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Student ID No:

STUDENT ENROLMENT FORM

CERTIFICATE IV IN LEADERSHIP AND MANAGEMENT
(BSB42015)
Please provide all applicable information. Some of the information requested in this form is for statistical purposes
according to the Australian Vocational Education and Training Management Information Statistical Standard (AVETMISS).
Please send completed form to: Student Registrations OR
KneeDeep
Suite 203, Level 2 Fax: +61 8 8231 3343
33 Pirie Street Email: admin@kneedeep.com.au
ADELAIDE SA 5000

Personal Details
1. Surname:       Given Names:      
2. Date of Birth:      /     /      (DD/MM/YYYY) Sex: Male Female
3. Residential      
Address:
      State:       Post Code:      
5. Postal Address:      
      State:       Post Code:      
7. Home Phone:       Mobile No:      
8. Email Home:       Email Work:      

Organisation Details
9. Business Name:      
10. Position Held:      
11. Business Address:      
      State:       Post Code:      
13. Business Phone:       Fax No:      

Emergency Contact Details

14. Full Name:       Relationship to you:      
15. Home Address:      
      State:       Post Code:      
17. Home Phone:       Mobile No:      

Language and Cultural Diversity

18. Country of Birth: Australia Other – Please Specify      
19. Language Spoken
at Home: English – Go to Question 17 Other – Please Specify      
20. English speaking Very Well Not Well
capability:
Well Not at All
21. Australian No
Aboriginal or
Yes, Australian Aboriginal Yes, Torres Strait Islander
Torres Strait
Islander status:

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KneeDeep Office Use Only
Student ID No:

Language, Literacy & Numeracy

22. Our training takes into account the language skills required by people wishing to increase their skills. We will
take into account the needs of clients who require additional assistance with language, literacy and numeracy.
If you believe you need further assistance please contact us and enquire about our LLN referral programs.

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Special Needs
23. Is there any information we need to be aware of that will assist us in delivering the best learning experience for
you as an individual? You may choose to contact us direct on (08) 7127 4885 to discuss.
No – Please go to Question 20
Yes – please specify      
24. Do you have a long term disability, impairment or dietary requirement?
No – Please go to Question 21
Yes – please specify – Note: We may also contact you for further information
Hearing Intellectual Acquired Brain Impairment
Vision Learning Medical Condition
Physical Mental Illness Other
Food Allergy/Dietary need – Please specify      

Schooling
27. Are you still attending high school: No Yes
28. Highest COMPLETED school level:
Year 12 or equivalent Year 11 or equivalent
Year 10 or equivalent Year 9 or equivalent
Year 8 or below Never attended school
– Please go to Question 24
29. Year in which you completed school:      

Previous Qualifications
30. Have you SUCCESSFULLY completed any of the below?
No – Please go to Question 26 Yes – Please go to Question 25
31. If YES, tick all applicable qualifications:
Bachelor Degree or Higher Certificate III (or Trade Certificate)
Advanced Diploma or Associate Degree Certificate II
Diploma (or Associate Diploma) Certificate I
Certificate IV (or Advanced Certificate/
Certificates other than those listed
Technician)

Employment
32. Which BEST describes your current employment status?
Full time employee Part time employee
Employer Self employed – not employing others
Unemployed – seeking full time work Unemployed – seeking part time work
Employed – unpaid worker in a family Unemployed – not seeking employment
business

Study Reason
33. What BEST describes the main reason for undertaking this course?
To get a job
To develop my existing business
To start my own business
To try for a different career
To get a better job or promotion
It is a requirement of my job
I wanted extra skills for my job
To get into another course of study
For personal interest or self-development
Other reasons

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Enrolment
34. Are you applying for recognition of prior learning?
Yes, I am applying for recognition of prior learning. Please go to Question 29
No, I am registering to participate in the whole program. Please select 12 units of competency
(4 core subjects and 8 elective units) as detailed in Question 30.
If you answered yes to Question 28 please contact KneeDeep on (08) 7127 4885 to discuss your eligibility.

Enrolment Subject Details – Certificate IV in Leadership and Management

35. What are the Units you are applying for RPL:
Core Subjects
BSBLDR401 Communicate effectively as a workplace leader
BSBLDR402 Lead effective workplace relationships
BSBLDR403 Lead team effectiveness
BSBMGT402 Implement operational plan
Electives Group A (Compulsory)
BSBINN301 Promote innovation in a team environment
BSBMGT403 Implement continuous improvement
Implement and monitor WHS policies, procedures and programs to meet
BSBWHS401 legislative requirements
BSBWOR404 Develop work priorities
Electives Group B (Choose at least 3 Units)
BSBCMM401 Make a presentation
BSBCUS401 Coordinate implementation of customer service strategies
BSBLED401 Develop teams and individuals
BSBMGT401 Show leadership in the workplace
BSBPMG522 Undertake project work
Electives (Optional)
BSBREL401 Establish networks
36. Please choose the units of competency in which you wish to enrol:
Core Subjects
BSBLDR401 Communicate effectively as a workplace leader
BSBLDR402 Lead effective workplace relationships
BSBLDR403 Lead team effectiveness
BSBMGT402 Implement operational plan
Electives Group A (Compulsory)
BSBINN301 Promote innovation in a team environment
BSBMGT403 Implement continuous improvement
Implement and monitor WHS policies, procedures and programs to meet
BSBWHS401 legislative requirements
BSBWOR404 Develop work priorities
Electives Group B (Choose at least 3 Units)
BSBCMM401 Make a presentation
BSBCUS401 Coordinate implementation of customer service strategies
BSBLED401 Develop teams and individuals
BSBMGT401 Show leadership in the workplace
BSBPMG522 Undertake project work
Electives (Optional)
BSBREL401 Establish networks
Note: Final electives may be subject to agreement/consultation with individual course participants

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Unique Student Identifier
As of 2015 January 1st, all students enroling for nationally recognised training are required to have a Unique
Student Identifier.
If you already have a USI, please enter into the field below.
If you do not already have a USI, please visit http://www.usi.gov.au/create-your-USI/Pages/default.aspx to create
a USI, and enter into the field below.
If you are unable to obtain a USI please contact us on (08) 7127 4885 for assistance.
37. USI:      

Terms & Conditions

 An enrolment fee of $1,000 is payable at the enrolment stage, $200 at the time of registration and the remaining $800
prior to course commencement.
 Upon receiving the completed enrolment form, KneeDeep will issue a tax invoice for the enrolment fee.
Invoices are to be paid in full within 14 days and prior to course commencement.
 In case of a Recognition of Prior Learning, KneeDeep will raise an invoice after the applicant has agreed on the
path to pursue.
 KneeDeep will raise an invoice for the 2nd instalment after the 3rd full-day training session ($1300) and the rest of the
course fee ($1300) after completion of the program or after completing the Recognition of Prior Learning process.
 If desiring to pay by instalments, both a 12 month and 24 month payment plan exist, as outlined below:
 On the 12 month plan; $200 payable at the time of registration/enrolment which also serves as the 1st
months payment, $310 monthly for the next 10 months and $300 for the final months payment.
 On the 24 month plan; $200 payable at the time of registration/enrolment which also serves as the 1st
months payment, $150 monthly for the next 22 months and $100 for the final months payment.
 Payment plans can be negotiated on mutual agreement by both parties.
 Invoices are to be paid in full within 14 days and prior to the issuance of Statement of Attainment and
Certificate of Completion.
 Cancellations notified more than 5 working days prior to course commencement date will NOT incur any fees.
 Cancellations notified less than 5 working days prior to course commencement date will incur the total
enrolment fee as the cancellation fee.
 No refunds will be issued after course commencement unless a medical certificate is provided.
 KneeDeep will refund the total enrolment fee if the company cancels a program or reschedules a program to a
date that is not suitable to the candidate.
 If any fees are not paid and the company deems necessary to engage a debt collector agency to collect the
outstanding amount, all costs associated with debt recovery will be added to the outstanding debt of the
candidate.
 All complaints about the provision of training or assessment services will be dealt with in accordance with our
Complaints Policy as detailed below.

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Complaints Policy
All complaints about the provision of training or assessment services will be dealt with efficiently, effectively,
transparently and fairly and all quality issues identified will be addressed.
The Company seeks to:
 Listen to the views of all our clients and stakeholders
 Address any concerns that they may have
 Constantly improve the quality of our services and processes.
If a participant has a complaint or problem with one of the Company’s programs or processes, he/she may also
report it to any staff member. Staff members will encourage complainants to lodge their complaints using the
Complaint Form.
All forms received will be referred to the Training Manager so they can be dealt with confidentially and promptly.
We will provide complainants with the opportunity to present their case and they can also bring a support person if
consider necessary and/or have access to an independent arbiter if needed.
We will keep the complainants informed of the progress of their complaints and will also give them the option to
contact us at any time to find out the current status of their complaint.
If the complaint has an origin in company policy, the Training Manager will escalate the complaint to the Managing
Director.
If the complainants are not satisfied with the outcome of the process they should be referred to the Department of
Further Education, Employment, Science and Technology, Quality Branch (08) 8241 8000, the National Training
Complaints Hotline (1800 000 674) or the Office of the Training Advocate (1800 006 488).
For a minimum of 5 years, we will keep all supporting evidence of:
 Data about complaints and appeals
 Records of actions taken to address the root cause of complaints
 Minutes of staff meetings at which actions arising from complaints were agreed on
 Documented changes to our systems
I accept these Terms & Conditions

Signature:       Date:      

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