College of Dermal Therapies

Testing form

    Enrollment Details

    Course Name (required)

    Delivery mode *

    Is RPL being sought as part of this qualification? If yes, please contact your trainer for further details

    Course Commencement Date

    Your Details

    First Name *

    Middle Name*

    Last Name*

    Street Address *

    Suburb *

    State *

    Postcode *

    Mobile *

    Other Phone

    Email*

    Your Gender

    Date of Birth

    Unique Student Identifier (USI)

    Are You*

    Where you born in Australia?*

    If no, in which country you born?

    Is English your first spoken language ? *

    Do you speak a language other than English at home?

    If yes, what other language do you speak?

    How well do you speak English? *

    Do you have a disability, impairment or long term health condition?

    If yes, please advise condition.

    Do you or your partner/dependant hold a health or pensioner care card with your name on it? *

    If yes, please upload a copy of your card.

    Your Message

    Password *

    As part of our commitment to ensuring the privacy of your personal and academic details, please provide us with a password. This password will allow you to access your own student information. Please note that any access by a third party will still require your written consent in each instance.

    Next to Kin

    Name *

    Relationship to you *

    Mobile phone *

    Other phone

    Education details

    Are you currently attending high school? *

    If yes, what year are you in?

    What is your highest completed school level? *

    Have you successfully completed any of the following qualification levels? Please select all that apply.
    Certificate ICertificate IIICertificate IVDiplomaAdvanced DiplomaBachelor Degree or higherNone

    Name of highest qualification?

    Year completed

    Have you started but not completed any qualifications?

    If yes, please specify
    Please select all that apply.
    Certificate ICertificate IICertificate IIICertificate IVDiplomaAdvanced Diploma of Association DegreeBachelor Degree or Higher Degree levelMiscellaneous

    Name of Qualification

    Year Started

    Employment status and details

    Of the following, which best describes your current employment status ? *

    If working, how many hours per week do you work?

    Employer Details

    Legal Name

    Trading Name

    Date employment commenced with Employer

    Reason For Study

    What is your main reason for undertaking this course?

    Traineeships/ Apprenticeships only

    Employer details

    Please note: applicable for Traineeships/ Apprenticeships only.

    Business Trading Name

    Workplace Supervisor Name

    Street Address

    Suburb

    State

    Postcode

    Phone

    Fax

    Email

    How did you hear about us? Please select all that apply.
    FacebookGoogle SearchWord of MouthOther

    Declaration

    Student Declaration

    Declaration *
    I confirm the accuracy of the information providedI have received and read the Student Information HandbookI have read, understood, and agree to the Refund PolicyI consent to the disclosure of my details by the RTO to government agencies as required under the Training and Employment ActIf doing a post school certificate III qualification under the Queensland Certificate III Guarantee Scheme, I understand I extinguish my entitlement to a subsidised training place once it has been successfully completed

    Verification

    Please enter any two digits *



    * These fields are mandatory