Inspire Student - Expression of Interest Form

Expression of Interest Form - Inspire Education

Qualification Details

Qualification Code (if know):(Required)

Example: CHC30313

Qualification name:(Required)

Example: Cert III Early Childhood Education and Care

Student Details

Student Name(Required)

First Name (& Middle Name) Last Name

Date of Birth(Required)

Mobile Phone(Required)

Email Address(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

**Is the student a minor (under 18)?(Required)

Yes

Parent / legal Guardian details (required if the student is a minor)

Parent / legal guardian full name:

First Name Last Name

Relationship to the student:

Mobile number:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Course progression with Inspire (if known)

Total number of units completed with Inspire:

Please enter a number greater than or equal to 0.

Any other concern you would like to raise:

Data access consent

Shafston is required to access your personal file within Inspire Education student management systems and learning management systems in order to assess what you are still required to complete to receive a qualification for the course you have enrolled with Inspire Education. This information will only be used to provide you with further instructions regarding the completion of your qualification for now and until your enrolment with Shafston International College is finalised.

Student Signature:(Required)

Signed Date(Required)

Parent / legal guardian signature:

Signed Date

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Expression of Interest Form - Inspire Education

Qualification Details

Student Details

Parent / legal Guardian details (required if the student is a minor)

Course progression with Inspire (if known)

Data access consent

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