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Step 3: Complete your enrolment

DVaware 2-Hour DV-aware (DV-aware: BATHURST - South Bathurst School, 251 Havannah St)

24/3/2019 to 24/3/2019

DV-alert Awareness Session

Location: South Bathurst School, 251 Havannah Street, Bathurst NSW 2795

Time: 12pm - 2pm

Delivered by Lifeline Central West

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:

*Last Name:

*DOB:

*Email:

*Gender:

Unique Student Identifier (USI):

Building/property name:

Flat/unit details:

*Street/lot number:

*Street name:

*Street type:

*Suburb:

State:

*Post Code:

* Phone Number

Home/Work:

Mobile:

*Legal Name:

*Trading Name:

*Email:

Building/property name:

Flat/unit details:

*Street/lot number:

*Street name:

*Street type:

*Suburb:

State:

*Post Code:

* Phone Number

Work:

Mobile:

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*Labour Force Status:

School Details

*At School:

Not Stated
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No

*School Level:

*Year Completed:

Other Details

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*Country of Birth:

*Disability:

Not Stated
Yes
No

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

*Prior Education:

Not Stated
Yes
No

Bachelor Degree or Higher Degree level
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Graduate Diploma or Graduate Certificate
Bachelor Degree
Advanced Diploma or Associate Degree
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Certificate IV
Certificate III
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Certificate I
Miscellaneous Education

Additional Fields

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