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Enrolment Form




General
Student Details
Employer Details
Employment Details
Education History
Nationality
Disability


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This enrolment form is currently in testing. IPS cannot guarantee a place in your selected course/s until we have had the opportunity to assess your eligibility for enrolment. If you are intending to access funding, it is possible that by the time this enrolment is processed by IPS, all funding for your selected course may have been allocated.
Please contact IPS on 07 3841 8011 if you would like information before completing this form.
Thank you for your patience.

General:


Who is your IPS Contact?*


Please refer to your IPS Documentation for your IPS Contact Person. If your IPS documentation does not refer to a managers name, please enter "none" into the text field.



Are you interested in seeing if you are eligible for funding?*
YesNo
Someone will be in contact with you to discuss this.
Which qualification would you like to enrol in?*
Of the followng, which reason best describes your reason for undertaking this course?*
Future Study: Are you intending to continue studying after this qualification is complete?
YesNo
If yes, what would you consider undertaking?
How did you hear about IPS?
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Student Details:


Title (eg. Mr, Ms etc.):*
MrMrsMsMissOther:
Name (As it should appear on your certificate):*



Date of Birth:*

Postal Address


Street No. and Name:*

Suburb / Locality / Town:*

State/ Territory:*

Postcode:*

Residential Address

Street No. and Name:

Suburb / Locality / Town:

State/ Territory:

Postcode:


Contact


Mobile Phone Number:*
Work Number:
Email Address:*
Next of kin:*
Next of kin's contact No:*
USI Number:*
If you do not have one, would you like IPS Institute to apply for a USI on your behalf?

apply for one myself.
Unique Student Identifier Privacy information.
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Employer Details:


Company Legal Name:
Company Trading Name:
ABN:*
Employment Start Date:

Postal Address


Street No. and Name:

Suburb / Locality / Town:

State/ Territory:

Postcode:

Location Address

Street No. and Name:

Suburb / Locality / Town:

State/ Territory:

Postcode:

Employer Contact

Name:
Phone:
Mobile:
Email:
Fax:

Supervisor Contact: (Leave blank if same as above)

Name:
Phone:
Email:
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Employment Details:


Employment Status:* (Choose best)


If "Other", please specify.


Current Position:*
Current Duties:*

Previous Employment

Please complete the following "Previous Employment Sections"or attach a current CV.


Current CV:


1. Previous Employment Section: Click me

Date of Employment:
Company:
Title:
Brief Description of your Duties:


2. Previous Employment Section: Click me

Date of Employment:
Company:
Title:
Brief Description of your Duties:


3. Previous Employment Section: Click me

Date of Employment:
Company:
Title:
Brief Description of your Duties:

Future Employment

Are you currently undertaking this study as part of your employer's succession planning?*
YesNo
Are you intending to remain within the same vocation?*
YesNo
If no, is study to benefit you in your future roles?
YesNo
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Education History:


Are you currently studying at school?*
YesNo
Highest school level:*
In which year did you complete that level?*
Have you successfully completed any of these qualifications?*



Please list your qualifications' titles and Year obtained (one qualification per line):*
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Nationality:


Country of Birth:*
City of Birth:*
Nationality:*
What is your main language spoken?*
Do you speak any other languages other then English?*
YesNo
If yes, which language(s)?
Proficiency in spoken English:*
Do you require an Interpreter?*
YesNo
Indigenous Status:*
Are you a(n):*
If so what type of Visa?


Specify Visa Number:


Proof of Residency (One of the following must be supplied):*
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Disability:


Do you have a disability?*


If "Other", please specify.


If you have any of the above would they inpact your training?
YesNo


This enrolment form is currently in testing. IPS cannot guarantee a place in your selected course/s until we have had the opportunity to assess your eligibility for enrolment. If you are intending to access funding, it is possible that by the time this enrolment is processed by IPS, all funding for your selected course may have been allocated.
Please contact IPS on 07 3841 8011 if you would like information before completing this form.
Thank you for your patience.
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