KENG 2025 Strategic Planning Survey

Step 1 of 6

Expression of Interest for Study

at Kingston East Neighbourhood Group

Note: If you are under 18 years of age a parent or guardian will need to sigh this form on your behalf. Please email or phone us using the details on our contact page

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

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

Date of Birth(Required)

Gender(Required)

Pronouns

Which course/s are you interested in studying?(Required)

Certificate I Traineeship in Hospitality (Paid)

Certificate III in Individual Support

Certificate III in Early Childhood Education and Care

Skills for Work and Vocational Pathways

Do you already have a USI number?(Required)

Yes

Unsure

What is a USI number?

Enter USI Number(Required)

Emergency Contact Information

In case of emergency while you are studying with us, who should we contact?

Emergency Contact Name(Required)

First Last

Emergency Contact Address

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

Emergency Contact Phone Number(Required)

What is this persons relationship to you? (e.g. parent, spouse, friend)(Required)