Qualification interested in commencing *

Full Name *

Email *

Email

Confirm Email

Phone *

Have you ever had a different surname? *

Yes
No

Previous surname/maiden name *

Date of Birth *

Gender *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Students must reside in Australia to enrol

Do you have a USI (Unique Student Identifier)? *

Yes
No

Enter USI *

You can find your USI via usi.gov.au

Are you currently employed by an aged care or disability service? *

Yes
No

Employer *

Do you require placement? *

Yes
No

Do you require assistance finding work placement? *

Yes
No

Have you completed any other qualifications? *

Yes
No

Qualification *

Are you currently enrolled in any other course/qualification? *

Yes
No

Course *

Do you have a current First Aid and CPR Certificate? *

Yes
No

If "No" you may have the option of completing First Aid and CPR as an elective unit in your course.

Are you an Australian Citizen? *

Yes
No (Visa Name & Subclass Number required)

What is your Visa Name and Subclass Number *

How did you hear about us? *

What is your preferred method of contact? *

Email
Phone

Do you have access to a reliable internet connection and a computer with up-to-date software? *

Please note this course cannot be completed using a mobile phone

Computer facilities are available for the use of students at Akadia

Additional Comments

Expression of Interest

Please complete the following form so we can provide you with advice on eligibility for enrolment and funding options that are available.

(07) 4659 5662

Street Address

Postal Address

(07) 4659 5662

ADDRESS