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1800 628 999 | ask@laserinstitute.edu.au

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Student Portal

Home
Courses
Getting Started
Resources
Contact Us

View Cart
Student Portal

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Online Student Enrolment Form

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Thank you for your interest to study with our institute. We require all new students to complete a Student Enrolment Form to ensure we maintain accurate details should we need to contact you or for processing your certificate.
Here's a checklist to help complete your enrolment
- A Unique Student Identifying (USI) number
- Picture of Photo ID (Drivers Licence, Passport, Photo ID)
- 10 minutes to fill all fields

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Personal Details
Name*
Title First Last
Date of Birth*
Day
Month
Year
Gender*
- Male
- Female
Place of Birth*
State Country
USI Number*
Unique Student ID - Get your USI Here
Confirm USI Number*
Apply Here
The USI is a free Government Student ID.
Please select a type of photo ID to be used for identification purposes*
- Australian Driver's License
- Australian Passport
- High School Student ID
- University Student ID
Please upload a copy of the photo ID you selected above*
Drop files here or
Accepted file types: jpg, gif, png, pdf.

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Address Details
Email*
Enter Email Confirm Email
Mobile Phone*
Work Phone
Personal Address*
Street Address Address Line 2 City State Postcode Country
Postal Address*
Same as previous
Street Address Address Line 2 City State Postcode Country
Company Name
Required if needing for business tax purposes

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Emergency Contact Details
Full Name*
Best Contact Number*

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Special Requirements
What is the main language spoken at home?*
- English
How well do you speak English?*
- Very Well
- Well
- Not Well
- Not at all
Are you of Aboriginal descent?*
- Yes
- No
Are you of Torres Strait Islander descent?*
- Yes
- No
Do you consider yourself to have a disability, impairment or long-term condition?*
- Yes
- No
Disability, impairment or long-term condition*
- Hearing
- Physical
- Intellectual
- Learning
- Mental Illness
- Acquired Brain Impairment
- Vision
- Medical Condition
Would you like additional support with any special needs (literacy, numeracy, physical)?*
- Yes
- No
This information is confidential and is only used as a means to provide the best support possible to suit your individual needs.
Please provide a brief description of the sort of support would best suit your individual needs*
We are committed to ensuring we offer training opportunities to all people on an equal and fair basis. All participants who meet our entry requirements will be accepted into any of our training programs. Any questions regarding access and equity can be directed to the Chief Executive Officer.

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Education Background
Are you currently studying at school?*
- Yes
- No
In what year did you complete High School?*
Highest Level of Secondary Education Achieved*
Any Tertiary Study Level/s Achieved?*
- Cert I
- Cert II
- Cert III
- Cert IV
- Diploma
- Advanced Diploma
- Associate Diploma
- Bachelor
- Masters
- Doctorate
Name of University / College*
Reason for undertaking additional study*
- To get a job
- To develop my existing business
- To start my own business
- Change Career
- To get a promotion
- Job Requirement
- Extra skills for my job
- To get into another course of study
- Personal Interest / Self Development

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Employment Details
Employment Status*
Employers Name*
Employers Contact Number*
Job Role / Title*
Address of Employment*
Street Address City State Postcode Country

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Course Enrolment
Select Course for Enrolment*
Course Short Description
Course URL
Applying for Recognised Prior Learning?*
- Yes, I meet the requirements
- No, new course study
Have you created an online Student Profile account yet?*
The Student Profile account allows you to login to the user area of this site. If you have processed an order on this site already you will have an account already.
- Yes - I have been through the checkout
- No - I haven't yet
Student Portal Access
This will be the password you use to log back into the site at a later stage. On completion of this Enrolment Form you will be automatically logged in and redirect to the course selected above.
Student Portal Password*
Enter Password Confirm Password
Strength indicator

Create a password to access your details and enrolled courses.

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Terms & Conditions
Before you can submit your application, please read through our full Terms & Conditions found by clicking the following link: READ OUR TERMS AND CONDITIONS.
I have read, understand and agree to the following:*
- a) I will follow all Information and Rules and Regulations as outlined on this form as well as all Policies and Procedures of the RTO.
- b) I will follow the instructions of my Trainers and Assessors as well as other staff and contractors engaged by the RTO.
- c) I release and hold harmless the RTO, its Directors, staff and agents in respect of any property loss or personal injury that I may sustain whilst participating in my course.
Your Signature*
I confirm the accuracy of the information in this form and hereby submit this form as my application for enrolment.*
- I agree
Enrolment Date
Date Format: DD slash MM slash YYYY
Email
This field is for validation purposes and should be left unchanged.

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At Clinical Therapies & Laser Institute we are focused on offering the extra ordinary. We strive for excellence as our mission is to equip our students with an advanced set of skills and confidence that places them far above the rest.

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Contact Details

2/10 Valente Close Chermside Q 4032
PO Box 5734 Stafford Heights Q 4053
1800 628 999 / +61 7 3350 6898
Email Us Here

Copyright © 2020 Clinical Therapies & Laser Institute RTO#41476 | A Clinical Partner

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