Short Course Enrolment Form

Short Course Enrolment Form
You will require about 20 minutes to complete this form. Please complete each section carefully. The form needs to completed and submitted in one session, there is no storage of data for forms that have not been finished and sent through.

Missing or incomplete fields will be highlighted in red.

At the point of submitting your enrolment you will be required to pay a non-refundable $50 enrolment fee.
Course(s) being applied for:*

Short Course - Reformer EssentialsShort Course - Reformer Intermediate and AdvancedShort Course - Pregnancy in MotionShort Course - The CadillacShort Course - Wunda Chair EssentialsShort Course - Wunda Chair Intermediate/AdvancedShort Course - Small EquipmentShort Course - Matwork Repertoire and DidacticsShort Course - Somatic Movement Education in PilatesShort Course - Balls Repertoire and Teaching MethodologyShort Course - Barrels RepertoireShort Course - Introduction to Laban & Movement TherapyIndividual Unit of Competency from an accredited course
Choose your Study Location
Please choose the name of the studio / location where you wish to study:*

Tensegrity Studio - Sunshine Coast, Rockhampton, Mackay, QLDTensegrity Studio - Hobart, TASMy Pilates - Drummoyne, NSWLifestyle Pilates - Newcastle, NSWBodiline Pilates - Port Macquarie, NSWPilates Excellence in Training - North Sydney, NSWBalance and Control Pilates - Prahan, VICQueens St Pilates - Adelaide, SAOther
Section 1 - Personal Details
Family Name*
Given Name (First Name only)*
Residential Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Check this box if your postal address is the same as your residential address
Postal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone
Work Phone
Mobile Phone
E-mail*
Confirm E-mail*
Date of Birth*

DayMonthYear
Under 18
Gender*

MaleFemaleN/A
Emergency / Next of Kin Contact Details:
Name
Phone
As of January 1st, 2015 you are required to provide your USI.

If you do not have one, click here to obtain one through the Department of Industry's website.
Unique Student Identifier (USI)*
Section 2 - Employment Details
Current Employer
Current Position
Phone Number
Section 3 - Language and Cultural Diversity
Are you of Aboriginal origin?*

YesNo
Are you of Torres Strait Islander origin?*

YesNo
Were you born in Australia?*

YesNo
If you were not born in Australia, please specify:
Are you an Australian citizen?*

YesNo
If you are not an Australian Citizen, please specify:
Do you speak a language other than English at home?*

No, English OnlyYes
If you do you speak a language other than English at home, please specify
How well do you speak English?

Very WellWellNot WellNot at all
Section 4 - Disability
Do you consider that you have a disability, impairment or long-term condition? (You may indicate more than one area)

VisionMental IllnessHearing/DeafLearningPhysicalAcquired Brain ImpairmentMedical ConditionIntellectualOther
Section 5 - Prior Education / Training
What is your highest completed school level?

Completed Year 12Completed Year 11Completed Year 10Completed Year 9 or equivalentCompleted Year 8 or lowerDid not go to school
In which year did you complete that school level?
Are you still attending secondary school?

YesNo
Have you successfully completed any of the following qualifications? (Please tick ALL applicable boxes)

Bachelor Degree or Higher DegreeAdvanced Diploma or Associate DegreeDiploma (or Associate Diploma)Certificate IV or Advanced Certificate / TechnicianCertificate III (or Trade Certificate)Certificate IICertificate ICertificates other than listed
Section 6 - Employment
Of the following categories, which best describe your current employment status?

Full time employeePart time employeeSelf employed - not employing othersEmployerEmployed - unpaid worker in a family businessUnemployed - seeking part-time workUnemployed - seeking full-time workNot employed - not seeking employment
Section 7 - Study Reason
Of the following categories, which best describes your main reason for undertaking this course?

To get a jobTo start my own businessTo get a better job or promotionExtra skills for my jobFor personal interest or self developmentTo develop my existing businessTo try for a different career working with peopleTo get into another course of studyIt was a requirement of my jobOther reasons
Section 8: Related Professional Qualifications
In order to successfully complete these short course you need to have an allied health background.
Of the following categories, tick which ones are relevant:*

PhysiotherapyExercise ScienceExercise PhysiologyPilatesOsteopathyChiropracticOther Allied HealthUnder care of health practitioner for injury that may affect participation in exercises of the course
Section 9 - Pilates or Movement Experience
Please provide a description of previous experience in Pilates or Movement modalities
Section 10 - Declaration and Permission
By signing electronically below:

I certify that all details provided on these forms are correct.

I understand that information contained in this form may be provided to government agencies for statistical purpose use.

I agree to pay the required deposit fee and scheduled payments to the course provider.

I grant Tensegrity Training the right to take and or use photographs/videos of me in connection with my participation in the above course. I agree that Tensegrity Training may use such photographs/videos for any lawful purpose, for example such purposes as education, training, publicity, illustrations, advertising and web content.

I also agree that Tensegrity Training may:

i. use any written feedback I provide for promotional and marketing purposes
ii. contact me to promote their courses
Ensure that you have read the Student and Partner Organisation Agreement.
I confirm that I have read and agree to the terms and conditions of the legally binding Student and Partner Organisation Agreement (linked above)
Electronic Signature*
Date Signed*

DayMonthYear
Parent / Guardian (required if under the age of 18)
Parent / Guardian Date Signed

DayMonthYear
When you click on the "Submit" button below, you will be sent to our payment page

to complete the payment of the $50 non-refundable enrolment fee

(which is a separate fee to the prescribed Course Fee)
Should be Empty:

Short Course Enrolment Form

Choose your Study Location

Section 1 - Personal Details

Section 2 - Employment Details

Section 3 - Language and Cultural Diversity

Section 4 - Disability

Section 5 - Prior Education / Training

Section 6 - Employment

Section 7 - Study Reason

Section 8: Related Professional Qualifications

Section 9 - Pilates or Movement Experience

Section 10 - Declaration and Permission