Marine Training Services

Recreational Boating Operators Licence

Course Student Enrolment Form

(Office use only)

POI Sighted : _____________________________
Instructor's initial

Certificate Number :________________________

* Please fill out all required fields

* Indicates required field
* Given Name * Date of Birth:
* Family Name * Gender:
* Address Phone:
Mobile:
* Email:
* Suburb    
* Postcode    
* Course Title Course Venue: Boatschool
  Course Date:
Photo Drivers Licence Number/Photo Learner Permit Number:

If you do not have Australian driver's licence, primary and secondary forms of evidence are required
(Please refer to our Proof of Identity page or Vic Roads for more information on Multiple Proofs of ID)

Proof of Identity ID Type ID Number
Primary
Secondary
We need to sight your ID otherwise we are not authorised to issue the Transport Safety Victoria Certificate required by Vic Roads.
Under the Privacy Act, the individual's registration details stated on this form will only be used for issuing a training certificate for the purpose of applying for a Victorian Recreational Boating License. However, Marine Safety Victoria have requested the phone and email details of course participants. Please read the full MTS Privacy Statement.
I have read the Marine Training Services Privacy Statement *
Do you give your permission for the training provider to supply Transport Safety Victoria with your phone and email details? *
Do you have any concerns regarding your literacy & numeracy skills? *

I certify that I am not currently subject to any boating licence suspension or cancellation.

 

Student  Signature:________________________________________

 

Date:_ _ / _ _ / _ _ _ _
 

(To Be Signed in Class)

  

(To Be Dated in Class)

Refund Policy:

Fees will be refunded on the following conditions:

1. Cancellation of the course.

2. When a course venue or timing is changed and this results in students being unable to attend.

3. Withdrawal before the course begins