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Info

Student Enrolment Form

You are enrolling in an Albury Standard Mental Health First Aid

Starts at 9am
2 day course (6 hours each day)

Please choose your enrolment type, then fill in the form. Fields with a red * are required.

Terms & Policies

Agreements

I have read and I agree to the Smart Link Training Privacy Notice *

I have read and I agree to the terms and conditions. *

Details

Full Name

Title *

Family name (surname) *

First given name/s *

Second given name (middle)

Date of Birth

Date of Birth *

Gender, Identity, and Pronouns

Gender *

Gender identity

Pronouns

Custom Pronouns

Enter your contact details

Your Email Address (Please ensure this is YOUR email address, and NOT a shared address) *

Confirm Your Email Address *

Alternative email address (optional)

Additional Email

This email address will be used as a CC email address on communications to you, please use this field to indicate if we need to CC another person / company in your communications.

Mobile *

Home Phone *

Work Phone

Preferred Contact *

Company / Organisation name

Company

Please enter the details for your your next-of-kin / Emergency Contact

Full Name *

Phone/Mobile *

Relationship *

Address

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 or territory’s ‘rural property addressing’ or ‘numbering’ system as your residential street address.

Building/property name is the official place name or common usage name for an address site, including the name of a building, Aboriginal community, homestead, building complex, agricultural property, park or unbounded address site.

Building/property name

Flat/unit details

Street or lot number (e.g. 205 or Lot 118) *

Street Name *

Suburb, locality or town *

Postcode *

State/Territory *

What is your postal address (if different from above)?

I have a postal address that is different to the residential address provided

Course

Course Specific Questions

Misc.

Language, Literacy & Numeracy

I require LLND (Language, Literacy, Numeracy and Digital) assistance.

How did you hear about us?

Referral Type

Is there anything else we need to know, in regards to your enrolment?

Additional Notes

Payment

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