FIRST AID ENROLMENT FORM Ready Health Nursing College
/ National Code: 91697 / Ph. (07) 5596 1735
Ph. 0414 507 292 / Registration: Online in Person
Groupon Phone
PLEASE PROVIDE ALL THE INFORAMTION REQUIRED IN THIS FORM. (PLEASE SIGN WHERE REQUIRED)
HLTAID001 Provide Cardiopulmonary Resuscitation Fee for Service Course Fee $50.00
HLTAID003 Provide First Aid Groupon Voucher Fee for Service Course Fee $85.00 / $
$
Total / $
Title: First Name: Middle Name: Surname:
Address: Suburb: State: Postcode:
Phone (h): / (w): / (m): / Remote: Regional:
Email: / Gender:M F Other / Date of Birth: _ _ / _ _ / _ _ _ _
CONCESSION INFORMATION (PLEASE TICK APPROPRIATE BOX AND ATTACH DOCUMENTATION)
Disabilities: Yes No
Specify:______
Special needs: Yes No
Job Find: Yes No
TFN: Yes No: ______
CRN. No: Yes No: ______/ Documents sighted:
Drivers Licence: Medicare:
Australian Passport: Visa:
Birth certificate: Citizenship:
National Police Check: Centrelink: / English Language:
Very Well
Well
Poor / Start Date: _ _/_ _/ _ _
End Date: _ _/_ _/ _ _
1st Extension: _ _/_ _/_ _
First Aid Date: _ _/_ _/ _ _
QUESTIONNAIRE:
Your information may be required by Ready Health College or the NSW Department of Industry, or Qld DET for the VET Investment Plan for research, statistical analysis, program evaluation, post-completion surveys and quality improvement. Privacy and Confidentiality will be maintained.
Thank you for answering the following questions.
In which City and Country were you born? Country:______
City/Town:______
Are you of Aboriginal or Torres Strait Islander origin? Yes No
What Language do you normally speak at home? ______
What is your residency status? Citizen PR Visitor Visa Student Visa
Is there a Visa Expiry? Yes No If yes record the date: _ _/_ _/_ _ _ _
Your main reason for undertaking this course is: ______
What is your highest completed school level? (e.g. Yr. 10) When (yr.)______
Which of the following would best describe your current employment status?
Full time Part Time Casual Employer Self employed
Employed, unpaid worker in a family business
Unemployed seeking: Full Time Employment Part Time Employment
Is this course related to your work currently? Yes No N/A / Have you successfully completed any of the following qualifications?
Bachelor or Higher Degree
Advanced Diploma or Associated Degree
Diploma (or Associate Diploma)
Certificate 1V
Certificate III (or Trade Certificate)
Certificate II
Certificate I
Miscellaneous Education
Are you seeking Recognition of Prior Learning (RPL)? Yes No
1st Qualification: 2nd Qualification:
How did you find out about us?
Flyers Street sign
Friend Newspaper Web Site Self
Groupon Other ______
Previous student Name ______
Method of payment: Cheque Groupon Cash Internet, EFT or Bank Deposit
Bank: ANZ Bank Account Name: READY HEALTH NURSING COLLEGE
(For internet banking use your name as a reference. Send an e-mail to the College with your payment/ transaction details.)
BSB: / 012 370 / Account No: / 1 / 8 / 4 / 5 / 0 / 2 / 6 / 8 / 8
Fee Structure: I understand the Fee Structure I understand the conditions of GROUPON
HLTAID001 Provide Cardiopulmonary Resuscitation Fee for Service Course Fee $50
HLTAID003 Provide First Aid Groupon Voucher Fee for Service Course Fee $85
PRINT NAME: / Signature: / Date: _ _/_ _/_ _ _
FOR OFFICE USE ONLY:
Date Enrolment Form received: _ _/_ _/_ _
Pending: _ _/_ _/_ _
Groupon Voucher receiver: _ _/_ _/_ _
Groupon Voucher processed: _ _/_ _/_ _
Resources provided: _ _/_ _/_ _
Confirmed: _ _/_ _/_ _
Student Number: RHN 00000 _ _ / USI Created: _ _/_ _/_ _
USI Activated: _ _/_ _/_ _
USI No:______/ Certificate No: ______
Date: _ _ / _ _ / _ _
Delivery Method:
Collected
Mailed
STUDENT ORIENTATION CHECKLIST
Student Name:Student No: RHN00000 __
I have completed the Enrolment Form and submitted and discussed it and signed for it.
I agree with the Fee Structure and the terms and conditions (Information provided) and I have signed the Fee Structure Form with agreed dates for payment
I understand the Terms and Conditions
I have received the First Aid Books. My date for First Aid Training is: / /Sign:
I understand that I must pay all fees prior to the actual Training.
I understand that if I fail to attend classes or CPR practicals, I will not achieve the competency. Any extension must be in writing and approved by the Course Coordinator/Director Clinical Governance.
I understand the College code of ethics and will maintain a high standard of professional behaviour while registered as a student.
I understand the Complaints procedure for ASQA, the NSW and Qld Government funded programs and Ready Health Nursing College.
I have been shown where the Policies and Procedures files can be located while at the College.
Ready Health Nursing College insurance covers the student while in the College. I would take every precaution to avoid taking risks. This is highlighted in the enrolment and orientation processes.
I will disclose any form of injury, current workcover claims and restrictions in my ability to perform CPR on the manikins on the floor.
I understand that I cannot use, post or share any pictures or video of the training on social media without the prior written consent from Ready Health Nursing College.
I consent the use of my data for the use of national data collection purposes.
I give permission for Ready Health Nursing College to use my Photos taken during training for marketing purposes.
I authorise Ready Health Nursing College to create the Unique Student Identifier (USI) on my behalf. I therefore consent to the use of my personal information for this procedure. I understand that I will be provided with the USI number directly to the email address I have provided to activate it, and set up the password. I have been provided with information on how to apply for USI if I wish to do so myself. Phone: 1300 857 536. Signature:
TERMS AND CONDITIONS OF ENROLMENT:
The Following Qualifications and course is offered by Ready Health Nursing College:
HLTAID001 Provide Cardiopulmonary Resuscitation Fee for Service Course Fee $50
HLTAID003 Provide First Aid Groupon Voucher Fee for Service Course Fee $85.00
Ready Health Nursing College will make all reasonable efforts to ensure all scheduled classes run as advertised. However, Ready Health Nursing College reserves the right to:
Run or withdraw any course Alter the dates or times for the whole or any part of the course
If any of these course changes becomes necessary, I will be advised in advance where possible, of the changes and the alternative arrangements which will be made available for me to complete my course.
Enrolment in courses is contingent to the payment of the prescribed course fee and places are allocated on receipt of payment.
REFUNDS:
A refund is considered only when a student is unable to complete a course due to medical reasons and produces a Medical Certificate, which covers the remaining period to include a rescheduled date. No refund will be awarded without a Medical Certificate. If the College cancels a course or unit, the student will be notified as soon as possible. A full refund of fees paid will be forwarded to the student within two weeks. For a refund to be processed the student must notify Ready Health Nursing College of any changes to their personal details.
Groupon clients: If unable to be accommodated, provided the voucher has not expired, Groupon will redeem or refund the student.
USI:
I understand the process for application of the Unique Student Number (USI). I accept Ready Health Nursing College assisting with my applicationwhile maintaining Privacy and Confidentiality, when using my information for this purpose.
STUDENT PRIVACY:
Personal information will only be collected to the extent necessary by lawful and fair means, for one or more specified purposes which are relevant to the operations of Ready Health Nursing College, with the person's consent.
PRINT NAME: Student Signature:Date: / /
STUDENT
PRINT NAME: College Signature:Date: / /
COLLEGE
First Aid Enrolment FormV3.4.18 / Ready Health Nursing College National Code: 91697