Protective Security Training Registration Form

Are you interested in obtaining a qualification? Yes No Unsure

What qualification are you seeking? (Choose a qualification) PSP30504 - Certificate III in Government (Security) - Government Security Stream PSP30504 - Certificate III in Government (Security) - Personnel Security Stream PSP41504 - Certificate IV in Government (Investigation) PSP41604 - Certificate IV in Government (Security) PSP41704 - Certificate IV in Government (Personnel Security) PSP51804 - Diploma of Government (Security)

Of the following choices which BEST describes your main reason for undertaking this course? Please select one option: (Please select) To get a job To develop my existing business To start my own business To try for a different career development To get a better job or promotion It is a requirement of my job I wanted extra skills for my job To get into another course of study For personal interest or development Other reasons

Title:*

(Mr/Mrs/Ms/Miss/Dr/Other – please specify)

(if different to above)

Gender: Male Female

Country of birth: Australia Other

If you answered other please specify:

Language spoken most often at home: English Other

If you answered other please specify:

How well do you speak English?

Very well Well Not well Not at all

Are you of Aboriginal or Torres Strait Islander background?

No Aboriginal Torres Strait Islander

Do you consider yourself to have a disability, impairment or long-term condition? Yes No

If yes, then please indicate the areas of disability, impairment or long-term condition:
(You may tick more than one box) Hearing/Deaf Physical Intellectual Learning Mental illness Acquired brain impairment Vision Medical condition Other

If you answered other please specify:

What is your highest completed school level?

(Please select) Year 12 or equivalent Year 11 or equivalent Year 10 or equivalent Year 9 or equivalent Year 8 or equivalent Never attended school

In which year did you complete that school level?

Are you still attending secondary school? Yes No

Have you successfully completed any of the following qualifications previously? Yes No

What qualification have you completed? (You may tick more than one box) Bachelor Degree or Higher Degree Advanced Diploma or Associate Degree Diploma (or Associate Diploma) Certificate IV (or Advanced Certificate/Technician) Certificate III (or Trade Certificate) Certificate II Certificate I Certificates other than these

Of the following choices which BEST describes your current employment status?Please select one option: (Please select) Full-time employee Full-time employee Part-time employee Employed - unpaid worker in a family business Self-employed - not employing others Unemployed - seeking part-time work Unemployed - seeking full-time work Unemployed - not seeking employment

Employer/Agency:*

Division/Branch/Section:*

Street or PO Box:*

Town/Suburb:*

State/Territory:*

Postcode:*

Work telephone:*

Mobile:*

E-mail:*

This e-mail address may be used to send a Learner Engagement Survey.

Residential address:*

Town/Suburb:*

State/Territory:*

Postcode:*

Emergency contact name:*

Relationship:*

Telephone:*

Mobile:*

Any special dietary requirements or other needs?

I understand and accept the Protective Security Training Centre Cancellation/Information Collection policies and I certify that the information supplied is accurate.

Cancellation Policy: If you are unable to attend, we would welcome a substitute participant. An invoice may be issued three weeks prior to the course commencement date and you will be liable for the course fees. So as to not incur the course fees, a written cancellation must therefore be received by the Protective Security Training Centre (PSTC) at least three weeks prior to the course commencement date. In the case of non-attendance due to illness, participants may reschedule to a later program at no charge but only if a medical certificate is provided to the Director of the PSTC. If the PSTC cancels a course, participants will be offered a rescheduled course or a full refund. The PSTC reserves the right to cancel, postpone or reschedule a course.

Identifying Personal Information: We collect your personal information for the purposes of course administration, statistical analysis and evaluation of our programs. Some course administration details may be disclosed to your employer for administration and statistical/monitoring purposes if they make a written request to the Protective Security Training Centre. Your information will not be used for any other purpose except as required or authorised by or under law. Your information may be used to inform you about other Protective Security Training Centre courses or sponsored events.

Confidentiality Policy: All information provided during assessment in either electronic or hardcopy format is official government information under the provisions of the Crimes Act 1914 (sections 70 and 79) and is issued on a need-to-know basis. It will be stored, transmitted and disposed of in accordance with Part C of the Protective Security Manual - 2005.

Please check this box if you do not wish to have your information used for marketing purposes.

This e-mail address will be used to send an Employer Satisfaction Survey.

The Invoice Authorising contact needs to complete the following section.

Note this information is mandatory.

Please check that the Employer/Agency Name is the entity name registered against the ABN.

The Tax Invoice will be emailed to the e-mail address provided, unless requested otherwise.

Accredited courses are GST-free. Non-accredited courses are GST inclusive. Morning tea, lunch and afternoon tea are provided during all full-day courses.

I understand and accept the Protective Security Training Centre Cancellation, Information Collection and Confidentiality policies and I certify that the invoice details are correct.