Register Which course are you registering for?*Choose a CourseBlacktown - MayOnline - MayBendigo - May/JuneName* First Last Age* 15-24 25-34 35-44 45-54 55-64 65+ Date of Birth* DD slash MM slash YYYY Do you identify as Aboriginal or Torres Strait Islander?* Aboriginal Torres Strait Islander Neither Country of Birth*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsMain Language Spoken at Home* Is your partner attending? Yes Partner's Name First Last Partner's Age* 15-24 25-34 35-44 45-54 55-64 65+ Partner's Date of Birth* DD slash MM slash YYYY Does your partner identify as Aboriginal or Torres Strait Islander?* Aboriginal Torres Strait Islander Neither Partner's Country of Birth*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsPartner's Main Language Spoken at Home* Residential Address* Street Address Address Line 2 City State Post Code This is also my postal address* Yes No Postal Address Street Address Address Line 2 City State Post Code MobileLandlineEmail* How did you hear about the course?* Ages of Children/Grandchildren*Knowing the ages of children in your care helps us to tailor the course to suit this age group. Course Fees - Online*(select which applies to you) Individual - $50 Couple - $70 Individual (concession) - $30 Couple (concession) - $50 Individual (sponsored) - $0 Couple (sponsored) - $0 Course Fees - Whalan, Mt Druitt*(select which applies to you) Individual - $20 Couple - $40 Individual (sponsored) Couple (sponsored) Course Fees - Bendigo, VIC*(select which applies to you) Individual - $50 Couple - $80 Individual (concession) Couple (concession) Course Fees - Face to Face*(select which applies to you) Individual - $80 Couple - $110 Individual (concession) - $30 Couple (concession) - $50 Individual (sponsored) - $0 Couple (sponsored) - $0 Course Fees - Sponsored Course*(select which applies to you) Individual - $0 (sponsored course) Couple - $0 (sponsored course) Payment* I'd like to pay via direct deposit I'd like to set up a payment plan You can make your payment into the following account: Fusion Training BSB: 037-012 A/c: 110679 *Please use FC followed by your surname as payment reference E.g. FCDavidson We will send a receipt when your payment has been receivedWe will be in touch with you after your registration to arrange payment.You can make your payment into the following account: Fusion Training BSB: 037-012 A/c: 110679 *Please use FC followed by your surname as payment reference E.g. FCDavidson We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Mornington BSB: 033-243 Account Number: 390462 *Please use FC followed by your surname as payment reference E.g. FCDavidson We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Bendigo BSB: 033 688 Account Number: 226032 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Bendigo BSB: 033 688 Account Number: 226032 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Australia BSB: 112-879 Account Number: 054 789 932 We will send a receipt when your payment has been receivedYou can make your payment into the following account: Account Name: Fusion Australia BSB: 112-879 Account Number: 054 789 932 We will send a receipt when your payment has been receivedWe will be in touch shortly to discuss payment plan options. Total $ 0.00
