Online Enrolment Form

Please fill in the below enrolment form.

Please be sure to fill in all fields to the best of your ability

Online Enrolment

Complete the below form to submit your enrolment.

Personal Details
Which course are you enrolling in?*
Which state are you enrolling in?*
Title*
Gender*
First Name*
Surname*
Middle Name
Date of Birth - DD/MM/YYYY*
USI
Contact Details
Mobile*
Landline
Primary Email Address*
Alternative Email Address
Building Property Name
Flat/Unit Details
Street Number
Street Name
Suburb / Town
State/Territory*
Postcode
Do you have a different postal address?*
- Yes
- No
Postal Street Number
Postal Street Name
Postal Suburb / Town
Postal State/Territory
Postal Postcode
AVETMISS Data
Leverage Academy is a Registered Training Organisation (RTO), and is required under the Data Provision Requirements 2012, Part 2 AVETMISS Compliance, to capture accurate VET information about learners, their courses, units of activity and qualification completion.
In which country were you born?*
Do you speak a language other than English?*
Please specify language spoken other than English
How well do you speak English?*
Are you of Aboriginal or Torres Strait Islander origin?*
Do you have a disability, impairment or long-term condition?*
If you do have a disability, please sepcify
Are you still attending school?
What year did you finish school?
What is the highest level of school you have completed?*
Have you completed any qualifications?*
Please specify which of the below qualifications you have completed?
What is your current employment status?*
Declaration*
By ticking this field I confirm that I have
Read and understood the course information Booklet for the course/qualification I am enrolling into;

I have read the Leverage Participant Handbook available at www.leveragegroup.com.au and acknowledge that the handbook forms part of the enrolment terms and conditions;

I confirm that Leverage may disclose my personal information to my employer, state and commonwealth Education Departments, and other parties as required by law, for the purposes of administration, verification, statutory reporting, and evaluation.

Online Enrolment Form

Online Enrolment

Personal Details

Contact Details

AVETMISS Data

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