Connection Group Australia

Enrolment & Induction 2022

Connection Group Australia | RTO 91155
Completion of this enrolment form will get your application to commence study with us underway. It is important to note that your enrolment is not complete until Connection Group Australia have completed your induction and determined that the course you have chosen to undertake is suitable.
Personal Details

Please write the name that you used when you applied for your Unique Student Identifier (USI), including any middle names. If you do not yet have a USI and want CGA to apply for a USI on your behalf, you must write your name, including any middle names, exactly as written in the identity document you choose to use for this purpose. See section on the USI at the end of this form for a detailed explanation. r your personal details.
Full Name:*

PrefixFirst NameLast Name
Middle Name:
Preferred Name:
Date of Birth:*

DayMonthYear
Date
Gener:*

MaleFemaleOther

Contact Details
Phone Number
Please enter a valid phone number.
Mobile*
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Email*
example@example.com
Alternative Email
example@example.com

Unit Of Competency

Select the Unit Of Comptency as per your booking confirmation. If you are unsure please contact our staff immediately on 1800 161 309 or enrolment@cga.edu.au
Select Unit Of Competency/ Qualification you are Enrolling into:*

Unique Student Identifier (USI)

From 1 January 2015, we Connection Group Australia can be prevented from issuing you with a nationally recognised VET qualification or statement of attainment when you complete your course if you do not have a Unique Student Identifier (USI). In addition, we are required to include your USI in the data we submit to NCVER. If you have not yet obtained a USI you can apply for it directly at https://www.usi.gov.au/students/create-your-usi on computer or mobile device.
Do you have a Unique Student Identifier?*

YesNo
Unique Student Identifier (USI) Number:
I give Connection Group Australia the authority to Locate my USI if I can not find it or remember it. If Connection Group Australia is unable to locate my USI I will be required to obtain it and provide it to them.

YesNo

Address Details

Please provide your registered physical address (do not enter post-office box) where you normally reside.
Registered Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Postal Address

(If different from above)
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact Details
Name:

First NameLast Name
Relationship:
Relationship of emergency contact
Phone Number:
Please enter a valid phone number.

Language & Cultural Diversity

The purpose of the ASQA Diversity and Inclusion Strategy 2019-2022 (the Strategy) is to acknowledge the value of our employees and highlight how their differences can improve the workplace for both the organisation and the individual.
In which country where you born?*
Please list the country in which you where born.
Do you speak a language other than English at Home?*
Please list any other languages.
Are you of Aboriginal or Torres Strait Islander origin?*

NoYes, AboriginalYes, Torres Strait IslandYes, to bothPrefer not to say

Schooling

If you are currently enrolled in secondary education, the Highest school level completed refers to the highest school level you have completed and not the level you are currently undertaking. For example, if you are currently in Year 10 the Highest school level completed is Year 9.
What is your highest COMPLETED school level? (Tick ONE box only)*

Year 12 or equivalentYear 11 or equivalentYear 10 or equivalentYear 9 or equivalentYear 8 or belowNever attended school.
Are you still enrolled in secondary or senior secondary education?

YesNo

Employment

For casual, seasonal, contract and shift work, use the current number of hours worked per week to determine whether full time (35 hours or more per week) or part-time employed (less than 35 hours per week).
Of the following categories, which BEST describes your current employment status?(Tick ONE box only)*

Full-time employeePart-time employeeSelf employed – not employing othersSelf employed – employing othersEmployed – unpaid worker in afamily businessUnemployed – seeking full-timeworkUnemployed – seeking part-time workNot employed – not seeking employment
Current employer *
Enter employers/ companies name
Position
Enter your position.

Agreement to Comply.

Acknowledgement.
I, have read and understood the information contained in the Learner Information Handbook and agree to comply with all the conditions and requirements therein.

I understand that if I have any questions, I should speak directly with my trainer or another representative of Connection Group Australia.

I have been provided with detailed information contained in the Student Handbook on complaints and appeals and fees and charges information.
Student Declaration

Due to privacy laws, we require your permission to share your information contained in these forms to State and Commonwealth agencies and third parties.
In signing below.*

You agree and provide your consent for Connection Group Australia to provide your information to State and Commonwealth Government agencies in the course of our business as a registered training organisation (RTO).You understand that penalties apply to the provision of false and misleading informationIf any of this information changes in the future, you will provide the detailsI agree and understand that my enrolment is not complete until I receive written confirmation from Connection Group AustraliaI hereby authorise Connection Group Australia (CGA) to publish photographs taken of me and my name and likeness for the use in CGA’s print, online and video-based marketing, promotional and training materials as well as other company publications.I agree to my employer having access to any records of my progress and a copy of my Statement of Attainment being provided to my employer if requested
I Full name* hereby declare that the information above is true, complete, and correct to the best of my knowledge and belief. I understand that in the event of my information being found false or incorrect at any stage, my training/ assessment shall be liable to cancellation/termination without notice or any compensation in lieu thereof.
Student Signature*

Clear
Should be Empty:

Enrolment & Induction 2022

Personal Details

Contact Details

Unit Of Competency

Unique Student Identifier (USI)

Address Details

Postal Address

Emergency Contact Details

Language & Cultural Diversity

Disability

Schooling

Previous qualifications achieved

Employment

Study Reason

Agreement to Comply.

Student Declaration