Enrolment Form


One on One Defensive Drive Course – Carlton VicRoads – December 2017

STEP 1 - Complete Your Enrolment Form

Ticket Type Price Spaces
One on Oner Defensive Driver Course - Carlton VicRoads - Non-Accredited
This is a non-accredited traditional defensive driver course, also known as a Verification of Competence Course for Safe Driving. This course is acceptable for Court Order Diversion Programs.
290.00
OPTIONAL - PRINTED A4 CERTIFICATE sent via REGULAR POST
All certificates will be sent electronically via digitally signed secured PDF. This option is for people who would like a printed copy of their Certificate sent to them via REGULAR POST. Delivery times are estimated between 2 to 14 days according to Australia Post.
10.00

2017 REGISTRATION FORM

PLEASE COMPLETE THIS FORM CAREFULLY

Required or compulsory information will be highlighted in RED TEXT and must be provided or your enrolment or it will be denied.
If you require assistance with this form please call (03) 9351 1068 or (03) 9350 7420.

Contact Details

If possible, PLEASE provide us with both a home (land line) number and a mobile number. As most of our courses have practical sessions, it may become important for our trainers to contact you should the need arise.

What is the address of your usual residence?

Please provide the physical address (street number and name not post office box) where you usually reside rather than any temporary address at which you reside for training, work or other purposes before returning to your home. If you are from a rural area use the address from your state’s or territory’s rural property addressing’ or ‘numbering’ system as your residential street. This is the address your qualification will be sent.

Emergency contact details

Who would you like us to contact in the unlikely event of an emergency? Please ensure you nominate somebody that can be contacted and knows your medical history.

Contact details for emergency contact

If possible, please provide us with both a home (landline) number and a mobile number. As most of our courses have practical sessions within them it may become important for our trainers to contact you should the need arise.


SECTION B

Applicant Declaration – This section MUST be completed. Please read the following information carefully, if left blank, the enrolment will not be accepted.

Personal information is collected solely for the purpose of operating as a Registered Training Organisation under the Australian Quality Training Framework (AQTF) administered by the Vocational Education and Training Accreditation Board who are the registering authority. The requirements of the registering authority may mean the release of your personal information for the purpose of audit, or for collection of data by Commonwealth and State Government departments and agencies. It is a requirement of the AQTF that students can access personal information held by Intelligent Training Solutions Pty Ltd and may request corrections to information that is incorrect or out of date. Please apply to the ITS Training Manager if you wish to view your own records.

Please tick ALL of the following statements

I agree to pay all fees and charges according to the payment schedule that is part of this agreement.
I further agree to give ITS Pty Ltd 7 days’ notice if I do not intend to attend a course I have been enrolled into and agree that should I fail to give such notice than I am liable for the FULL course fee to be invoiced to me. Failure to officially withdraw from a course (as stated in our refund clause) will result in a vacant position within the course and will deprive ITS and the course from the revenue it would provide.

By completing the following fields, you are signing this enrolment form electronically. You agree your electronic signature is the legal equivalent of your manual signature on this enrolment.


What happens next?

ITS P/L will make contact with you to confirm your enrolment. If you have not received confirmation within 1 working day please call us on (+61) 3 9351 1068.


Payment

Intelligent Training Solutions can accept payment in the following ways:


Intelligent Training Solutions Pty Ltd
BSB: 633 000
Account: 145987467

ITS Pty Ltd will charge an extra 1.75% surcharge when using this method. NOTE: You do not need a PayPal account to use this feature.

Cheques should be made payable to Intelligent Training Solutions Pty Ltd

NOTE: If you select the 'PayPal' method of payment and then don't finalise your payment your enrolment form will be cancelled and you will be required to fill our the enrolment form again.