145-147 High Street, Mansfield VIC 3722

03 5775 2077

MACE

MANSFIELD ADULT COMMUNITY EDUCATION

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Thank you for your interest in enrolling in one of our upcoming classes at MACE.

To help us continue delivering accessible and affordable courses, we are required to collect some additional information as part of our funding and compliance obligations.

Please rest assured that all information provided is kept strictly confidential and stored securely in accordance with our privacy policy. We appreciate your time and cooperation in completing the details below before your course begins.

Enrolment Form

Please take a moment to fill out the form.

First Name

Middle Name

Last Name

Residential Address

Date of Birth

Phone

Emergency Contact (Name & Contact Number)

Are you still attending secondary school? *

Yes

What is your highest COMPLETED school level?

In which YEAR did you complete that school level? (e.g. 2017)

If aged 25 or under, what is your Victorian Student Number (VSN)?

Of the following categories, which BEST describes your current employment status?

Which of the following classifications BEST describes your current or most recent occupation?

Have you SUCCESSFULLY completed any of the following qualifications? * Required

Bachelor Degree or Higher Degree

Advanced Diploma or Associate Degreee

Diploma

Certificate IV

Certificate III

Certificate II

Certificate I

Miscellaneous Education

None

If you selected any of the qualifications listed above, please specify the field or area of study

Of the following categories, which BEST describes your main reason for undertaking this course/activity?

In which country were you born?

Do you speak a language other than English at home? If yes, please specify

How well do you speak English?

Are you Aboriginal or Torres Strait Islander origin?

Do you consider yourself to have a disability, impairment or long-term condition? *

Yes

If you answered YES to the above, please indicate the areas of disability, impairment or long-term condition

Please specify any relevant details related to the above

Do you have any further queries or information to provide us regarding your enrolment?

I accept terms & conditions noted above

Your Signature

Thanks for submitting!

PRIVACY STATEMENT, VICTORIAN GUARANTEE ACKNOWLEDGEMENT & PAYMENT OF FEES ACCEPTANCE

I understand that:

MACE may be required to provide the Victorian Government, through the Department of Education and Training, with student and training activity data which may include information I provide in this enrolment form. Information is required to be provided in accordance with the Victorian VET Student Statistical Collection Guidelines (which are available at http://www.education.vic.gov.au/training/providers/rto/Pages/datacollection.aspx). The Department may use the information provided to it for planning, administration, policy development, program evaluation, resource allocation, reporting and/or research activities. For these and other lawful purposes, the Department may also disclose information to its consultants, advisers, other government agencies, professional bodies and/or other organisations. I have been advised by the training organisation that I may be contacted and requested to participate in a National Centre for Vocational Education Research survey or a Department-endorsed project or audit or review.

The Education and Training Reform Act 2006 requires MACE to collect and disclose my personal information for a number of purposes.

For more information in relation to how student information may be used or disclosed please contact our office on 03 5775 2077 or email reception@mace.vic.edu.au.

Participant Declaration:

I acknowledge that I have read and understood these terms of enrolment; and
I acknowledge and agree to the terms described in the Privacy Statement above; and
I understand the MACE Privacy Policy and am aware I can access this policy on the website www.mace.vic.edu.au at any stage; and
I accept all fees as stated on page one (1) of this enrolment form; and
I am aware there is a Fees and Refunds Policy available and I can access this policy on the MACE website www.mace.vic.edu.au at any stage
I understand I will not be provided with a Certificate of Participation until all fees attributed to this course have been paid.