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Student Information

Please ensure that you enter your full name exactly as it is recorded on your photo ID that you will use to register with AMSA after completing the course. Note that AMSA will not accept a photo ID with initials only for any first or middle names, they require that all names are fully spelt out on your photo ID.

Please use the “Preferred Name” field if you prefer to be addressed by something other than your first name.

First Name*

Middle Names

Last Name*

Preferred Name

Email*

Mobile*

Landline

Date of Birth

Address

Country

Building/property name

Flat/unit details

Street or Lot No

Street Name

Suburb

State

Postcode

Additional Information

Unique Student Identifier

Maritime Related Qualifications

Special Assistance Required?