Macarthur Community College

ENROLMENT FORM

Print this form, then fax or email it back to Macarthur Community College

Enrolments are accepted under the terms and conditions published in the brochure.

Course Code: _________  Course Name: _____________________ $____

Course Code: _________  Course Name: _____________________ $____

Course Code: _________  Course Name: _____________________ $____

Do you wish to become a College Member? if yes, add $5.50 (inc. GST) $____

CONCESSIONS ARE AVAILABLE FOR PENSIONERS AND SOCIAL SECURITY BENEFICIARIES - SEE ESSENTIAL INFORMATION

First Name: _____________   Surname/Family Name: ________________

Address: ___________________________Suburb: _________________

email address: ______________________________________________

Postcode: ______          Male:  r       Female:   r

Phone H) __________  W): _________ Mobile: __________ Fax: ________

Social Security No: _______________  Type of benefit: _______________

Signature: ______________________

PAYMENT DETAILS:  

Cash  r Cheque  r Money Order  r Bankcard  r  Mastercard  r Visa

Card No:rrrr  rrrr  rrrr rrrr  Expires: ______

Cardholder Name: _____________________   Signature: ______________

 

The following information is required by the Federal Government for all enrolments in adult education. Your information is coded and cannot be identified.

 

What Country were you born in? ___________________ Date of birth: __________

 

Do you speak a language other than English at home?    Yes / No  

If yes, which language? _____________________

 

Are you of Aboriginal or Torres Strait Islander origin?          Yes / No

 

Do you consider you have any disabilities?    Yes / No    If yes what type? ___________

 

What is your highest completed school level? r  Yr 12 r  Yr 11 r Yr 10  r  Yr 9 or lower

 

 In which YEAR did you complete that school level?   19____

 

 Since leaving school have you attempted or gained any formal qualifications?   Yes / No 

 

 If yes please tick:    

r  Bachelor Degree or higher   r Advanced Diploma or Associate Degree   r  Diploma r  Certificate IV 

r  Certificate III  r  Certificate II   r Certificate I r Miscellaneous

 

Which of the following would best describe your current employment? Please tick.

r  Full time employee

r  Part time employee

r  Unemployed - Seeking full time paid work                   

r  Employed unpaid worker in family business

r  Unemployed -  Seeking part time paid work

r  Self employed  - not employing others

r  Employer 

r  Not employed - not seeking including students, retired, volunteers

 

Send your form and payment BY POST to:

Macarthur Community College Inc.

Reply Paid Post#1 Enrolments

PO Box 5772

PRESTONS NSW 2170

BY FAX TO: 9826 6977

ENROL BY PHONE ON: 9826 6455

BY EMAIL TO: info@macarthurcc.com.au

                                                [ref: web03]