CPR Enrolment Form

Ampd Academy - RTO: 31946
​07 5690 1260 | hello@ampdacademy.com.au

YOUR DETAILS

Let's get to know you better!
Title
Entity Data - Profile - Title
First Name
Entity Data - Profile - First Name
Middle Name
Entity Data - Profile - Middle Name
Surname
Entity Data - Profile - Surname
Birth Date
Entity Data - Profile - Birth Date
Are you under 18?
Basic - Radio buttons
Gender
Entity Data - Profile - Gender
Best contact number
Entity Data - Contact - Work - Mobile Number
E-mail Address (if you have done a course with us before, please use the same email)
Entity Data - Contact - Work - E-mail Address
Please type your address here
Entity Data - Address - Home - Lookup
Address - Home - Unit/Flat Number
Entity Data - Address - Home - Unit/Flat Number
Address - Home - Street/Lot number
Entity Data - Address - Home - Street/Lot number
Address - Home - Street Name
Entity Data - Address - Home - Street Name
Address - Home - Suburb
Entity Data - Address - Home - Suburb
Address - Home - Post Code
Entity Data - Address - Home - Post Code
Address - Home - State
Entity Data - Address - Home - State
Address - Home - Country
Entity Data - Address - Home - Country
Parent/guardians email
Basic - Text
Parent/guardians contact number
Basic - Text
Unique Student Identifier (USI)
Entity Data - AVETMISS - Unique Student Identifier (USI)
Verification of Identification
Please upload a colour copy of your Identification
Basic - File
Please specify uploaded identification
Basic - Radio buttons
Do you have a valid concession card?
Basic - Radio buttons
If yes, please upload proof of concession
Basic - File
Concession type:
Basic - Radio buttons

DIVERSITY

In which country were you born?
Entity Data - Profile - Country of Birth
What is your citizenship status?
Entity Data - Profile - Citizenship Status
What language do you speak at home?
Entity Data - AVETMISS - Main Language
Are you of Aboriginal or Torres Strait Islander origin?
Entity Data - AVETMISS - Indigenous Status
Do you consider yourself to have a disability, impairment or long-term condition?
Entity Data - AVETMISS - Disability Flag
If yes, please specify:
Entity Data - AVETMISS - Disability Type

EDUCATION & EMPLOYMENT

What is your highest completed school level?
Entity Data - AVETMISS - Highest School Level
Year that highest school level was completed
please ensure this entered as 4 digit number eg 2009, not 09
Entity Data - AVETMISS - Year Completed (Highest School)
Are you still enrolled in secondary or senior secondary education?
Entity Data - AVETMISS - At School
Have you successfully completed any qualifications?
Entity Data - AVETMISS - Prior Education Flag
If yes, please specify
Entity Data - AVETMISS - Prior Education Type
Of the following categories, which best describes your current employment status?
For casual, seasonal, contract and shift work, use the current number of hours worked per week to determine whether full time (35 hours or more per week) or part-time employed (less than 35 hours per week).
Entity Data - AVETMISS - Labour Force Status
Are you completing this qualification in partnership with your workplace?
Basic - Radio buttons
Please indicate the name of your employer, and their best contact details.
(optional)
Basic - Text
Do you give Ampd Academy authoriation to share details of your study and a copy of your qualification/Statement of Attainment with the employer specified above?
Basic - Radio buttons
Which best describes the main reason you are undertaking this course
Entity Data - AVETMISS - Study Reason

PRIVACY NOTICE & STUDENT DECLARATION

POLICIES & STUDENT HANDBOOK 

Please click on the below to review:
REFUND POLICY

Ampd Academy rights and obligations include:

  • Provision of quality assessment services in a competent manner through the provision of quality resources and staff
  • Assessment be performed by qualified assessors with the required knowledge and currency in the needs of industry
  • Guaranteeing to provide assessment services to customers who have met their obligations about completion of enrolment details, and financial payment
  • Guaranteeing that if Ampd Academy cannot deliver a course, a full refund of all monies paid to Ampd Academy will be refunded to the purchaser.  
  • Choosing to terminate a customer’s training if they fail to uphold these standards

 I agree to undertake training with Ampd Academy. During this program, I understand and acknowledge that:

  • My rights and obligations, as defined in the Student Handbook.
  • I will adhere to Ampd Academy code of conduct as outlined in the Student handbook.
  • I have read and understand the progression policy and that I have 3 months from the start date to complete my online assessments
  • My obligation at all times to conduct myself safely and in adherence to all relevant legislation.
  • I will actively attempt all training and assessment tasks with serious effort.
  • I will comply with all safe and lawful requests; I will arrive on time and will return on time from all breaks.
  • I will not bully, abuse, vilify or fail to treat all people participating, associated with, or in the vicinity of training venues with the utmost respect and courtesy.
  • I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above
  • I permit Ampd Academy take photographs/videos of me whilst participating in training and assessment activities. I also give permission to any material for future promotional, commercial and educational purposes. I understand I can stop my consent by emailing hello@ampdacademy.com.au
  • I acknowledge and agree to meet the pre-requisites for my chosen course as outlined by Ampd Academy, including minimum age, eligibility, placement requirements, access to technology, and any course specific requirements.
Basic - Radio buttons
Student Name:
Basic - Text
Student Signature
Basic - Digital Signature
Date
Basic - Date

Payment

Payment Options
Provide Cardiopulmonary Resuscitation 		$50.00
$50.00
$0.00
$50.00