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Enrolment For Online / Print FSS Course Certificate

Do you currently hold a Food Safety Supervisor Certificate?* Yes NO
You need to have an existing Food Safety Supervisor Certificate to proceed.*
CURRENT FSS Cert Expiration Date: *
1. Personal Details
Surname: *
Given Names: *
Title: Ms/Mrs/Mr *
Date of Birth: *
(dd/mm/yyyy)
Gender: * Male  Female
USI Number (click here if you do NOT have one) *
Phone No:Home *
Phone No:Work
Mobile
Email: *
Confirm Email Address: *
Residential Address: *
City/Town: *
State: *
Post Code: *
As Above.
Postal Address: *
City/Town: *
State: *
Post Code: *
Are you of Aboriginal origin?*  
Are you of Torres Strait Islander origin?*  
Where you born in Australia?*  
If no, what Country were you born in?
Are you still attending secondary school?*  
If yes, which school?
What is your highest COMPLETED school level?*  
What year did you complete your highest level?
Have you completed any of the following in Australia?*  
If Other : Please detail
2. Credit Transfer
Just Careers Training recognises all AQF Qualifications and Statements of Attainment issued by any other RTO. Do you hold any AQF Qualifications and/or Statements of Attainment that may be useful to shorten the requirements of the qualification you wish to enrol in?*
Details:
Do you speak a language other than English at home?
If yes, what language, other than English is spoken at home?
How well do you speak English? Very Well   
Well    
Not Well   
Not at all
Do you feel that you may require assistance with Language, Literacy and/or Numeracy? No, Not at all    
Some Assistance    
Lots of assistance
Do you consider yourself to have a permanent disability, impairment or long term condition?
If YES, then please indicate the areas. (You may indicate more than one area)
Study Reason – which BEST describes the reason for undertaking this training and/or assessment.
3. Course and Employment Details
Which course are you wanting to complete?*  
Are you currently employed?*  
Are you employed Full time or Part time?  
Name of Employer:
Worksite:
Supervisor’s Name:
The code and name of the qualification you are enrolling in:

How would you like to complete this course?

 Online
 Via Correspondence
Participant Declaration & Privacy Statement
  • I have read the Participant/Client Information Handbook available online; I understand the roles and responsibilities as the participant, including the pathways and options available to me for training and assessment.
  • I hereby agree to abide by the RTO policies and procedures relating to fees, charges and regulations of the organisation.
  • I declare that the information supplied on this form is correct and complete.
  • I agree that personal information and records (this may include written, verbal, photographic and other formats) collected by the Registered Training Organisation (RTO) may be:
    • Used by the RTO for research, statistical analysis, program evaluation and internal management purposes
    • Used by the NSW Food Authority or ACT Health and other by government departments for audit, research, statistical analysis, program evaluation.
  • I understand that my personal information will only be disclosed to other third parties with the appropriate legal documents or agreement/ permission in writing by myself.
 
 
I have read and understood the terms and conditions set out above.
Security Code: *
Just to further protect your information by making sure you are not a robot, please complete the following before sending.