Course Selection

Courses Available: *

Personal Details

Title: *
First Name: *
Middle Name:
Last Name: *
Gender: *
Date of Birth: *
Country of Birth: *
City/Town of Birth: *
Origin: *I am applying from within Australia?

Unique Student Identifier (USI)

Do you have a USI: *  What is a USI?
USI Number: *
We can apply for a Unique Student Identifier on your behalf. Please indicate below whether you would like us to do so.
Obtain a USI?: *
Please provide a means of identification that we can use.
You will need to get a USI from the USI Website and provide it to us, before commencing this course.
Identification Type? *
Drivers Licence State: *
Drivers Licence Number: *
Get help locating this information on your Drivers Licence.
Medicare Number: *
Individual Ref Number: *
Medicare Card Colour: *
Expiry Date: *
Name Line 1: *
Name Line 2: *
Name Line 3: *
Name Line 4: *
Get help locating this information on your Medicare Card.
Passport Number: *
Get help locating this information on your Australian Passport.
Country of Issue: *
Passport Number: *
Get help locating this information on your Non-Australian Passport.
Birth Certificate State: *
Registration Number: *
Certificate Number:
Registration Date: or
Registration Year:
Date Printed:
Get help locating this information on your Birth Certificate.
Acquisition Date: *
Register Number: and
Entry Number: or
Client Number:
Get help locating this information on your Certificate of Registration By Descent.
Acquisition Date: *
Stock Number: *
Get help locating this information on your Citizenship Certificate.
Immicard Number: *
Get help locating this information on your ImmiCard.

Contact Details

Building or Property Name:
Unit or Flat Number:
Street Number: *
Street Name: *
Suburb/Town: *
Suburb/Town/City: *
State: *
State/Province/Region: *
Postcode: *
Post Code/Zip Code: *
Country: *
Post Box: Do you have a PO Box or RMB?
Box Number:
Postcode: *
Email Address: *
Mobile Phone:
Home Phone:
Work Phone:
Note: Please specify at least one of the above contact numbers.

Educational Details

What is your highest COMPLETED school level? *
Are you currently at school? *
What is your CURRENT school level? *
Have you completed any other qualifications? *
Select all that apply
Bachelor degree or higher degree
Advanced diploma or associate degree
Diploma (or associate diploma)
Certificate IV (or advanced certificate/technician)
Certificate III (or trade certificate)
Certificate II
Certificate I
Certificates other than the above
Are you applying for credit transfer? *
Which best describes your reason for this study? *

Individual Needs

Which best describes your employment status? *
Are you an Aboriginal or Torres Strait Islander? *
Select an option
Yes, Aboriginal
Yes, Torres Strait Islander
Yes, Aboriginal AND Torres Strait Islander

Do you speak a language other than English at home? *
Please specify which language:
Do you have a disability or impairment? *
Select all that apply
Mental illness
Acquired brain impairment
Medical condition
Not specified

Do you have any individual needs we should know about?
Please specify:


You may upload documents in support of your application.
Select Files
Note: These files will be sent via email, so please limit their size to less than 10MB in total.


In applying for this training, you are advised that Commonwealth Departments are entitled to collect enrolment and training activity information about you for the purpose of monitoring training quality and reporting on training activity. The information you provide will be accessed to support the ongoing statistical analysis of the Australian vocational training sector. We will not disclose your personal information to any unauthorised persons or organisations.

The information collected in this form is required to facilitate your enrolment and will be handled and stored in line with our Privacy Procedures. We reserve the right to verify any of the details you have provided on this form in order to process your application.

By submitting this form, I certify that:

I have reviewed the Student Information Booklet available on this website and have been informed about my rights and obligations.
I have reviewed the course fees and payment arrangements and have been informed of the refund policy.
I have reviewed the relevant course brochure and have been informed of the training and assessment services to be provided.
The information provided is true and correct. I further certify that I have been provided sufficient information about my rights and obligations to make an informed decision about enrolment and I agree to the services being provided.
I have good English language, literacy and numeracy skills and am confident I will be able to undertake the assessments as set out by the course and I have advised Riklan of any additional support I may need.
I agree to complete a medical summary form on commencement of my training declaring I have no pre-existing conditions which could affect my ability to complete this course.

Click Submit to check and send in your form.

© 2022 • Riklan Emergency Management Services • RTO No: 51994