Have you completed Salesperson Certificate under CPP41419 Certificate IV in Real Estate Practice?
Date of Birth
Company Name (if required for invoicing)
Country of Birth
Are you an overseas student studying in Australia on a STUDENT VISA?
If you speak a language other than English at home, please advise what language
How well do you speak English?
Not At All
Are you of Aboriginal origin?
Are you of Torres Strait Islander origin?
Yes No Address/Contact Details
Postal Address (if different from above)
Unique Student Identifier (USI) *Please provide your USI number OR one form of identification below (Photocopy required)
USI number (if you have one)
Drivers Licence No
Country of Issue
Passport Expiry Date
Name as it appears on proof of identity document
Do you consider yourself to have any disability, impairment or long-term condition? *
Please refer to the Disability Supplement for an explanation of the following disabilities
Medical Conditions (tick those that apply)
Hearing/Deaf Physical Intellectual Learning Mental Illness Vision Acquired Brain Impairment
If you have other medical conditions, please provide a brief description of the sort of support which would best suit your individual needs and a Company representative will contact you. If you are not sure if your English language, literacy & numeracy skills are at the standard required to achieve competency, please contact our office and we can provide you with a short Literacy & Numeracy test to complete, which will enable us to ascertain if you will need additional assistance.
Other Medical Conditions
What year did you complete High School?
Highest year completed at High School
Are you still enrolled in secondary or senior secondary education?
Have you completed any of the following qualification?
Bachelor Masters Advanced Diploma/Assoc Degree Diploma/Assoc. Diploma Cert IV Cert III or Trade Cert Cert II Cert I
Unpaid worker-family business
Unemployed, seeking full-time work
Unemployed, seeking part-time work
Not seeking employment
Study Reasons (select one reason which describes your main reason to undertake this course)
To get a job
To develop my existing business
Extra skills of job
To get a better job/promotion
Requirement of my job
Get into another course
Personal interest/self development
To get skills for community/voluntary work
Would you like additional support with any special needs (literacy, numeracy, physical)?
If yes, please provide a brief description of the sort of support which would best suit your individual needs and the CEO of there representative will contact you.