National Recognised Training Application Form

Certificate IV in Community Services

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Personal Details

Title:

First Name:

Surname:

Preferred Name:

Date of Birth:

Gender:

Female

Male

E-mail Address:

Mobile Number:

Home Phone:

Please upload a colour copy of your Drivers Licence or 18+ Card

Unique Student Identifier Number (USI)

If you are a new or continuing student undertaking nationally recognised training, you need a USI in order to receive your qualification or statement of attainment. Your USI will look something like this: 3AW88YH9U5

You can retrieve or create your USI by visiting https://www.usi.gov.au/

Unique Student Identifier (USI):

Address - Home - Unit/Flat Number

Address - Home - Street/Lot Number

Address

What is the address of your usual residence?

Please provide the physical address (not post office box) where you usually reside rather than any temporary address at which you reside for training, work or other purposes before returning to your home.

Address 1:

Address 2:

Address - Home - Street Name

Suburb:

State:

Post Code:

Country

Do you have a different Postal Address?

Yes

Postal Street Address 1

Postal Street Address 2

Address - Postal - Unit/Flat Number

Address - Postal - Street/Lot Number

Address - Postal - Street Name

Postal Suburb

Postal State

Postal Post Code

Postal Country

Emergency Contact:

Full Name:

Relationship:

Contact Number:

Language & Cultural Diversity

In which country were you born?

What language do you speak at home?

Are you of Aboriginal or Torres Strait Islander origin?

What is your citizenship status?

Personal Circumstance & Disability

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

Not Stated

Yes

If you indicated the presence of a disability, impairment or long-term condition, please specify:

Is there anything about your personal circumstance that may impact your studies?

For example: Specific disability requirements, limited or no internet access, assistance wih language, literacy or numeracy etc.

Schooling & Previous Qualifications

What is your highest COMPLETED school level?

In which YEAR did you complete that school level?

Are you still attending secondary school?

Not Stated

Yes

Have you SUCCESSFULLY completed any of the following qualifications in Australia? If YES, then tick ANY applicable boxes:

Have you SUCCESSFULLY completed any of the following qualifications Internationally? If YES, then tick ANY applicable boxes:

Entry Requirements: If your course has specific entry requirements then please upload any evidence of relevant qualifications or certificates that you have obtained - alternatively please upload your CV here :

Credit Transfer

Would you like to apply for Credit Transfer/s?

Credit transfers will only be awarded for authenticated and eligible qualifications/transcripts as outlined in our Student Handbook.

Yes

Please upload any evidence of relevant qualifications or certificates that you have obtained for Credit Transfer/s:

Recognised Prior Learning

Do you wish to apply for Recognised Prior Learning?

An RPL interview will be conducted by your Trainer Assessor after enrolment to determine eligibility. Please note, RPL is not necessarily a quick process. A student is required to collate and coordinate evidence to show they have sufficient, valid and current knowledge and skills equivalent to the qualification they are enrolled in.

Yes

Please upload any evidence of relevant qualifications or certificates that you have obtained for Recognised Prior Learning:

Payment Option, Employment & Reason For Study

What is your preferred payment option?

I would like to pay for the Full Fee

I would like to go on a Fortnightly Payment Plan

My workplace is paying

What is your job title?

What is the name of your workplace to be invoiced?

Who is your workplace contact person?

What is their contact number?

Workplace postal address:

What is your workplace email address?

Please upload your purchase order / workplace authorisation document here:

Please specify if you are on any Concession

Concession Expiry Date

Of the following categories, which BEST describes your current employment status?

Of the following categories, which BEST describes your main reason for undertaking this course/traineeship/apprenticeship?

Privacy Statement and Student Declaration

By ticking the below listed statements and signing this application, I declare:

Privacy Consent Statement

I declare that the information I have provided to the best of my knowledge is true and correct.

I have accessed, read and understood the student handbook, schedule of fees and all related course information on the Australian Institute of Social Relations website.

The information contained on my enrolment form and my training activity data may be used or disclosed by the Australian Institute of Social Relations for statistical, regulatory and research purposes. The Australian Institute of Social Relations may disclose my personal information for these purposes to third parties including:

- School, if I am a secondary student undertaking VET, including a school based apprenticeship or traineeship.

- Employer, if I am enrolled in training paid by my employer.

- Commonwealth and State or Territory government departments and authorised agencies.

- National Centre for Vocational Education Research Ltd (NCVER).

- Organisations conducting student surveys; and

- Researchers.

Under the Data Provision Requirements 2012 and National VET Data Policy (which includes the National VET Provider Collection Data Requirements Policy), Registered Training Organisations are required to collect and submit data compliant with AVETMISS for the National VET Provider Collection for all Nationally Recognised Training.

This data is held by the National Centre for Vocational Education Research Ltd (NCVER), and may be used and disclosed for the following purposes:

populate authenticated VET transcripts;
facilitate statistics and research relating to education, including surveys and data linkage;
pre-populate RTO student enrolment forms;
understand how the VET market operates, for policy, workforce planning and consumer information; and
administer VET, including program administration, regulation, monitoring and evaluation.

You may receive a student survey which may be administered by a government department or NCVER employee, agent or third party contractor or other authorised agencies. Please note you may opt out of the survey at the time of being contacted.

NCVER will collect, hold, use and disclose your personal information in accordance with the Privacy Act 1988 (Cth), the National VET Data Policy and all NCVER policies and protocols (including those published on NCVER's website at www.ncver.edu.au).

Yes, I agree

Student Full Name

Digital Signature

Draw It
Clear

Are you under 18 years of age?

Yes, I am

Please provide the full name of the Guardian:

Signature of Guardian

Draw It
Clear

Subscribe me to the Australian Institute of Social Relations e-newsletter to receive information on upcoming courses and promotions

How did you hear about us?

Brochure, Poster or Postcard

Email Newsletter

Expo or Community Event

Social Media (eg Facebook, Twitter, Youtube etc)

Traditional Media (Newspaper, Television, Radio, Magazine)

Word of Mouth

Website

Industry Conference or Exhibition

This course is currently not open for enrolments