Current Details Medical Questionnaire Agreements Declaration Complete Applicant Details Title - Select - Mr Miss Other Full Name Preferred Name Date of Birth Gender - Select - Male Female Other Home Address Suburb Postcode Postal Address Leave blank if same as home address Unique Student Identifier (USI) Number What school do you attend? Are you Aboriginal or Torres Strait Islander? Aboriginal Torres Strait Islander No Emergency Contact Details (Parent/Guardian) Full Name Relationship Contact Number Residential Address Email Second Emergency Contact Details (Parent/Guardian) Full Name Relationship Contact Number Residential Address Email Current Qualifications If you currently hold any of the below, please provide copies(may not be relevant to all) NT Working with Children Clearance (Ochre Card) (If 15 years or older) NT Driving Licence (C Class) Immunisation record Provide First Aid Provide Advanced First Aid Provide Advanced Resuscitation Files Unlimited number of files can be uploaded to this field.5 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
