Enrolment Form – South Western Sydney Recovery College

First Name

Last Name

Date of Birth

Address

Suburb

Postcode

Mobile

Phone

Student Type:

Person with lived experience Carer/Support Person Service Provider/Worker

Do you identify as:

Aboriginal Torres Strait Islander Both Neither

Language spoken at home?

Do you identify as having a disability? If yes, we can talk to you about your support needs.

Yes No

Gender

Employment Status

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

Buried in Treasures - TAHMOOR (starting Tue 16 Feb) Buried in Treasures - FAIRFIELD (starting Wed 17 Feb) Mental Health Recovery - Mondays - BANKSTOWN (starting Mon 1 Feb) Mental Health Recovery - Wednesdays - CAMDEN (starting Wed 3 Feb) Mental Health Recovery - Thursdays TAHMOOR (starting Thur 4 Feb) Mental Health Recovery - ONLINE (starting Tue 2 Feb) 'It's Time to Talk - What is a healthy relationship?' via Zoom for Youth 18-25yrs (two workshops 22 Feb & 1 Mar, 5:30-7:30pm) CANTERBURY/BANKSTOWN 'Healthy Relationships' at Chester Hill - Girl Guides Hall (two workshops Fri 26 Feb & 5 Mar, 10am-12pm) CANTERBURY/BANKSTOWN

Other - NOTE: for webinars, registration is VIA zoom, check online learning pages for registration links

Have you previously enrolled in a SWS Recovery College course/workshop? If yes, and your details are up to date, there is no need to complete any more of the form below.

Yes No

Other

Someone may be in contact with you about your enrolment. When is the best time to contact you?

Emergency Contact or Extra Support Details

Personal: Name

Professional: Name

Relationship

Phone

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. I also acknowledge and agree to the Covid-19 Conditions of Entry.

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