AICSE Enrolment Form

Personal Details

1. Name

First NameLast Name

2. Date of Birth

DayMonthYear

3. Gender

4. Phone Number

Area CodePhone Number

Home phone

Area CodePhone Number

Email

example@example.com

Address

Building/ property name

Flat/unit details

CityState / Province

Postal / Zip Code

Address

Building/ property name

Flat/unit details

CityState / Province

Postal / Zip Code

Name:

Relationship to you:

Address:

Home Number

Area CodePhone Number

Work:

Area CodePhone Number

Mobile:

Area CodePhone Number

Email

example@example.com

7. Birth country

Birth Country

8. Do you speak a language other than English?

If Not English then which language?

9. Are you of Aboriginal or Torres Strait Islander origin?

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

11. If you indicated the presence of a disability, impairment or long-term condition, please select the area(s) in the followinglist: (You may indicate more than one area)

12. What is your highest COMPLETED school level (tick one box only)If you are currently enrolled in secondary education, the Highest school level completed refers to the highest school level you have actually completed and not the level you arecurrently undertaking. For example, if you are currently in Year 10 the Highest school level completed is Year 9. -Go to question 14

13. Are you still enrolled in secondary or senior secondary education?

14. Have you completed any previous qualifications?

15. Details of qualification:

Name of qualification:

Year Completed:

Country of Qualification Completion:

16. Of the following categories, which BEST describes your current employment status? (Tick one box only)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-timeemployed (less than 35 hours per week).

18. Enter your Unique Student Identifier (USI)If you already have one

19. If you do not have a USI, would you like us to apply for a USI on your behalf?

APPLYING ON YOUR BEHALF
If you would like AICSE to apply for a USI on your behalf you must authorise us to do so and declare that you have read the privacy information at
https://www.usi.gov.au/documents/privacy-notice-when-rto-applies-their-behalf
You must also provide some additional information as noted at the end of this form so that we can apply for a USI on your behalf. Please provide your town/city of birth and ensure that the name written in ‘Personal Details’ section is exactly the same as written in the identity document you select below. In accordance with section 11 of the Student Identifiers Act 2014, AICSE will securely destroy personal information which we collect from individuals solely for the purpose of applying for a USI on their behalf as soon as practicable after we have made the application or the information is no longer needed for that purpose, unless we are required by or under any law to retain it.

USI APPLICATION DECLARATION

20. Town/City of Birth

21. We will also need to verify your identity to create your USI. Please provide details for one of the forms of identity below (numbered 1 to 7).

1) Australian Driver’s License

2) Medicare Card

3) Australian Passport

4) Non-Australian Passport (with Australian Visa)

5) Immicard

6) Citizenship Certificate

7) Certificate of Registration by Descent

http://www.usi.gov.au/Training-Organisations/Pages/Privacy-Notice.aspx

Signature

Date

Student Name:

First NameLast Name

PRIVACY NOTICE
Under the Data Provision Requirements 2012, AICSE is required to collect personal information about you and to disclose that
personal information to the National Centre for Vocational Education Research Ltd (NCVER).
Your personal information (including the personal information contained on this application form and your training activity data) may be
used or disclosed by AICSE for statistical, regulatory and research purposes. AICSE may disclose your personal information for these
purposes to third parties, including:
− Employer – if you are enrolled in training paid by your employer;
− Commonwealth and State or Territory government departments and authorised agencies;
− NCVER;
− Organisations conducting student surveys; and
− Researchers.
Personal information disclosed to NCVER may be used or disclosed for the following purposes:
− Issuing statements of attainment or qualification, and populating authenticated VET transcripts;
− facilitating statistics and research relating to education, including surveys;
− understanding how the VET market operates, for policy, workforce planning and consumer information; and
− administering VET, including programme administration, regulation, monitoring and evaluation.
NCVER will collect, hold, use and disclose your personal information in accordance with the Privacy Act 1988 (Cth), the VET Data Policy
and all NCVER policies and protocols (including those published on NCVER’s website at www.ncver.edu.au).
You may receive an NCVER student survey which may be administered by an NCVER employee, agent or third-party contractor. You
may opt out of the survey at the time of being contacted.

Have you ever studied with AICSE before?

Do you wish to apply for Credit Transfer? If YES, certified copies of transcripts from previous qualifications must be provided with this form, along with a Credit Application Form.

Do you wish to apply for Recognition of Prior Learning?If you indicate YES, you will be contacted to discuss this further

Have you ever had any visa refused previously by the Australian Department of HomeAffairs? If Yes, please send us the Immi Refusal Letter together with this application.

Select Course

Student Type

Intake year:

Intake month (Onshore)

Intake month (Offshore)

Campus

I select to pay more than 50% of the course fees upfront

I recommend that an offer be given to this applicant. I confirm that I have briefed the applicant and the applicant’s parents (if applicant is under 18) on the Terms and Conditions relating to this application and that I have provided the applicant with relevant information on AICSE and the course consistent with the requirements of the ESOS Act 2000 and the National Code 2018. Are you a registered agent with AICSE?

Where did you hear about AICSE?

If you have selected option other than agent , please specify:

Agency Company Name:

Name of Agent’s Staff Assigned

Signature

Date

Provide a copy of the following documents with your application (you will need to bring the originals to your orientation day for verification): Please tick those that you are providing.

File Upload

Student Declaration and Consent (please tick all)

Student Signature:

Date

Name

First NameLast Name

Enrolment Application Form International Students

5. What is the address of your residence?

6. What is your postal address (if different from above)?

Next of kin/emergency contact

Language and cultural diversity

Disability

Schooling

Previous qualifications achieved

Employment

Study reason

Unique Student Identifier (USI)

Learning Details

Select your course and intake

Application Checklist