Student Enrolment Form

HLTPAT010 Collect Specimens for Drugs of Abuse Testing

To confirm registration for Nationally recognised training in collect specimens for drugs of abuse testing, the enrolled student must complete all the fields of this enrolment form. This is a mandatory requirement for Registered Training Organisations and must be submitted before training can commence. Thank you.

This field is for validation purposes and should be left unchanged.

Company Name of Course Payment & Booking(Required)

Payment Method Used for this Training Registration(Required)

Payment Method – If Other Please Specify

Do you wish to apply for RPL or Credit Transfer? If yes, please specify which option you are applying for.

How did you hear about this training course? (Sales team, Google Search, Website, Existing Client, Social Media etc)

By entering your name in full above, you confirm your agreement to undertake training with Alcolizer Technology.

Participant Details

Date of Birth(Required)

Gender(Required)

Title

Name(Required)

First Middle Last

Student Name (This is what will appear on your qualification)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Phone(Required)

Emergency Contact Name & Mobile Number(Required)

Cultural Background

Country of Birth(Required)

City of Birth

Citizenship Type(Required)

Do you Identify as?(Required)

Special Needs

Do you speak a language other than English at home?

If yes, please specify

Do you require assistance with any of the following?

Does the student have a hearing impairment?

Do you consider yourself to have any disabilities that we should be aware of?

If yes, please specify

If other, please specify

If you answered YES to the above question do you require any assistance to participate in this course?

Employment & Education

Employment (please select)(Required)

Highest school level completed?(Required)

Year completed School?

If you didn’t complete high school in Australia,which country?

Are you currently enrolled in any studies?

If Yes, please specify the school name

Have you SUCCESSFULLY completed any of the qualifications listed below in Australia?

Which BEST describes your main reason for undertaking this course?

Student Information

Unique Student Identifier (USI)

From 1 January 2015, Alcolizer Pty Ltd is prevented from issuing you with a nationally recognised VET qualification or statement of attainment when you complete your course if you do not have a Unique Student Identifier (USI). In addition, we are required to include your USI in the data we submit to NCVER.

Please Provide Your USI Number – if you don’t have a USI or need to check if you already have one, you can do so online.(Required)

👉 Create or check your USI – https://www.usi.gov.au/students/find-your-usi

Why We Collect and Use Your Personal Information

As a registered training organisation (RTO), we collect your personal information so we can process and manage your enrolment in a vocational education and training (VET) course with us. We use your personal information to enable us to deliver VET courses to you, and otherwise, as needed, to comply with our obligations as an RTO.

How We Disclose Your Personal Information

We are required by law (under the National Vocational Education and Training Regulator Act 2011 (Cth) (NVETR Act)) to disclose the personal information we collect about you to the National VET Data Collection kept by the National Centre for Vocational Education Research Ltd (NCVER). The NCVER is responsible for collecting, managing, analysing and communicating research and statistics about the Australian VET sector. We are also authorised by law (under the NVETR Act) to disclose your personal information to the relevant state or territory training authority.

How the NCVER and Other Bodies Handle Your Personal Information

The NCVER will collect, hold, use and disclose your personal information in accordance with the law, including the Privacy Act 1988 (Cth) and the NVETR Act. Your personal information may be used and disclosed by NCVER for purposes that include:

Populating authenticated VET transcripts
Administration of VET
Facilitation of statistics and research relating to education, including surveys and data linkage
Understanding the VET market

The NCVER is authorised to disclose information to:

The Australian Government Department of Education, Skills and Employment (DESE)
Commonwealth authorities, State and Territory authorities (other than RTOs)
VET regulators

The NCVER may also disclose personal information to persons engaged by NCVER to conduct research on its behalf. The NCVER does not intend to disclose your personal information to any overseas recipients.

For more information, refer to the NCVER’s Privacy Policy. For DESE’s privacy handling, visit the DESE VET Privacy Notice.

Surveys

You may receive a student survey which may be run by a government department or an NCVER employee, agent, third-party contractor or another authorised agency. Please note you may opt out of the survey at the time of being contacted.

Contact Information

At any time, you may contact Alcolizer to:

Request access to your personal information
Correct your personal information
Make a complaint about how your personal information has been handled
Ask a question about this Privacy Notice

Student Declaration & Consent

Please read and accept the following declarations.

Student Declaration – by entering your name in full below, you confirm your agreement to undertake training with Alcolizer Technology.(Required)

During this program, I understand and acknowledge:

My rights and obligations, as defined in the Student Handbook including the Fee and Refund Policy and the Complaints and Appeals.
That I will adhere to Alcolizer Pty Ltd code of conduct as outlined in the Student handbook.
My obligation at all times to conduct myself safely and in adherence to all relevant legislation.
I will actively attempt all training and assessment tasks with serious effort.
That I will comply with all safe and lawful requests, I will arrive on time and will return on time from all breaks.
That I will not bully, abuse, vilify or fail to treat all people participating, associated with, or in the vicinity of training venues with the utmost respect and courtesy.

Alcolizer Pty Ltd Rights and Obligations Include:

Provision of quality assessment services in a competent manner through the provision of quality resources and staff.
Assessment be performed by qualified assessors with the required knowledge and currency in the needs of industry.
Guaranteeing to provide assessment services to customers who have met their obligations about completion of enrolment details, and financial payments.
Guaranteeing that if Alcolizer Pty Ltd cannot deliver a course, a full refund of all monies paid to Alcolizer Pty Ltd will be refunded to the purchaser.
Committing that training will not be offered to participants who fail to wear PPE or fail to pay for the course.
Choosing to terminate a customer’s training if they fail to uphold these standards.

I acknowledge that I have read the above and declare that the information I have provided to the best of my knowledge is true and correct and that I have read and accepted the terms and conditions of the fees and refund policy as described in the Student Handbook. I am aware that Alcolizer Pty Ltd may use the email address I have supplied as a point of contact for any information it deems necessary. I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above and authorise Alcolizer Pty Ltd to share information about my training progress and completion with my employer or service provider, this may include a copy of my certification being sent to my employer.

Please declare you have access to the following equipment and resources:(Required)

AS3547.1:2019 Approved Breath Tester

Access to Wi-Fi Connection

Computer Access

Workplace Policies and Procedures (Drug and Alcohol Policy)

Acknowledgment and Signature(Required)

Please type your full name as your electronic signature to indicate that you have reviewed and accepted the terms and conditions provided.

Date