New Survey Response

1. First name: *

2. Surname: *

3. Email:

4a. Preferred phone number: *

4b. Other phone number:

5a. Postal address: *

5b. Suburb/City/State: *

5c. Postcode: *

6a. Are you currently enrolled at CDU in a Higher Education course? *

6b. If so please provide the course name

7a. What level of study have you completed? *

7b. If other, please specify:

8. Which semester would you like to enrol in? *

9. Which course program do you wish to study when you finish TEP? *

10. Which area (s) of study would you be interested in after studying TEP? *

11. Do you wish to study TEP as an internal or external student? *

12. How did you find out about TEP? *

13. Gender: *

14. Date of birth: *

15. Age bracket: *

16. Are you of Australian Aboriginal or Torres Strait Islander Descent? *

17. Is English your second language? *

18. Do you consider yourself to have a disability, impairment or long-term medical condition? *

19. Please specify today's date: *

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