was a requirement of my job

ú I wanted extra skills for my job

ú To get into another course of study

ú Other reasons

ú For personal interest or self-development

This information is sought under the compliance requirements of the Australian Government (VET Training Framework) and any reporting is subject to the Privacy Policy of the company.

Our Privacy Policy can be located in our student handbook at our website www.farsta.com.au

Thank you for your cooperation.

Chris Todman

Director

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2015 Finance and Related Services Training Academy Pty Ltd ACN 104 554 725