Enrolment FormStep 1 of 425%Name* First Last Gender*MaleFemaleDate of Birth* Day Month YearAddressHome* Street Address City State / Province / Region ZIP / Postal Code Postal Street Address City State / Province / Region ZIP / Postal Code Postal same as Home AddressContact DetailsHome PhoneMobile*Work PhoneEmail Emergency Contact DetailsNameRelationshipPhone Course TLILIC2001A - Licence to operate a Forklift Truck RIIMPO301C - Conduct Hydraulic Excavator Operations RIIMPO304B - Conduct Wheel Loader Operations RIIMPO318A - Conduct Skid Steer Loader Operations RIIMPO311A - Conduct Haul Truck Operations RIIMPO319A - Conduct Backhoe/Loader Operations RIIMPO312A - Conduct Scraper Operations RIIMPO205B - Operate a Roller_Compactor RIIMPO310B - Conduct Grader Operations CPCCOHS1001 - Work Safely in the Construction Industry (White Card)Employers details Self Employed UnemployedNamePhoneAddress Street Address City State / Province / Region ZIP / Postal Code Demographic InformationIn which country were you born?*AustraliaOther - Please specifySpecifyDo you speak a language other than English at home?*No - English onlyOther - Please specifySpecifyHow well do you speak English?*WellVery wellNot wellNot at allAre you of Aboriginal or Torres Strait Islander origin?*NoYes, AboriginalYes, Torres Strait IslanderYes, Aboriginal and Torres Strait IslanderDo you consider yourself to have a disability, impairment or long-term condition?*NoYesIf YES, then please indicate the areas of disability, impairment or long-term condition. Hearing/deaf Physical Intellectual Learning Mental illness Acquired brain impairment Vision Medical condition OtherWhat is your highest COMPLETED school level?*Still attending schoolYear 12 or equivalentYear 11 or equivalentYear 10 or equivalentYear 9 or equivalentYear 8 or belowNever attended schoolIn which YEAR did you complete that school level?Have you SUCCESSFULLY completed any of the following qualifications? 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 aboveWhich BEST describes your current employment status?*Full-time employeePart-time employeeSelf-employed – not employing othersEmployerEmployed – unpaid worker in a family businessUnemployed – seeking full-time workUnemployed – seeking part-time workNot employed – not seeking employmentYour major reason for study?*Get a jobTo develop my existing businessTo start my own businessTo try for a different careerTo get a better job or promotionIt was a requirement of my jobI wanted extra skills for my jobTo get into another course of studyFor personal interest or self-developmentOther reasons CITBDo you have a Construction Industry Training Board (CITB) number?*YesNoIf Yes please supply numberTerms and ConditionsTerms and Conditions What you get? All fees quoted, or agreed for a course with ACMT INCLUDE: training materials (texts, learner guides etc.),training delivery, assessment services, assessment materials, equipment, statement of attainment/parchment issuance, white-cards, licences or operator tickets which are advertised as outcomes of successful completion of the training and ACMT is legally able to issue. NO separate charges are made for printed materials required for training and/or assessment purposes. What is not included? Standard fees quoted do NOT include: • the provision of safety hats or safety boots • the re-issuing of a white-card, licence, operator ticket or Statements of Attainment • a licence to perform high-risk work (these are issued by the State Government) Additional charges: Re-issuing: Re-issuing of Statements of Attainment, originally issued by ACMT will incur a fee equal to $10. Re-issuing of Tickets, originally issued by ACMT will incur a fee equal to $33 inc GST plus any government charges incurred by ACMT for the purposes of re-issuing the particular document. How to obtain a replacement Statement of attainment or ticket please contact us by phone: 08 8240 5523 or email firstname.lastname@example.org Deposits Where a course requires a deposit to be paid by the participant or employer, the deposit must be paid to ACMT 14 days prior to course commencement to finalise the enrolment. Part Payment Participants enrolled in courses which require the payment of additional fees in advance after the commencement of their course must pay these amounts by the due date as set out in their schedule of fees. Arrears ACMT reserves the right to refuse to continue training participants with payments in arrears for more than seven days. If the services of a debt collector are required, the client (employer or participant) who has requested the services of ACMT is responsible for the payment of the debt collection agency fees. Balance Payable Participants will be invoiced for all outstanding tuition fees on the day of or after the conclusion of the course (the last day of scheduled attendance). All outstanding tuition fees are payable within 14 days of the date of invoice. Fees are payable regardless of whether a participant has been found competent or not in one or more Units of Competency at the completion of their training course. Cancellations Participants who wish to cancel their enrolment may do so at any time prior to course commencement. To cancel their enrolment, participants must inform ACMT in writing (letter, email or fax). Written cancellation does not automatically entitle participants to a refund. Please see below for details of refunds for cancellations. Refunds Deposits and Up-front Short Course Payments: Deposits and payments in full for short courses made prior to commencement are refundable only up to seven days prior to commencement of the course. Deposits and payments in full for short courses made prior to commencement are transferrable to another individual in the event that an employer or individual wishes to transfer the enrolment. Fees Paid in Advance – Once Course has Commenced: Participants must give written notice (letter, email or fax) of their intention to withdraw from a course once a course has commenced. Non-attendance at a course does not constitute notice of withdrawal and therefore does not confer any rights to refunds. Scheduled fees paid in advance are non-refundable. Any fees paid in advance in excess of the required scheduled payments are fully refundable from the date ACMT receives written notice of intention to withdraw. Refund Examples: Peter enrols on 1 March in a course commencing on 1 April. Peter’s course costs $1,200. Peter is required to pay $200 deposit and then make two monthly payments of $500 (1 April, 1 May). Scenario 1: Peter pays the deposit on 10 March. On 19 March Peter emails ACMT informing them that he is cancelling his enrolment. Peter has provided more than seven days’ notice. Peter receives a full refund of his deposit. Scenario 2: Peter pays his deposit on 1 March. On 25 March Peter emails ACMT informing them that he is cancelling his enrolment. Peter has provided only five days’ notice. Peter is not entitled to a refund of his deposit. Scenario 3: Peter commences his course on 1 April. Peter decides he wants to pay the balance of $1,000 in full rather than make two payments. He makes $1,000 payment on 1 April. On 28 April Peter emails ACMT informing them that he is withdrawing. Peter has provided the required written notice of his intention to withdraw. • Peter’s deposit is non-refundable. • Peter’s scheduled first $500 payment made on 1 April is non-refundable. • However, Peter has paid the second payment before it was due and is therefore eligible for a refund of $500 as this amount has been paid in excess of the required scheduled fee payments. Scenario 4: Peter commences his course on 1 April. Peter decides he wants to pay the balance of $1,000 in full rather than make two payments. He makes $1,000 payment on 1 April. Peter commences his course but fails to attend after 16 April and cannot be contacted to discuss his enrolment. On 10 May ACMT receives an email from Peter stating that he wants to withdraw. Peter has not provided the required notice on time. He is not entitled to a refund as he was still enrolled on 1 April when his second payment of $500 was due. Illness, Work and Other Extenuating Circumstances: Participants who are unable to commence or complete their course due to illness, work commitments or other extenuating circumstances should inform ACMT immediately and refer to the full Terms and Conditions available on the website www.acmt.net.au for details on deferrals and refunds in these circumstances. Please note a medical certificate or letter form employer will be needed to obtain a refund. Administration of Refunds: All refunds will be determined and refunded within 28 days of ACMT receiving the notice of cancellation or withdrawal. Complaints Your first point of contact: • Training issues: ACMT has in place a robust appeals and complaints process that addresses any issues that Participants may have regarding any aspect of our training. Your trainer is the first point of contact should you have any issues with your training or assessment. If you are uncomfortable approaching your trainer, you can speak to the CE/Training Operations Manager. • Enrolment, fees or refunds: You should contact the CE if you have any problems, issues or are dissatisfied in any way with your enrolment, fees or refunds. • Equity, Access, Harassment and Bullying: You should contact the Chief Executive/Training Operations Manager. Formal complaints or grievances: If you are uncomfortable communicating your issue directly, or are unsatisfied with the response received through initial face to face communication with ACMT, you should forward your complaints or appeals in writing by letter or using the notification of complaint form available on request. to email@example.com or post to: ACMT PO Box 3274 PORT ADELAIDE SA 5015 Trainers, and all staff, upon receipt of a written complaint should document the complaint using the ACMT Complaints form. The person to whom the complaint was addressed initially will attempt resolve the Participant’s complaint through discussion and negotiation. The outcome, if successful, will be documented on the ACMT Complaints form and passed to the Chief Executive The Chief Executive will place a copy of the complaints form in the individual’s file and record the complaint in the Complaints register. Otherwise, the complaint will be forwarded to the Chief Executive. The Chief Executive will attempt to resolve the issue with the Participant. All negotiations will be documented and filed in the Individual’s file Appeals: All individuals may appeal any decision reached by ACMT in relation to their complaint. Individuals should forward their complaints or appeals in writing to: Chief Executive ACMT PO Box 3274 PORT ADELAIDE SA 5015 Where practicable, ACMT aims to ensure any complaint or appeal is resolved within 15 days of receiving a complaint or notice to appeal. All correspondence and negotiations will be documented and recorded in the Individual’s file. All complaints will be logged in a complaints register, where these complaints result in changes to policy or procedures in relation to organisational operations or training, these outcomes will be recorded in the continuous improvement register. The complaints register will be reviewed as part of ACMT’s Continuous Improvement Processes. Appealing or Taking Further Action for Participants Participants should contact the Office of the Training Advocate on 1800 006 488 IF a complaint is specifically about: • refunds, fees and charges • problems with transferring to another provider • accommodation, welfare and support for students under 18 • course attendance or progress • the training provider suspending, deferring or cancelling your enrolment • education agents Where appropriate, The Chief Executive will offer to forward the complaint to the Office of the Training Advocate or ASQA where appropriate for adjudication. The Chief Executive must obtain written approval from the Participant approving the release of information associated with the complaint/appeal. Notification to the participant must take place within one working day of determination to refer the complaint/appeal. Participants will be informed of their rights to independently complain or appeal directly to other regulatory bodies where the complaint/appeal cannot be resolved to the satisfaction of the Participant. The Australian Skills Quality Authority (ASQA) ASQA is responsible for investigating complaints concerning whether an ASQA RTO is breaching (or has breached) its legislative requirements under the National Vocational Education and Training Regulator Act 2011 (the Act), including the Standards for NVR Registered Training Organisations 2011, and any additional conditions imposed by ASQA on its registration, and Subdivision A of Part 6 of the Act. Please visit http://www.asqa.gov.au/complaints/making-a-complaint.html for further information on lodging a complaint with ASQA.Declaration* I have read and understand the above terms and conditions of my enrolment with Australian Civil and Mining Training.