Female specific trainer Enrolment Form Enrolment – Step 1 of 2 Click to view Student Participant Handbook Before you complete our online enrolment form, please read the above Student Participant Handbook. Female specific trainer Enrolment Form Female specific trainer Enrolment Form Select Female Specific Trainer date*23 February 202125 March 202124 June 2021To be confirmedName* First Last Date of Birth* Date Format: DD slash MM slash YYYY Phone*Email* Preferred method of contact?*Phone (during business hours)Phone (outside business hours)SMSEmailDo you have any disabilities that may impact your ability to study?*YesNoIf yes - please download medical clearance from here download medical clearance. Please fully complete THIS FORM and have it signed by a Doctor and emailed to info@h-p-c.com.au PRIOR to course commencement.If yes, please provide details below:Do you have any medical conditions or injuries that may impact you from participating in exercise?*YesNoIf yes - please download medical clearance from here download medical clearance. Please fully complete THIS FORM and have it signed by a Doctor and emailed to info@h-p-c.com.au PRIOR to course commencement.If yes, please provide details below:Are you pregnant?*YesNoIf yes - please download medical clearance from here download medical clearance. Please fully complete THIS FORM and have it signed by a Doctor and emailed to info@h-p-c.com.au PRIOR to course commencement.Gender*MaleFemaleEmergency / Next of Kin ContactFirst PersonName* First Last Phone*Relationship to you*Second Contact PersonName* First Last Phone*Relationship to you*Your Residential Address* Street Address Suburb State Postcode 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 Islands Country ID File Uploader (10MB Limit) Page 1 (ID is required for student record identity purposes)*ID File Uploader (10MB Limit) Page 2 (optional)Of the following categories, which best describes your current employment status?*Full-time EmployeePart-time employeeEmployed – unpaid worker in a family businessSelf-employed – not employing othersUnemployed – seeking part-time workUnemployed – seeking full-time workNot employed – not seeking employmentOf the following categories, which best describes your main reason for undertaking this course?*To get a jobIt was a requirement of my jobTo develop my existing businessI wanted extra skills for my jobTo start my own businessTo try for a different careerFor personal interest or self-developmentTo get a better job or promotionWithin the last two years, have you regularly attended a gym/training facility or undertaken structured physical activity, twice per week?*YesNoHow did you hear about us?*Notes/CommentsI have read and understood the contents of the HPC student handbook* Yes I have read and understood all Terms and Conditions associated with enrolment* Yes Payment Method*Please selectCredit Card over the phone / Pay in the centrePayPalCAPTCHA
