Enrolment Form

Use this form to enrol in the course of your choice. Fill it in as much as you can we will collect any othetr information when you come into Span.

Personal details:

Medical:

Home and Community Care


Span is funded to provide support under the Home and Community Care Program (HACC). This funding is to support special needs groups including: socially isolated; financially disadvantaged community members; people with a disability; mental illness; dementia; carers.

Concession Entitlement:


If you are seeking a concession rate, Span must sight your current concession card. If you are posting or emailing your form, a current copy of your concession card must be attached to this form prior to course start date. Otherwise full fees will apply.
How did you find out about Span?

Privacy Statement

I understand Span Community House Inc. is required to provide the Victorian Government, through the Department of Education and Training, with ACFE student and training activity data which may include information that I have provided in this enrolment form.

The information is provided in accordance with the Victorian VET Student Statistical Collection Guidelines that are available at www.education.vic.gov.au/training/providers/rto/Pages/datacollection.aspx

Unidentified statistical data may be used to improve the services at Span.

Photo consent:

I give consent for photographs/recordings to be taken as part of my involvement with programs of Span. I also give permission for my first name to be used with these photos. Types of publicity may include social media, display boards, power point presentations, newsletters, articles or annual reports.

Acceptance and Signature

If you have a digital copy or a photo of your signature upload it with this form. Otherwise bring it into Span when you can