New Survey Response

1. Title

2. First Name *

3. Surname *

4. Previous Surname

5. Email address *

6a. Preferred phone number *

6b. Other Phone Number

7a. Postal Address or PO Box Address *

7b. Postal Suburb / Town *

7c. State *

7d. Post Code *

8. Gender *

9. Are you of Aboriginal or Torres Strait Islander origin? *

10. What is your Citizenship and Residence Status? *

11. Is English your second language? *

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

13. Date of Birth *

14. Age bracket

15. What is your highest level of study?

16a. Have you previously studied the Tertiary Enabling Program? *

16b. Have you completed, or are you due to complete, TEP1 - Orientation to Tertiary Study? *

17a. Have you previously completed the TEP Diagnostic Task? *

17b. If yes, in what year did you complete the TEP Diagnostic Task? *

18. Which Semester would you like to enrol in? *

19. In which location and mode do you wish to study TEP? *

20. What type of course or program do you wish to study when you finish TEP?

21. Which area of study are you wishing to pursue after TEP?

22. How did you find out about TEP?

23. Please specify today's date *

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