Register your course

Please Select Course *

Course Dates Available *

APPLICANT DETAILS

First Name *

Last Name *

Date of Birth

Gender

Female Male

Phone *

Mobile

Email *

Home Address

Suburb

Post Code

Are you a Union Member?

Yes No

Are you of Aboriginal or Torres Strait Islander origin?

Yes No

Which of the following best describes your current workforce status?

Full-Time Employee Part-Time Employee Casual Other

Language Spoke at Home

How well do you speak English?

Very Well Well Not Well Not Well at All

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

Yes No

If YES, please tick applicable condition:

Vision

Hearing

Physical

Intellectual

Learning

Medical Condition

Medical Illness

Acquired Brain Impairment

Other:

Do you require special assistance because of a disability?

Yes No

Assistance

Do you require assistance with reading, writing or math?

Yes No

Where did you hear about CWU Training Services?

EMPLOYEMENT DETAILS

Employer Name

Position

Work Phone

Work Fax

Work Adress

suburb

Postcode