CHC50121 Diploma of Early Childhood Education and Care Application Form Ver 009 Ref: APEX/QMS/SAM/FM-10 Revision Date:

CHC50121 Diploma of Early Childhood Education and Care

Application form
This application form consists of:

1) Applicant information questions

2) Suitability for the industry questions

3) Training preferences questions

4) A language and literacy test

5) A numeracy test

6) Student declaration

The combination of these questions and tests will be used to determine whether or not a student is eligible for enrolment. Students who are assessed as not having the required level of language, literacy and numeracy skills may be denied enrolment and/or referred to internal or external support services. Students denied enrolment can apply for enrolment again once they have developed skills in that area.

Apex Training Institute will comply with the national privacy principles in the handling of the personal information of students. Completion of the test should be supervised by an Apex Training institute member of staff.

IMPORTANT DOCUMENTS

Kindly note you must review the course fact sheet of the course you wish to enroll in prior to applying and enrolling. You can access all course fact sheets, 24 hours a day, 7 days a week via the following link: http://www.apextraining.edu.au/course-fact-sheets. ( Shortened link: http://bit.ly/2kB3ubk )

You are also required to review the student handbook prior to applying and enrolling. Access information can be found below- - You can access the student handbook 24 hours a day, 7 days a week via the following link: https://www.apextraining.edu.au/resources
Email*

NAME
Do you have:*

Single nameBoth first and last name
Name

First NameLast Name
Single Name
Have you previously been known by any other name(s)?*

YesNo
Your previous name was

Single nameBoth first and last name
Name

First NameLast Name
Single Name

APPLICANT INFORMATION
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemaleOther
What is the address of your usual residence?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What is your postal address (if different from above)?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Number*
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Home Phone Number
Please enter a valid phone number.
Course applying for? (Select All that Apply)*

CHC30121 Certificate III in Early Childhood Education and CareCHC50121 Diploma of Early Childhood Education and Care
When do you want to start your course? *

MonthDayYear
Date
Citizenship*
Visa Subclass (If None, Type N/A)*

UNIQUE STUDENT IDENTIFIER (USI)

Kindly note that the following two items are mandatory in order to study at Apex:- To have a USI or obtain one within 14 days of enrolment at Apex- To grant Apex Training Institute access to one's USI transcript. Kindly note the transcript will be accessed in line with our privacy policies and procedures.
Do you have a Unique Student Identifier (USI)?*

YesNo

Enter your Unique Student Identifier (USI) (if you already have one)

OBTAIN AND PROVIDE A USI

If you don't already have one
I acknowledge that I will visit www.usi.gov.au, obtain a Unique Student Identifier, and submit it to Apex within 14 days of enrolment*

YesNo

Queensland Government Funding Eligibility Documents
To be eligible to access the Higher Level Skills funding, you must:
- Be an Australian or New Zealand citizen, or an Australian permanent resident (including humanitarian entrants), or a temporary resident with an eligible visa subclass
- Be 15 years old or over
- Live in Queensland and have left school*
  not already have, or be enrolled in, a certificate IV level or higher qualification.
Below, kindly attach proof of the above as directed.
Proof of Appropriate Visa or Citizenship

This can be verified by supplying us with a copy of one of the following documents:
- Australian passport
- Citizenship certificate
- Medicare card
- Healthcare card
- Concession card
- Pensioners card
- A digital copy of your visa
Please attach proof of citizenship or appropriate visa here

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Proof of Queensland Residency

This can be verified by supplying us with a copy of one of the following documents:
- Queensland driver's licence
- Proof of age card
- Healthcare card
- Concession card
- Pensioners card
- A utility bill with your name on it from within the last 3 months
Please attach evidence of Queensland residency here

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Proof of Concession

This can be verified by supplying us with a copy of one of the following documents:
- Healthcare card
- Concession card
- Pensioners card
Please attach evidence of Concession here

Cancelof

Co-Contribution Fees

Your fees, also known as co-contribution fees, have been listed below. You have been given the total fees and the cost per unit of competency you study at Apex. You must prepay in full before your studies commence. All the costs below are GST-free.

Cost Per Unit	Price
Concession	$0.53
Non-Concession	$1

Total Cost (15 Units)	Price
Concession	$9
Non-Concession	$17

You may be eligible for the concessional fee if you:

Hold a current Health Care Card, Pensioner Concession Card, or Commonwealth Seniors Health Card (or are listed as a partner or dependant on one)
Identify as Aboriginal or Torres Strait Islander
Have a disability (supported by a concession card or documentation)
Are an adult prisoner (with formal confirmation from your place of incarceration

Proof of eligibility can be provided as a clear photocopy, scan, or screenshot of your concession card or supporting documents.

Please Note: The fee may be paid on your behalf by an employer or another third party but cannot be paid or waived by the training provider or any organisation related to the training provider unless approved by the Queensland government.

Once enrolled, you will no longer be eligible for further Government subsidised training under the Certificate III Guarantee.

I {name}, understand that if I enroll in this course I will no longer be eligible for any further Government Subsidised Training Places under the Certificate III Guarantee.

Name*

First NameLast Name
Signature*

Clear

COURSE AND POLICY AND PROCEDURE INFORMATION

Verifying students have all relevant information about the course, Apex policies and procedures prior to enrolment
Have you reviewed the student handbook in full? (including complaints policy, refund policy, code of practice, rights and responsibilities, etc.) - https://www.apextraining.edu.au/resources*

YesNo
Have you reviewed the course fact sheet for your course in full? (Attached along with the link to this form)*

YesNo

LANGUAGE LITERACY AND NUMERACY QUESTIONS: READING.
READ THE PARAGRAPH BELOW AND USE IT TO ANSWER THE QUESTIONS BELOW

Ling completed school at the age of seventeen and wanted a job that would allow her to work anywhere in Australia. Ling is now nineteen years old and is considering a career as an aged carer. She has always loved taking care of people and often visits and takes care of her grandmother who suffers from dementia. Ling wants to complete an aged course so she can take care of others, just like she feels her parents have done for her all her life. She found Apex Training institute via Google and enrolled to complete the CHC33015 Certificate III in Individual Support.
How old is Ling?*
What condition does Ling's Grandmother suffer from?*
What course did she enrol in?*
Why does she want to study aged care?*

SUITABILITY FOR INDUSTRY
A DAY IN THE LIFE OF AN EARLY CHILDHOOD EDUCATOR

A day in the life of an Early Childhood Educator can include working varied hours and can include shift work. They need to be able to stay on their feet for long periods. Their duties will vary depending on the age of the children in their care. For example, caring for a group of 0-3-year-olds can be quite different from caring for a group of 4-5-year-olds. They often share basic tasks, such as cleaning or food preparation, and work in teams. Their level of care will include assisting children with their daily routine including eating, toileting, sleeping, and dressing. They will use a range of educational and play equipment and materials daily, from play dough, paints, dress-up clothes, cardboard boxes, and large plastic playground equipment and musical instruments. Almost anything that is non-toxic and safe for children to manipulate and play with may be used.

As a room leader, you are in charge. This does not mean you sit and make everyone do the work, but it means you need to direct and manage what happens in the room. You will have to ensure that the staff that work in your room are working in accordance with policy and procedures and ensure they are included in programming and planning. You will also mentor students on practical placement and develop children’s programs reflecting early years learning guidelines. You will also be required to ensure that the room is compliant with WH&S policy to ensure you provide a safe environment for staff and children with particular attention to asthma, anaphylaxis, allergies, etc. You will also be responsible for maintaining accurate records of accidents, injuries, incidents, and medication.
Is this the type of work environment you are expecting to work in after successfully completing this qualification?*

YesNo
Do you have any previous qualifications or units of competency relevant to this course?*

YesNo
If you answered yes, please provide us with a copy of the Certificate by attaching it below or send it to supportteam@apex.edu.au within 14 days of enrolment.

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What work experience or existing knowledge do you have of the industry that you want to apply to study (e.g. previous work in a child care facility)?*
Why does this course appeal to you?*
What do you hope to achieve from gaining this qualification (e.g. skills and knowledge to get a job or a pathway to a higher qualification)?
If already working in the industry, do you enjoy working in it (and why)?*

WORK PLACEMENT

As part of completing this course, it is mandatory to complete 280 hours of work placement. The questions below assist with assessing your readiness for work placement and making the necessary preparations to complete your work placement.
DISABILITIES
Do you have any pre-existing injuries, disabilities, diseases, or ailments that might affect your suitability for attending work placement?*

YesNo

DISABILITIES INFORMATION
If you have any pre-existing injuries, disabilities, diseases, or ailments that might affect your ability to attend work placement, please give more information below.*

SECURITY CLEARANCE
Do you have a valid working with children check? (for working with children check information and the different validity periods in different states, please click on this link: http://bit.ly/1cb3hnx)

YesNo
Do you have any criminal offences that disqualify you from working with children?

YesNo

UPLOAD WORKING WITH CHILDREN CHECK / BLUE CARD
Please attach a working with children check for employment purposes that is 3 years old or less.

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WORK
Are you currently working?

YesNo

WORK SCHEDULE
On what days and times would you be available to attend work placement? Kindly note, the further away you get from a full-time schedule for work placement on weekdays, the harder it gets to secure work placement.
What days and times do you work in a typical work week? (e.g., Wednesday - 7 am - 3 pm)

CHILDREN BELOW 5
Do you have children below the age of 5 years old?

YesNo

CHILDREN INFORMATION
If you had to attend work placement beginning at 7 am every weekday morning, have you or would you be able to make arrangements for your children to be taken care of during the shift so that you can be at the facility by 6:30 am every weekday morning?
Please tell us more about how your children would be taken care of while you attend your work placement shift.

WORK PLACEMENT TRANSPORTATION
How far from home are you willing to travel for work placement?

Less than 50 kms50-100 kmsMore than 100 kms
Which of the following best describes you?

I have my own car that I have access to all the timeI have a car I share with my spouse or other family members or friendsI am driven everywhere by other family membersI always use public transport
If you had to attend work placement beginning at 7 am every weekday morning, how would you be able to get to the facility by 6:30 am every weekday morning?*

ADJUSTMENT OF SCHEDULE FOR PLACEMENTS
Do you agree that you will attend 280 hours of work placement?

YesNo
How do you intend on adjusting your schedule at work, home, school, etc., in order to ensure you attend work placement (about 7-8 weeks full time)?

PAYMENT METHOD

For more information on the various prices, please refer to the relevant course fact sheet ( https://www.apextraining.edu.au/course-fact-sheets )
How do you wish to pay?

Pay in full upfront via debit or credit cardPay weekly, fortnightly or monthly via direct debitPay in full upfront via Bank Transfer

PRIVACY NOTICE
Please Note that your Enrolment form can only be assessed if the information provided by you is correct.

Why do we collect your personal information?

As a registered training organisation (RTO), we collect your personal information so we can process and manage your enrolment in a vocational education and training (VET) course with us.

How do we use your personal information?

We use your personal information to enable us to deliver VET courses to you, and otherwise, as needed, to comply with our obligations as an RTO.

How we disclose your personal information?

We are required by law (under the National Vocational Education and Training Regulator Act 2011 (Cth) (NVETR Act)) to disclose the personal information we collect about you to the National VET Data Collection kept by the National Centre for Vocational Education Research Ltd (NCVER). The NCVER is responsible for collecting, managing, analysing and communicating research and statistics about the Australian VET sector.

We are also authorised by law (under the NVETR Act) to disclose your personal information to the relevant state or territory training authority.

How the NCVER and other bodies handle your personal information?

The NCVER will collect, hold, use and disclose your personal information in accordance with the law, including the Privacy Act 1988 (Cth) (Privacy Act) and the NVETR Act. Your personal information may be used and disclosed by NCVER for purposes that include populating authenticated VET transcripts; administration of VET; facilitation of statistics and research relating to education, including surveys and data linkage; and understanding the VET market.

The NCVER is authorised to disclose information to the Australian Government Department of Education, Skills and Employment (DESE), Commonwealth authorities, State and Territory authorities (other than registered training organisations) that deal with matters relating to VET and VET regulators for the purposes of those bodies, including to enable:

administration of VET, including program administration, regulation, monitoring and evaluation
facilitation of statistics and research relating to education, including surveys and data linkage
understanding how the VET market operates, for policy, workforce planning and consumer information.
The NCVER may also disclose personal information to persons engaged by NCVER to conduct research on NCVER’s behalf.

The NCVER does not intend to disclose your personal information to any overseas recipients.

For more information about how the NCVER will handle your personal information please refer to the NCVER’s Privacy Policy at www.ncver.edu.au/privacy.

If you would like to seek access to or correct your information, in the first instance, please contact your RTO using the contact details listed below.

DESE is authorised by law, including the Privacy Act and the NVETR Act, to collect, use and disclose your personal information to fulfil specified functions and activities. For more information about how the DESE will handle your personal information, please refer to the DESE VET Privacy Notice at https://www.dese.gov.au/national-vet-data/vet-privacy-notice.

Surveys

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

Contact information

At any time, you may contact Apex Training Institute to:
• request access to your personal information
• correct your personal information
• make a complaint about how your personal information has been handled
• ask a question about this Privacy Notice

Apex Training Institute

Brisbane Branch

Street Address: 1374 Logan Road, Mount Gravatt, QLD 4122

Postal Address: PO Box 6803, Upper Mount Gravatt, QLD 4122

Phone Number: 07 3420 5861

Email - supportteam@apex.edu.au

The Apex Training Institute privacy policy can be found in the Student Handbook which can be accessed on the resources page of the Apex website: https://www.apextraining.edu.au/resources
I have read the privacy notice and all the information provided by me is correct

YesNo

STUDENT ENROLMENT DECLARATION AND AGREEMENT
I, the undersigned, declare and agree as follows:
- That the information entered on this form is, to the best of my knowledge, true, correct and complete.
- While a student at Apex Training Institute, I agree to be bound by the codes of conduct, regulations, policies and procedures of Apex Training Institute while I remain an enrolled student.
- I agree to be bound by the policies, procedures and rules as laid out in the Apex Training Institute Student Handbook. The student handbook can be accessed 24 hours a day, 7 days a week via this link: http://www.apextraining.edu.au/resources
- I agree to comply with any and all reasonable instructions given to me by staff members of Apex Training Institute.
- I authorize and approve of the release of details of my course and grades at Apex Training Institute to education institutions and academically relevant professional bodies.
- If Apex Training Institute is required to by law, it may disclose student details to State and Commonwealth authorities.
- I declare that should I have any existing condition or injury which may prevent me from either participating in learning and assessment at Apex Training Institute or performing functions associated with vocational placement, I agree to provide full details of any such limitations to Apex Training Institute staff.
Agreement 1*

Please select this checkbox to declare and agree to the above
Agreement 2*

Please select this checkbox to declare you have read and understood the relevant course fact sheet and student handbook
I agree that I have completed this form to the best of my ability and have been honest in all my responses.

YesNo
Name*

First NameLast Name
Signature*

Clear
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CHC50121 Diploma of Early Childhood Education and Care

NAME

APPLICANT INFORMATION

UNIQUE STUDENT IDENTIFIER (USI)

OBTAIN AND PROVIDE A USI

Digital Literacy Self Assessment

Can you confidently do the following?

🗣️ Tell Us More (Optional)

QUEENSLAND GOVERNMENT FUNDING ELIGIBILITY QUESTIONS

Queensland Government Funding Eligibility Documents

COURSE AND POLICY AND PROCEDURE INFORMATION

LANGUAGE LITERACY AND NUMERACY QUESTIONS: READING.

LANGUAGE LITERACY AND NUMERACY QUESTIONS: NUMERACY

TRAINING PREFERENCE QUESTIONS

SUITABILITY FOR INDUSTRY

WORK PLACEMENT

DISABILITIES

DISABILITIES INFORMATION

SECURITY CLEARANCE

UPLOAD WORKING WITH CHILDREN CHECK / BLUE CARD

WORK

WORK SCHEDULE

CHILDREN BELOW 5

CHILDREN INFORMATION

WORK PLACEMENT TRANSPORTATION

ADJUSTMENT OF SCHEDULE FOR PLACEMENTS

HOW DID YOU FIND OUT ABOUT APEX?

PAYMENT METHOD

PRIVACY NOTICE

STUDENT ENROLMENT DECLARATION AND AGREEMENT