NSW Course Enrolment Call Stuart: 0408 463 425 If you are unlicensed, please download the P650 form below, fill it in and either email it back to me website@pact365.com.au or print it out and bring it on the day. p650 Download Fireground Enrolment Agreement Form 2026 1Personal details and USI2Course and AVETMISS data3Declarations and signature Accredited CoursesPlease select the course and date below.Select Course(Required)Select a courseSelect Date(Required)Select a dateOptional extras Firearms Safety Training Licence Ammunition Purchase Tick any extras you need on the day. Leave both unticked if you do not.Course Total (Inc GST) Personal detailsLegal name as per photo ID, which will need to be sighted to verify legal name.Family name (Last Name)(Required)Your Last NamePrevious namePrevious Last Name (If Married)Given name (First Name)(Required)Your First NameEmployerDate of birth(Required) Day Month Year Town or city of birth(Required)Gender(Required) Female Male Other Residential address(Required) Street Address Address Line 2 City State / Province / Region Postcode Postal Address Same as Residential If different, un-tick to add an address.Postal address Street Address Address Line 2 City State / Province / Region Postcode Phone (home)Phone (work)Phone (mobile)(Required)Email(Required) Driver's licence numberDriver's licence stateSelect a stateACTNSWNTQLDSATASVICWAUnique Student Identifier (USI)A USI is required by all Australians undertaking nationally recognised training. Fireground cannot issue Certificates or Statements of Attainment without a USI. If you do not have a USI, you can create one at www.usi.gov.auUSI(Required) AVETMISS data collectionLanguage and cultural diversityAre you of Aboriginal or Torres Strait Islander origin?(Required) No Yes, Aboriginal Yes, Torres Strait Islander For persons of both Aboriginal and Torres Strait Islander origin, mark both ‘Yes’ boxes.Were you born in Australia?(Required) Yes No Country of birth (if not Australia)(Required)Do you speak a language other than English at home?(Required) No, English only Yes, other Language spoken at home(Required)How well do you speak English?(Required) Very well Well Not well Not at all EmploymentWhich best describes your current employment status?(Required) Full time employee Part time employee Self employed Employer Employed, unpaid in a family business Unemployed, seeking full time work Unemployed, seeking part time work Not employed, not seeking work Select one option only.SchoolingWhat is your highest completed school level?(Required) Year 12 or equivalent Year 11 or equivalent Year 10 or equivalent Year 9 or equivalent Year 8 or below Never attended school Select one option only.In which year did you complete that school level?(Required)Please enter a number from 1950 to 2026.Are you still attending secondary school?(Required) Yes No Previous qualifications achievedHave you successfully completed any of the following qualifications?(Required) 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 the above N/A Select all that apply.DisabilityDo you consider yourself to have a disability, impairment or long term condition?(Required) Yes No Areas of disability, impairment or long term condition(Required) Hearing/Deaf Physical Intellectual Learning Mental illness Acquired brain impairment Vision Medical condition Other You may select more than one.Other disability (please specify)(Required)Study reasonWhich best describes your main reason for undertaking this course?(Required) To get a job To develop my existing business To start my own business To try for a different career To get a better job or promotion It was a requirement of my job I wanted extra skills for my job To get into another course or study Personal interest or self development Other reasons Select one option only.Other study reason (please specify)(Required) PRIVACY NOTICE Why we collect 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. How we use your personal information 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 NCVER and other bodies handle your personal information NCVER will collect, hold, use and disclose your personal information in accordance with the law, including the Privacy Act 1988 (Cth) (Privacy Act) 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; and understanding the VET market. NCVER is authorised to disclose information to the Australian Government Department of Employment and Workplace Relations (DEWR), Commonwealth authorities, state and territory authorities (other than registered training organisations) that deal with matters relating to VET and VET regulators for the purposes of those bodies, including to enable: administration of VET, including program administration, regulation, monitoring and evaluation facilitation of statistics and research relating to education, including surveys and data linkage understanding how the VET market operates, for policy, workforce planning and consumer information. NCVER may also disclose personal information to persons engaged by NCVER to conduct research on NCVER’s behalf. NCVER does not intend to disclose your personal information to any overseas recipients. For more information about NCVER’s handling of your information, please see the NCVER Privacy Policy: www.ncver.edu.au/privacy To seek access to or correct your information, please contact your RTO in the first instance. DESE is also authorised by law, including the Privacy Act and the NVETR Act, to collect, use and disclose your information for its functions and activities. For more details, see the DESE VET Privacy Notice: www.dese.gov.au/national-vet-data/vet-privacy-notice Surveys At any time, you may contact Fireground Pty Ltd 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 declarationsI have read and understand the information provided, and consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice.(Required) Yes No I give permission for Fireground Pty Ltd to access my Unique Student Identifier (USI) for the purpose of recording my results.(Required) Yes No I give permission for Fireground to discuss my training progress and results with my employer (if applicable) and provide the employer with a copy of my results. (Corporate clients only) Yes No I grant permission to Fireground to use photographs and/or video of me taken during the training, in publications, news releases, social media, and in other communications.(Required) Yes No I acknowledge that I can access the Fireground Student Handbook at www.fireground.com.au(Required) Yes No View the Student HandbookI declare that the information I have provided is true and correct.(Required) Yes No Learning supportDo you believe you may require additional support with reading, writing, numeracy, or other learning needs during this course?(Required) Yes No If you select “Yes”, a member of our team will contact you confidentially to discuss how we can best support your learning.Student signature(Required)Date(Required) Payment InformationCourse NameSelect a courseCoupon Total (Inc GST) Credit Card
