TLIF2010 Application Form
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1 Step 1
ENROLMENT FORM: TLIF2010 Apply Fatigue Management Strategies

In order to apply for extended hours driving (BFM or AFM) through your employer, a driver of a vehiclewith a GVM of over 12 tonnes, or a combination of the total of the GVMs is over 12 tonnes, and/or a 12 or more seater bus/coach, must hold the accreditation of ‘TLIF2010 Apply Fatigue Management Strategies’.

PARTICIPANTS DETAILS:

First Name
Middle Name
Last Name
Home / Postal Addressyour full name
Suburb
State
Post Code
Contact Number

PLEASE NOTE: Your DOB and License number will not be used for any other purpose than to create a login to our system.

Date of Birth
Drivers Licence Number
Company Position

If you successfully complete this course and are deemed competent, you will receive a 'Statement of Attainment' . Where do you require us to mail this to?

Mailing Address

EMPLOYERS DETAILS (if applicable):

Name of Employer
Employer's Postal Address
Suburb (Employer)
State (Employer)
Post Code

IF APPLICABLE: 2 x Employer's contact that you require us to also email details to:

Name of Contact (1)your full name
Contact Number (1)your full name
Name of Contact (2)your full name
Contact Number (2)your full name

SUPPORT, SERVICES AND SPECIAL NEEDS

CIRCADIAN AUSTRALIA will take every possible action to ensure we support you throughout your training and assessment process. If at anypoint throughout your course you require any assistance or support please discuss these needs with CIRCADIAN AUSTRALIA’s staff and wewill do our best to help. If you have any special needs, including language, literacy or learning issues, please notify our staff prior toenrolment to allow us to cater for your needs. If you do not notify us of any condition that may affect your learning, we will not be able toassist you if the need arises.

YOUR RIGHTS

As part of your training and assessment, you have various rights. CIRCADIAN AUSTRALIA wants to ensure your learning experience is bothbeneficial and enjoyable. If you feel you need to complain about an aspect of service or training and assessment you may do so verbally orin writing. Appeals on any decision made by CIRCADIAN AUSTRALIA may be lodged with the Director and must be done so in writing. Formore information on your rights, please talk to our staff.

STUDENT HANDBOOK

I hereby acknowledge receipt of a Student Handbook which I have read and understand. I understand my responsibilities as a student whileenrolled with CIRCADIAN AUSTRALIA. I understand the responsibilities of the registered training organisation and am aware that should Irequire additional information about CIRCADIAN AUSTRALIA’s Policies and Procedures they will be made available to me on request.

PARTICIPANT'S ACKNOWLEDGEMENT

Enter your name
Date

EMPLOYER'S ACKNOWLEDGEMENT

Enter your name
Date
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[[[[]],[[]],"and"]]
1 Step 1
ENROLMENT FORM: TLIF2010 Apply Fatigue Management Strategies

In order to apply for extended hours driving (BFM or AFM) through your employer, a driver of a vehiclewith a GVM of over 12 tonnes, or a combination of the total of the GVMs is over 12 tonnes, and/or a 12 or more seater bus/coach, must hold the accreditation of ‘TLIF2010 Apply Fatigue Management Strategies’.

PARTICIPANTS DETAILS:

First Name
Middle Name
Last Name
Home / Postal Addressyour full name
Suburb
State
Post Code
Contact Number

PLEASE NOTE: Your DOB and License number will not be used for any other purpose than to create a login to our system.

Date of Birth
Drivers Licence Number
Company Position

If you successfully complete this course and are deemed competent, you will receive a 'Statement of Attainment' . Where do you require us to mail this to?

Mailing Address

EMPLOYERS DETAILS (if applicable):

Name of Employer
Employer's Postal Address
Suburb (Employer)
State (Employer)
Post Code

IF APPLICABLE: 2 x Employer's contact that you require us to also email details to:

Name of Contact (1)your full name
Contact Number (1)your full name
Name of Contact (2)your full name
Contact Number (2)your full name

SUPPORT, SERVICES AND SPECIAL NEEDS

CIRCADIAN AUSTRALIA will take every possible action to ensure we support you throughout your training and assessment process. If at anypoint throughout your course you require any assistance or support please discuss these needs with CIRCADIAN AUSTRALIA’s staff and wewill do our best to help. If you have any special needs, including language, literacy or learning issues, please notify our staff prior toenrolment to allow us to cater for your needs. If you do not notify us of any condition that may affect your learning, we will not be able toassist you if the need arises.

YOUR RIGHTS

As part of your training and assessment, you have various rights. CIRCADIAN AUSTRALIA wants to ensure your learning experience is bothbeneficial and enjoyable. If you feel you need to complain about an aspect of service or training and assessment you may do so verbally orin writing. Appeals on any decision made by CIRCADIAN AUSTRALIA may be lodged with the Director and must be done so in writing. Formore information on your rights, please talk to our staff.

STUDENT HANDBOOK

I hereby acknowledge receipt of a Student Handbook which I have read and understand. I understand my responsibilities as a student whileenrolled with CIRCADIAN AUSTRALIA. I understand the responsibilities of the registered training organisation and am aware that should Irequire additional information about CIRCADIAN AUSTRALIA’s Policies and Procedures they will be made available to me on request.

PARTICIPANT'S ACKNOWLEDGEMENT

Enter your name
Date

EMPLOYER'S ACKNOWLEDGEMENT

Enter your name
Date
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