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Step 3: Complete your enrolment

DVaware DV-alert Awareness Session (DV-aware: MUDJIMBA - North Shore Community Centre, 701 David Low Wy)

6/6/2019 to 6/6/2019

DV-alert Awareness Session

Location: North Shore Community Centre, 701 David Low Way, Mudjimba QLD 4564

Time: 11am - 1pm

Delivered by Lifeline Bundaberg

If you have already enrolled onto a course, ordered a product or registered for an event, your login details will have been provided via e-mail.

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Student:

*Title:

*First Name:

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*DOB:

*Email:

*Gender:

Unique Student Identifier (USI):

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Flat/unit details:

*Street/lot number:

*Street name:

*Suburb:

State:

*Post Code:

* Phone Number

Home/Work:

Mobile:

*Legal Name:

*Trading Name:

*Email:

Building/property name:

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*Street/lot number:

*Street name:

*Suburb:

State:

*Post Code:

* Phone Number

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Mobile:

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*Disability:

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No

Hearing/Deaf
Physical
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Learning
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Acquired Brain Impairment
Vision
Medical Condition
Other
Not Specified

*Prior Education:

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No

Bachelor Degree or Higher Degree level
Advanced Diploma or Associate Degree
Diploma
Certificate IV
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Certificate II
Certificate I
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Additional Fields

Do you have any participatory requirements to ensure that you can participate fully in the workshop? For example, hearing or vision impairment.