Expression of Interest
Response Employment and Training RTO 90278
Which Course are you Interested in?
CHC33021 Certificate III Individual Support
CHC43121 Certificate IV in Disability
CHC42021 Certificate IV Community Services
BSB50420 Diploma of Leadership & Management
CPP30321 Certificate III in Cleaning Operations
CHC43315 Certificate IV Mental Health
CHC43515 Certificate IV in Mental Health Peer Support
Will you be studying with Funding
*
Yes
No
Unsure
Name
*
Mr
Mrs
Miss
Ms
Prefix
First Name
Middle Name
Last Name
Date of Birth
*
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a year
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Best Contact Method
Please Select
Email
Mobile
Work Phone
E-mail
*
example@example.com
Contact Phone Number
*
Please enter a valid phone number.
Residential Address
*
Unit/Number
Street
Suburb
Post Code
State
Were you born in Australia?
*
Yes
Other
Are you Aboriginal and/or Torres Strait Islander?
*
Please Select
Neither
Aboriginal
Torres Strait Islander
Both
Rather not say
What is your citizenship status?
*
Please Select
Australian Citizen
New Zealand Citizen
Australian Permanent Resident
Temporary Visa Holder
Overseas Resident
In which YEAR did you complete your highest level of schooling?
*
Please select your highest level of schooling
*
Year 8 or below
Year 9 or below
Completed Year 10
Completed Year 11
Completed Year 12
Did not attend school
Have you completed any other qualifications? Please select all that apply
*
Certificate I
Certificate II
Certificate III
Certificate IV
Diploma
Advanced Diploma or Associate Degree
Bachelor Degree or Higher
No other qualifications
Do you have a USI number
*
Yes
No
Unsure
What is your employment status?
*
Full-time employee
Part-time employee
Unpaid/Volunteer employment
Unemployed - seeking full-time work
Unemployed - seeking part-time work
Unemployed - not seeking work
Self-employed (not employing others)
Self-employed (employing others)
Other
Save
Submit
Should be Empty: