Student Enrolment Application Form Today Ftiness Student Enrolment Form (1) Step 1 of 7 - Personal Details 14% STUDENT ENROLMENT FORM - TODAY FITNESSWelcome to the PT Academy Student Enrolment Application. These details are required as a part of your application and ensure that we provide you the assistance you require when undertaking a Fitness Qualification with us. Once you qualify you will be joining the ranks of PT Academy graduates, which are the most sought after in the industry.PERSONAL DETAILSTitle Mr Mrs Miss Ms Given Name* Surname* Date of Birth:* DD slash MM slash YYYY Sex* Male Female Intersex Other Mobile Number*Email* Please insert image of drivers licenceAccepted file types: jpg, png, Max. file size: 1 GB.Allowed file types are jpg, png USI (Unique Student Identifier)* Please visit www.usi.gov.au to get your USI! It’s ESSENTIAL for any student undertaking nationally recognised training or courses. You MUST have USI in order to receive your qualification or statement of attainment.Residential Address* Suburb* State*ACTNSWNTQLDVICWASATASPostcode* The following questions have been designed as part of the data requirements that are submitted annually to the National Centre for Vocational Education Research (NCVER) www.ncver.edu.au. This information comes under the standard privacy policy act that is defined under our terms and conditions.EMPLOYMENT STATUSOf the following categories, which BEST describes your current employment status?* Full-time employee Part-time employee Self-employed - not employing others Employed - Unpaid in a family business Unemployed - seeking part-time work Unemployed - seeking full-time work Nothing employed - not seeking employment Occupation Identifier (please tick the most applicable) Manager Professional Technical and Trade workers Community and Personal services worker Clerical and Administrative worker Sales worker Machinery operators and drivers Labourer EDUCATIONAre you still attending secondary school?* Yes No What is your highest COMPLETED school level?* Year 12 Year 11 Year 10 Year 9 or equivalent Year 8 or equivalent Did not attend high school. In what year, did you complete this school level?* In which country were you born?* PREVIOUS QUALIFICATIONHave you SUCCESSFULLY completed any of the following qualifications?* Yes No If YES. tick all applicable Bachelor Degree of higher Degree Advanced of Associate Diploma Diploma or Associate Diploma Certificate IV Certificate III or Trade Certificate Certificate II Certificate I Certificate other than those above Tick Applicable Australian Qualification Australian Equivalent International Qualification LANGUAGEDo you speak a language other than English at home?* Yes No If yes, please indicate which language you speak? How well do you speak English?* Very Well Well Not Well Not at all SUPPORT REQUIREMENTSDo you consider to have a disability, impairment or long-term condition?* Yes No If Yes, please tick the most applicable: Hearing Physical Intellectual Learning Mental Illness Acquired brain impairment Vision Medical Condition Other Do you require any additional support?* Yes No Please state what type of support you would require?Indigenous StatusAre you of Aboriginal or Torres Strait Islander origin?* Yes No If yes, please tick which one: Aboriginal Torres Strait Islander COURSE INFORMATIONWhich course/s are you enrolling into?*--- Select Course/s ---Gym Instructor - (SIS30315) Certificate III in Fitness ONLYCertificate IV in Fitness - (SIS40215) Certificate IV in Fitness ONLY (Must have valid Cert III)Career Personal Trainer - Certificate III (SIS30315 Pre-Req Units) + Certificate IV (SIS40215)Personal Trainer - (SIS30315) Certificate III & (SIS40215) Cert IV FitnessPTA Movement CoachYou must have completed a current SIS30315 Certificate III in Fitness to enrol.Which course option are you enrolling in?*EssentialsPremium - WorkshopsPayment Option* $1500 Deposit Payment Plan Of the following categories, which BEST describes your main reason for undertaking this course?* To get a job To develop my existing business To start my own business To try for a different career To get a better job or promotion It was a requirement of my job I wanted extra skills for my current job To get into another course of study For personal interest or self-development Other reasons What are you expectations? What do you hope to gain from obtaining this qualification?* What current fitness experience do you have?Fitness Experience* Weight Training Group Fitness Classes Small Group Training/Outdoor Group Training Jogging/Running/Walking Competitive Dance/Recreation Other How long have you been doing this for? Less than 12 months ago 1-3 years ago 3-5 years ago more than 5 years ago No Fitness ExperienceHave you exercised previously in the past?* Yes No If Yes, how long ago were you exercising? 1-3 years ago 3-5 years ago more than 5 years ago Do you have access to a fitness facility?* Yes No Name of facility If Yes, please tick which one: Member of a local Community Gym Member of a commercial Fitness Club chain Member of a 24hr Fitness Centre Member of a Women's Fitness Centre Fitness Studio Outdoor Training Group Do you currently personally or professionally know of or have access to any qualified Personal Trainer in your local area?* Yes No If Yes, where do they currently work or operate their business? LEARNING STYLEIndicate below your preferred learning style(s) (you may select more than one)*My learning style includes: Participating in classes face to face with teacher and other students Online completion of the course. Blended online and classroom participation How would you best describe your study and learning behaviours? (you may select more than one).* I am self-directed, disciplined and can work on my own independently. I like to study at my own pace and can manage my time effectively. I am comfortable using various kinds of technology such as navigate webpages, download and upload files and images, search engines to locate information, and use software. I am a hands on practical type of person and understand concepts better this way. I like interacting through group work and role plays with other students. I like to discuss and ask questions with the teacher. Being in a classroom environment motivates me. DIGITAL TECHNOLOGIESHave you ever completed a fully online course before?* Yes No If Yes, please detail date and course: Do you regularly use and have access to any of these digital technologies?*(tick all that are applicable) Desktop or laptop computer Tablet or Smartphone Internet (you have internet speeds that allow you to watch streaming video) Applications such as Microsoft Word, Excel or PowerPoint Other (access to digital technologies): How do you rate your skills in the use of digital technologies above?* Beginner Very limited Capable Advanced STUDENT DECLARATIONI,* Student Name* Date* MM slash DD slash YYYY * I acknowledge that I am the named person above and any false claims will result in penalty. Terms & Conditions In consideration of Personal Training Academy Pty Ltd (Hereinafter called 'PTA') entering into and providing training as described on the accompanying pages of this agreement (the accompanying pages of this agreement to be read in conjunction with and forming part of this agreement) with the person named on the reverse (Hereinafter called the 'Student'), the student hereby agrees to be bound by the following terms and conditions. The student also understands that all policies and fees are subject to change. Enrolment. Confirmation of enrolment will only be provided on initial payment and receipt of this enrolment form. All successful students will receive notification of enrolment from PTA via email containing course platform access. If you do not receive notification of enrolment within 10 working days, you must contact PTA. Initial payment or deposit of this course will be deemed as enrolment and bound the student to these terms and conditions.. Payment. The student agrees to pay PTA the total course fee agreed to. A deposit will reserve a place in the chosen face-to-face course and initiate online enrolments. Any funds paid by a student for training as mentioned in this agreement (including deposits and all other fees paid) are not transferable to any other persons or entities, including deceased or bankrupt estates. Students may incur an additional costs when participating in practical assessments and extracurricular activities. Payment Plans – Students are to submit their payment details to PTA, to enable set up of a recurring direct debit payment until the full agreed total has been paid. If any recurring payments decline, then PTA will contact the student to collect missed payments within 30 days. If payments continue to decline, then further contact with the student will be made to collect missed payments within 60 days, course access will also be suspended. If the account remains in arrears of up to 90 days, then the student may be referred to a Collection agency (Local Recoveries Group) to follow up payment and be charged a $200 arrears fee. Certifications will not be released until the course fees have been paid in full. Upfront payment - PTA will accept payment of no more than $1,500 from each individual student prior to the commencement of the course. Following course commencement, PTA may require payment of additional fees in advance from the student but only such that at any given time, the total amount required to be paid which is attributable to tuition or other services yet to be delivered to the student does not exceed $1,000. Credit Application: The student agrees that Personal Training Academy Pty Ltd may obtain a consumer credit report containing information about them from a credit-reporting agency for assessing their application for commercial credit. The student also agrees that Personal Training Academy Pty Ltd may exchange information about them with those credit providers named in a consumer credit report issued by a credit reporting agency for assessing their application, to notify other credit providers of a default by them, to exchange information with other credit providers as to the status of this loan where the student is in default to other credit providers and/or to access their credit worthiness. The student understands that the information exchanged can include anything about their credit worthiness, credit standing, credit history or credit capacity that credit providers can exchange under the Privacy Act. Withdrawal and Refund requests must be made in writing using the Withdrawal/Refund Request Form. This is available on the website www.ptacademy.edu.au. If the student wishes to withdraw from the course within the 7-day cooling-off period an administration fee of $250 is applicable. After this period is over the following comes into effect. A withdrawal request without a refund does not constitute a cease of future payments. Refunds will not be given for any of the following reasons; 1) Change of mind about a course, 2) Non- completion of assessments. 3) Failure to attend a scheduled training session 4) Non-commencement of the course 5) Financial difficulties 6) Request is submitted after course expiry. The student’s financial obligations continue until the course is paid in full or a decision is pending on the request. Refunds will only be considered based on extenuating circumstances, which may impair the student's ability to complete the course. This needs to be supported with evidence as outlined in the student handbook provided. Should PT Academy cancel a course, students will be entitled to a full refund (or pro rata adjusted if a Statement of Attainment can be issued), or to transfer to another future course date. Students are given 12 months to complete for each course SIS30315 Certificate III in Fitness and SIS40215 Certificate IV in Fitness, Career PT – SIS30315 Bridging units 9 months and SIS40215 Certificate IV in Fitness 12 months. Students are entitled to apply for extensions, fees will be incurred for extensions at $100 per month. Extensions based on medical reasons must be supported by medical documents from a specialist (a GP letter will not suffice). These must include date of diagnosis and length of incapacity to complete the course. Applications for extensions are for course content only not for payments, condition to approval. Students will have ACCESS to the course materials for up to 3 years from date of purchase, students can access and view the course material for self-improvement; this access is independent to the allocated course duration and extension/deferment clauses and will begin from the student's enrolment date. Practical Wavier and Release. I hereby waive and release PTA and/or sub-contractor (to be known as the "Workplaces or Release Parties") from liability pertaining to the matters set forth below. I understand that by signing this form, I expressly and willingly agree to assume complete responsibility for any risk of injury that may arise from my training and study. On behalf of myself, my heirs, my assigns and next of kin, I waive all claims for damages, injuries and death sustained to me or my property that I may have against the above named Released Party. I do not have any physical limitations, medical aliments, physical or mental disabilities (other than states on the reverse) that would limit or prevent me from participating in the above-mentioned activity, and if required, will obtain a medical examination and clearance. Student Responsibilities. Students must provide PTA Administration with all changes to contact details, new address, and new mobile numbers or submit via their Learner App online. Students agree to read all information provided in PTA communications and if unsure of content approach a staff member for further clarification. Students are responsible for all personal items while on the campus premises. Exclusivity. The content contained in PTA course is for the personal use of the account holder only. You can print any of the content contained in the members section and in online courses if you use the printed copies for your personal use only. You must not provide any of the materials or content in the PTA website to any other fitness professional, personal trainer or any other person associated with the fitness industry unless they are a member of PTA, without the prior written consent of PTA. You must keep your Username and Password secure and you must not provide this information to any other person. Copyright. The copyright of all the PTA web site is the property of PTA and is protected by International copyright laws. The copyright of all the course material in each online course is the property of the course provider named in the course home page. Failure to abide by these terms is a breach of copyright and legal remedy may be sought under copyright and International law. . Declaration. I declare that the information I have supplied in this application is correct and complete. I understand that PTA may vary or cancel any decision it makes if the information I have supplied is found to be incorrect or incomplete. I recognise that it is my responsibility to provide all documentary evidence requested in this application. I authorise PTA to obtain further information where deemed necessary. I agree to comply with the rules governing admission and enrolment of PTA. I understand that I am responsible for the prompt payment of any fees related to the program to which I am applying for admission. I understand that PTA may be required to release the information supplied to Commonwealth and State agencies. I understand that PTA maybe required by law to provide student information to the Department of Education relating to course completion. Privacy Statement. Under the Data Provision Requirements 2012, PTA is required to collect personal information about you and to disclose that personal information to the National Centre for Vocational Education Research Ltd (NCVER). Your personal information (including the personal information contained on this enrolment form), may be used or disclosed by PTA for statistical, administrative, regulatory and research purposes. PTA may disclose your personal information for these purposes to: Commonwealth and State or Territory government departments and authorised agencies; and NCVER. Personal information that has been disclosed to NCVER may be used or disclosed by NCVER for the following purposes: populating authenticated VET transcripts; facilitating statistics and research relating to education, including surveys and data linkage; pre-populating RTO student enrolment forms; understanding how the VET market operates, for policy, workforce planning and consumer information; and administering VET, including program administration, regulation, monitoring and evaluation. You may receive a student survey which may be administered by a government department or NCVER employee, agent or third party contractor or other authorised agencies. Please note you may opt out of the survey at the time of being contacted. NCVER will collect, hold, use and disclose your personal information in accordance with the Privacy Act 1988 (Cth), the National VET Data Policy and all NCVER policies and protocols (including those published on NCVER's website at www.ncver.edu.au). For more information in relation to how PT Academy collects, uses, and discloses your personal information generally, including how you can make a complaint about a breach of privacy please contact PT Academy on 1300 566 540 or email [email protected]. * I acknowledge the above terms and conditions, that I have read, understood, and agree to all pages of this document. PhoneThis field is for validation purposes and should be left unchanged. Δ