RSA Classroom Course Application Form

Please ensure you have read the Affirm Training Pre-enrolment information prior to enrolment. If you need help to fill out this form, please contact Affirm Training representative for assistance. 

To renew the RSA competency card, please complete the Liquor and Gaming NSW refresher course.

Course

×
× ×

Personal Details

Please complete all required fields below

Title
Entity Data - Profile - Title
First Name
Entity Data - Profile - First Name
Middle Name(s)
Entity Data - Profile - Middle Name
Surname
Entity Data - Profile - Surname
Name Commonly Known As
Entity Data - Profile - Known By
Birth Date
Entity Data - Profile - Birth Date
Gender
Entity Data - Profile - Gender
Unique Student Identifier (USI)

NOTE: if you don't already have a USI, please click HERE to apply for one now!
Entity Data - AVETMISS - Unique Student Identifier (USI)
Identification
Submit a document covering the criteria:
(you may protect sensitive information such as document number)
  • Photo
  • date of birth
  • signature
  • current residential address.
Basic - File

Contact Information

Please complete all required fields below

E-mail Address (Personal)
Entity Data - Contact - Home - E-mail Address
Mobile Number
Entity Data - Contact - Work - Mobile Number
Emergency Contact
Entity Data - Contacts - Type
Emergency Contact - First Name
Entity Data - Contacts - First Name
Emergency Contact - Surname
Entity Data - Contacts - Surname
Emergency Contact - Phone Number
Entity Data - Phone - Home - Phone Number
Emergency Contact - E-mail Address
Entity Data - Phone - Home - E-mail Address
Contact - Relationship
Entity Data - Contacts - Relationship
Are you an ACES Staff?
Basic - Dropdown

Residential Address

Please complete all required fields below

Street Number
Entity Data - Address - Home - Street Address 1
Street Name
Entity Data - Address - Home - Street Address 2|These fields have been deprecated as they didn't properly feed the address information. Please use the newly added fields: Unit/Flat Number, Street/Lot Number and Street Name.
[Home] Address -
Entity Data - Address
Residential Address
Entity Data - Address - Lookup
[Home] Address - Street Address 1
Entity Data - Address - Street Address 1
[Home] Address - Street Address 2
Entity Data - Address - Street Address 2
[Home] Address - Unit/Flat Number
Entity Data - Address - Unit/Flat Number
[Home] Address - Street/Lot number
Entity Data - Address - Street/Lot number
[Home] Address - Street Name
Entity Data - Address - Street Name
[Home] Address - Suburb
Entity Data - Address - Suburb
[Home] Address - Overseas State/Province
Entity Data - Address - Overseas State/Province
[Home] Address - State
Entity Data - Address - State
[Home] Address - Post Code
Entity Data - Address - Post Code
[Home] Address - Country
Entity Data - Address - Country
Postal Address (Same as above)
Basic - Radio buttons
[Postal] Address -
Entity Data - Address
Postal Address
Entity Data - Address - Type/Location
Postal Address
Entity Data - Address - Lookup
[Postal] Address - Street Address 1
Entity Data - Address - Street Address 1
[Postal] Address - Street Address 2
Entity Data - Address - Street Address 2
[Postal] Address - Unit/Flat Number
Entity Data - Address - Unit/Flat Number
[Postal] Address - Street/Lot number
Entity Data - Address - Street/Lot number
[Postal] Address - Street Name or Post Office Box details
Entity Data - Address - Street Name
[Postal] Address - Suburb
Entity Data - Address - Suburb
[Postal] Address - Overseas State/Province
Entity Data - Address - Overseas State/Province
[Postal] Address - State
Entity Data - Address - State
[Postal] Address - Post Code
Entity Data - Address - Post Code
[Postal] Address - Country
Entity Data - Address - Country

AVETMISS Information

Please complete all required fields below

Labour Force Status
Entity Data - AVETMISS - Labour Force Status
Country of Birth
Entity Data - Profile - Country of Birth
Town/City of Birth
Entity Data - Profile - Town/City of Birth
Citizenship Status
Entity Data - Profile - Citizenship Status
Nationality
Entity Data - Profile - Nationality
Indigenous Status - Are you of Aboriginal or Torres Strait Islander descent?
Entity Data - AVETMISS - Indigenous Status
Main Language - what is your primary language?
Entity Data - AVETMISS - Main Language
At School - do you still attend school (K-12)?
Entity Data - AVETMISS - At School
Highest School Level - what is the highest school level you have completed?
Entity Data - AVETMISS - Highest School Level
Year Completed - what year did you complete your highest school level?
Entity Data - AVETMISS - Year Completed (Highest School)
Disability - do you consider yourself to have a disability?
Entity Data - AVETMISS - Disability Flag
Disability Type
Entity Data - AVETMISS - Disability Type
Prior Education - have you completed any prior qualifications?
Entity Data - AVETMISS - Prior Education Flag
Prior Education Type
Entity Data - AVETMISS - Prior Education Type
How comfortable are you using a computer, tablet or smartphone to complete online tasks (e.g. email, online forms, uploading documents)?
Basic - Radio buttons
How confident are you reading, writing and doing calculations at the level required for this training (e.g. reading course materials, completing written assessments)?
Basic - Radio buttons
Do you have any prior skills, licences, or experience relevant to this training that we should be aware of (e.g. for RPL, credit transfer, or entry requirement purposes)?
Basic - Radio buttons

Declaration

Please complete all required fields below

Terms and Conditions

Please read our Terms and Conditions HERE.
Basic - Checkboxes
Digital Signature
Basic - Digital Signature
Date
Basic - Date

Payment