Student Enrolment Form

You are enrolling in a Kalgoorlie Educator Foundation Program

Course Start date: 05 May 2021

Please fill in the Registration form below. Fields with a red * are required.

Student Details

Your Details

  Yes
  No

Your Address



Emergency Contact

  Yes
  No

Enrolment Details

       Yes
  No
  Own experience
  Supported a friend
  Supported a family member
  Carer
  Mental Health Worker
  Alcohol and Other Drug Worker
  Prefer to not say
  None
  Prefer to self-describe:
  Other:
  Language, literacy and numeracy support, e.g. computer literacy
  Disability support, e.g. access and equity for blind students
  Cultural or community support, e.g. linking students with a buddy
  Interpreting Services for culturally and linguistically diverse students
  Technology requirements for remote students, e.g. teleconferencing or Zoom meeting
  Not applicable

Privacy Notice

Privacy Notice

Western Australian Recovery College Alliance complies with the Privacy Act of 1988.
Your information is used to assist you in your learning needs and evaluation of the program.
Your information will be stored on the WARCA Record Management System.

I have read and I agree to the Privacy Notice. *

Finalise

       Yes
  No