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Please complete the ACFI Appraiser Distance Learning (17564)Registration form and return by email to REGISTRATION FORM [email protected] or fax to 02 6885 7518. Student Information ( please complete all questions) Title: Gender: Male Female Date of birth: Family name: Other Name: Given name (in full): Preferred name: Home Address: Suburb: State: Postcode: Phone: (Home) (Mobile) Email address: Facility: Suburb: Phone: (Work) (Fax) Email address: 1. Citizenship and Residency - Do you reside in Australia? 3. Do you consider yourself to have a disability, Cross one box only Yes No impairment or long term condition? Please mark your citizenship or residency status below, Mark one box only Yes No marking more than one box if appropriate. I am an Australian citizen a New Zealand citizen If Yes, place a cross (X) in any applicable box/boxes an Australian permanent resident Vision Hearing/Deaf Physical Not residing in Australia Intellectual Medical Condition Mental Illness a Permanent humanitarian visa holder Acquired Brain Impairment Learning Other Holder of an Australian temporary visa and my visa sub-class is: 2. Are you of Aboriginal or Torres Strait Islander origin? Do you require assistance because of this If you are both Aboriginal and Torres Strait Islander mark both disability, impairment or long term condition from a boxes 2 and 3. TAFE NSW Teacher Consultant? 1. No 1. No 2. Yes If YES, contact a TAFE Disability Teacher Consultant for further information (details 2. Yes, Aboriginal 3. Yes, Torres Strait Islander are available at the campus enrolment centre) Student Declaration: I acknowledge that it is a condition of my enrolment that I abide by all TAFE NSW policies and procedures. I have read the section titled Management of Risk of Harm to Students and Staff. I also acknowledge that it is a condition of my enrolment to advise the Campus Manager, a TAFE Counsellor or my Head Teacher if I have a history of violence. I confirm the accuracy of the information I have provided on this registration form and acknowledge that providing any false information and/or failing to disclose any relevant information, including any history of violence, may lead to the immediate termination of my enrolment at TAFE NSW. I acknowledge that the information provided on this registration form and that which will be collected by TAFE NSW throughout my enrolment will be used by TAFE NSW in accordance with the information handling practices documented in the Student Privacy notice. AND Have read and agree with the terms & conditions on page 2 of this document Student Signature Date:

Cost : $330.00 inc GST Course Fee Payment Details

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Cheque or Money Order – To be made out to ‘TAFE NSW Western Institute (if within 2 weeks of course date, cheques MUST be sent by Express Post)

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Tax Invoice – Please provide Purchase Order or request on Business Letter Head to accompany the registration form (include student name, Course name & Cost) FAX TO: 02 6885 7518 (this page only) Please complete the ACFI Appraiser Distance Learning (17564)Registration form and return by email to REGISTRATION FORM [email protected] or fax to 02 6885 7518.

TERMS AND CONDITIONS

TAFE NSW – Western Institute regrets it cannot accept responsibility for changes in students’ work commitments or personal circumstances and will not refund the course cost.

CANCELLATIONS AND REFUNDS 1) Payment must accompany registration form. 2) Once the Registration form and payment are received by TAFE NSW – Western Institute, the study package will be sent to the student and study is deemed to have commenced and the student has 5 weeks to complete the course. 3) Substitute delegates are required to complete a registration form and fax to the ACFI Team on 02 6883 3615 with details of who they are substituting. 4) Substitutes are required to pay an administration charge of $110.00 (inc GST).

If paying by Cheque/Money Order please fax this form to the number below to ensure your place in the course and note on it that the cheque is being posted. If within 2 weeks of course date, please send Express Post

By Mail: ACFI Training TAFE NSW – Western Institute PO Box 787, DUBBO NSW 2830 (Phone: 1300 553 718) Or

By Credit Card:  By Fax: 02 6885 7518

A receipt will be issued on payment of fee.

This course has been endorsed by APEC number 090225001 as authorised by Royal College of Nursing, Australia (RCNA) according to approved criteria.

Attendance attracts 12 RCNA Continuing Nurse Education (CNE) points as part of RCNA’s Life Long Learning Program (3LP). Changes to courses Outstanding fees and charges TAFE NSW endeavours to provideEnrolment courses in accordance with InformationPlease note that in accordance with TAFE NSW policy, if you the details published. However, TAFE NSW reserves the right have outstanding fees or charges from any current or previous to: enrolment you will not be issued with documentation such as  run or withdraw any course Transcripts or Testamurs relating to any enrolments.  hold a course at a Campus other than that advertised Disability services If you would like information about disability support and  alter the times or dates for the whole or any part of the services please contact a Teacher/Consultant for students with course. a disability. Contact details are available at your campus of If any of these course changes become necessary, you will be enrolment or via Disability services. You should do this before advised of the changes and the alternative arrangements which the start of your class. may be available for you to complete your course. TAFE NSW credit transfer Temporary visa holders, international students & VET Fee Some commercial programs have formal assessment. If you Help students have successfully completed the SAME or an EQUIVALENT Temporary visa holders, international students and VET Fee unit to one that is in your current course, the result from your Help students enrolled in TAFE NSW are subject to specific previous study will be TRANSFERRED to your current course conditions. For further information contact the Temporary Visa and included on your TAFE NSW Transcript of Academic Holders Officer at the local TAFE NSW campus or see Record. Your Head Teacher/Teacher can advise you of the Temporary visa holders or, for international student information, units for which grades will transfer. There may be some cases visit where it is NOT possible to transfer a grade. In these cases, http://www.detinternational.nsw.edu.au/tafe/ap_howtoapply.html your TAFE NSW Transcript of Academic Record will indicate . For VET Fee Help information, follow the links on the TAFE that the unit has been achieved BY ADVANCED STANDING. NSW website or contact your campus. TAFEcard Payment of the Course Fee Students in some commercial programs will need to obtain the For commercial programs (also referred to as TAFE PLUS) full TAFE NSW student identification card, called TAFEcard. You payment of the course fee or the first instalment, if applicable, is will be advised if this will be useful or necessary for you. If you required prior to the start of class(es). already have a TAFEcard from previous study you can Refund of the Course Fee have it re-activated. Refund of the Course Fee is only due in the following Student Association circumstances: The annual Student Association membership fee funds facilities  TAFE NSW has cancelled the course and services that improve the educational environment of a you were enrolled in; or campus. For more information, contact the Campus  You formally advise the campus in Administration Office, a Student Association or visit the website. writing, at least 7 days prior to the start of your course that you are withdrawing. Secure Internet access and email Students must abide by the Department of Education and In any other circumstances, full or partial refund of the Course Training's (DET) policies when using the Internet and email Fee is at the discretion of the campus delegate. services. If you are under 18 years of age you are required to If you are unable to attend the course and it is within 7 days take home an Under 18 Information Brochure for your parent or prior to the start date you are allowed to send an appropriate guardians to read. delegateManagement in your of place. risk of In harm this tocase students you should and staff contact the campusTAFE NSW offering is required the bycourse law to ensureand advise the health them and ofsafety the of substitution. students, staff and visitors on our premises. In order to meet these legal obligations it is necessary for us to assess and manage any known risk of violent behaviour. If you have a history of violence that may suggest that you could pose a current risk of any type to TAFE students, staff and/or visitors it is a condition of your enrolment to advise the Campus Manager, a TAFE Counsellor or your Head Teacher prior to attending your first class. For these purposes 'violence' is not restricted to physical acts. It includes any behaviour in the last ten years that seriously interferes with the physical or psychological safety and well being of others such as:  actual violence to any person  possession of or use of a weapon or any item with the intention to cause harm or injury to others  threats of violence or intimidation of others  suspension or expulsion from any school or educational institution for violent or aggressive behaviour. TAFE NSW is committed to offering vocational education and training to the entire community. Following your advice of a potential risk, we will carry out an assessment of the current risk and, if necessary, provide support and a management plan. Only in exceptional circumstances will a risk assessment lead to exclusion from enrolment. It is our aim to provide an appropriate, safe environment to suit every student's needs and maximise your success in your studies.

Student privacy The NSW TAFE Commission (having its principal office located at Level 2, 35 Bridge Street Sydney NSW 2000) collects personal information concerning students during their enrolment at TAFE NSW including, but not limited to, their attendance, participation, and academic progress. The information collected by TAFE NSW throughout a student's enrolment (collectively "the information") will be used by TAFE NSW or other authorised organisations for the purposes of general student administration, identification, communication, state and national reporting, program monitoring and evaluation. Student information will be held securely and disposed of securely when no longer needed. The information may be disclosed to Centrelink, the Department of Veteran's Affairs, the Department of Education, Employment and Workplace Relations, the Department of Immigration and Citizenship, the Universities Admissions Centre, Office of the Board of Studies and the National Centre for Vocational Education Research (NCVER) and/or an agency authorised to undertake surveys. In order to meet the requirements of Registered Training Organisations under the Apprenticeships and Traineeships Act 2001, apprentice and trainee information is provided to employers, Australian Apprenticeship Centres and State Training Services (or the relevant State Training Authority). Statewide and regional statistics derived from information provided by all students will also be provided to the Commonwealth. While the provision of this information is not mandatory under legislation, it is a requirement of TAFE NSW that this information be provided in order for your enrolment to be accepted. This is to assist TAFE NSW in recording enrolments for certain target groups for which funding is provided for student services. Without that funding, TAFE NSW would be unable to continue providing training and services at current levels. You may correct your personal details by contacting your TAFE NSW campus administration or by using TAFE NSW Student e-Services.