Enrolment Form – South Western Sydney Recovery College

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Enrolment Form

Eligibility: People with a lived experience, carers or service providers living or working within South Western Sydney.

IMPORTANT: Covid-19 Conditions of Entry

Use this enrolment form for the short and long courses only – For online workshops, registration is VIA zoom, check Online Learning pages for more information.

First Name

Last Name

Date of Birth

Suburb - Must live or work in South Western Sydney

Postcode

Which LGA are you from? (Note: we are funded for South Western Sydney only)

Campbelltown Camden Bankstown Fairfield Liverpool Wingecarribee Wollondilly

Email

Mobile

Phone

Student Type:

Person with lived experience Carer e.g. family, friend Service Provider/Worker Other

Language spoken at home?

Country of Birth

Do you identify as:

Aboriginal Torres Strait Islander Both Neither

Do you identify as having a disability?

Yes No

Do you have any specific needs in relation to learning or access that may assist us to improve your experience at Recovery College? (e.g. wheelchair access, learning styles)

Gender

Employment Status

Name of the Course / Workshop you wish to enrol in: (Popular courses/workshops may have a waiting list)

Workshop - Roads to Recovery: Psychosis - Campbelltown (RESCHEDULED to Thursday 24 July)

How did you hear about SWS Recovery College?

Macarthur Disability Services Primary Health Network One Door Mental Health Mental Health Worker Support Worker Family or Friend Brochure/Website Facebook Community College Other

Other

Emergency Contact or Extra Support Details

Name of Emergency Contact

Relationship

Phone

Data Consent

Do you give consent for SWSRC/MDS to provide your de-identified demographic data (no names or contact details) to our funding body, SWS PHN? (For more info, please refer to our website: https://swsrecoverycollege.com.au/frequently-asked-questions/ )

Face to Face Covid-19 Requirements (current as 22/02/2022)

I understand that training facilitated in the training room at Macarthur Disability Services, Campbelltown requires full vaccination for all in attendance (other Covid-safe conditions of entry will apply).

I understand that training facilitated at non Macarthur Disability Service venues (e.g. Bryan Brown Theatre and Function Centre), does not require vaccination (unless it is a venue requirement) and it is possible that I may interact with non-vaccinated students (other Covid-safe conditions of entry will apply).

I understand that it is my responsibility to complete a Rapid Antigen Test (RAT) prior to attending any face to face training and to not attend if feeling unwell or showing flu-like symptoms.

I acknowledge and agree to all other covid-19 conditions of entry.

Electronic Signature:

By typing your name below and clicking on “I Agree” below, you acknowledge and agree that your information will be sent to the South Western Sydney Recovery College for the purpose of student enrolment.

Signature

I Agree

Are you between 12 and 18? If so, we'll need a guardian to co-sign your form so you can attend.

By typing your name below and clicking on “I Agree” below, you acknowledge and agree that you are a legal guardian of the student listed above and are giving your consent for the student to participate in this course.

Signature

I Agree

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