CHC33021 Certificate III in Individual Support Application Form Ver 006 Ref APEX/QMS/SAM/FM-12 Revision Date: Sep 2024

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

Apex Training Institute will comply with the national privacy principles in the handling of the personal information of students.

IMPORTANT DOCUMENTS

Kindly note you must review the course fact sheet of the course you wish to enrol 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 before applying and enrolling. You can access the Handbook 24 hours a day, 7 days a week on the Resources Page of the Apex site: https://www.apextraining.edu.au/resources
Email*
Alternative Email Address (Optional)

APPLICANT NAME
Do you have*

Both a first and last nameA single name only
Name

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

YesNo
Your previous name was

A first and last nameA single name only
Name

First NameLast Name
Single Name

APPLICANT INFORMATION
Date of Birth*

DayMonthYear
Date
Gender*

MaleFemaleOther
What is the address of your usual residence? *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is your postal address the same as the address of your usual residence?*

YesNo
Postal address

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)*

CHC33021 Certificate III in Individual Support (Ageing)CHC33021 Certificate III in Individual Support (Disability)Other
When do you want to start studying?*

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

UNIQUE STUDENT IDENTIFIER (USI)
Kindly note that a USI is mandatory to study at Apex. For that reason, you must have a USI or obtain one within 14 days of enrolment at Apex-

It is also mandatory to grant Apex Training Institute access to one's USI transcript; the transcript will be accessed in line with Apex's privacy policies and procedures which can be found in the Student Handbook ( https://www.apextraining.edu.au/resources )
Do you have a Unique Student Identifier (USI) ?*

YesNo
Unique Student Identifier (USI)

OBTAIN AND PROVIDE A USI
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

YesNoOther

GOVERNMENT FUNDING ELIGIBILITY DOCUMENTS
To be eligible to access the Certificate 3 Guarantee, you must:
- be a Queensland resident
  be aged 15 years or over, and no longer at school (with the exception of VET in Schools students)
- be an Australian or New Zealand citizen or Australian permanent resident (including humanitarian entrants), or a temporary resident with the necessary visa and work permits on the pathway to permanent residency
- not hold, or be enrolled in, a certificate III level or higher qualification (not including qualifications completed at school and foundations skills training).
Below, kindly attach proof of the above as directed.
Proof of Date of Birth

This can be verified by supplying us with a copy of one of the following documents:
- Drivers licence
- Proof of age card or 18+ card
- Heavy vehicle or marine licence
- Birth certificate or birth extract
- Australian, New Zealand or international passport
Proof of Date of Birth

Kindly attach a clearly visible document thanks
Cancelof
Proof of Appropriate Visa or Citizenship

This can be verified by supplying us with a copy of one of the following documents:
- Birth certificate or birth extract
- Australian, New Zealand or international passport
- Medicare card (current green only)
- Blue Medicare card ( Subclass 201 and 202 Humanitarian visa holders, with visa and work permits and commencement of application for permanent residency. )
Proof of appropriate Visa or Citizenship

Kindly attach a clearly visible document thanks
Cancelof
Proof of Queensland Residency

This can be verified by supplying us with a copy of one of the following documents:
- Heavy vehicle or marine licence showing a Queensland residential address
- Driver's licence showing a Queensland residential address
- Department of Veterans’ Affairs showing a Queensland residential address
- Pensioner Concession Card showing a Queensland residential address
- Health Care Card showing a Queensland residential address
  Commonwealth Seniors Health Card showing a Queensland residential address
Proof of Queensland residency

Kindly attach a clearly visible document thanks
Cancelof
Proof of Concession

Kindly attach a clearly visible document thanks
Cancelof
Proof of Concession

This can be verified by supplying us with a copy of one of the following documents:
- Department of Veterans’ Affairs Card
- Pensioner Concession Card
- Health Care Card
- Commonwealth Seniors Health Card

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	$8
Non-Concession	$15

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

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SUITABILITY FOR INDUSTRY
A DAY IN THE LIFE OF AN AGED CARE WORKER

Aged care workers in residential facilities play a crucial role in supporting older adults who need assistance with daily living. They help maintain residents' independence and dignity through personalized care such as showering, dressing, grooming, and meal preparation, while also engaging them in social activities to foster a sense of community.

Beyond physical care, aged care workers provide holistic support that addresses emotional, social, and psychological well-being. They collaborate with residents, families, and healthcare professionals to create tailored care plans that meet individual needs. By monitoring health, reporting concerns, and prioritizing safety, these workers significantly enhance residents' quality of life, enabling them to thrive in a nurturing communal environment.

A DAY IN THE LIFE OF A DISABILITY SUPPORT WORKER

A disability support worker provides personal, physical, and emotional support to individuals with disabilities who need assistance with daily living. Their tasks include helping with showering, dressing, eating, and facilitating social activities. Support can occur in clients' homes, community settings, or residential facilities, and the level of assistance depends on the client's abilities and health.

Disability support workers are responsible for monitoring changes in their clients’ physical or mental health and reporting any concerns. They must be vigilant about safety hazards and know how to use equipment like wheelchairs and hoists. Additionally, they may assist with medication management and utilize communication technologies for clients with speech or hearing impairments.
Are either of these the type of work environment you are expecting to work in after successfully completing this qualification?*

YesNo
Have you previously completed any short course, units of competency or qualifications 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.

Cancelof
What work experience or existing knowledge do you have of the industry that you want to apply to study (e.g. previous work in an aged 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)?

SPECIALISATIONS
Pursuing Certificate III in Individual Support gives you the opportunity to take your career in two exciting directions - Ageing and Disability.

The Ageing specialisation prepares you to work in a range of nursing homes and residential aged care facilities, while the disability specialisation qualifies you to work for NDIS and disability support providers.

The combination of the two specialisations qualifies you for multiple jobs including:
1. Senior Personal Care Assistant
2. Care Assistant
3. Accommodation Support Worker
4. Residential Support Worker
5. Community Access Coordinator
6. Community care worker
7. Community House Worker
8. Residential Care Worker
9. Food Services Deliverer
10. Transport Support Worker
11. In-Home Respite Worker
12. Disability Service Officer
13. Care Worker
14. Client Assistant
15. School Support Officer (Disability)
16. Family Support Worker
17. Care Service Employee
18. Planned activity assistant
19. Residential aide
20. Field Officer (Community Services)
21. Nurse’s Aide
22. Home care assistant
I want to*

Take your career to the next level and open up a world of employment possibilities by completing two specialisations

WORK PLACEMENT
Do you have any pre-existing injuries, disabilities, diseases, or ailments that might affect your suitability for attending work placement?*

YesNo
If you have any pre-existing injuries, disabilities, diseases, or ailments that might affect your ability to attend work placement, please provide more information below.
Do you have an Australian Federal Police check?*

YesNo
Is your Federal Police check less than a year old?*

YesNo
Are there any disclosable outcomes in your police check?*

YesNo
Kindly upload a copy of your Federal Police check that is less than 1 year old.

Cancelof

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 in full upfront via Bank TransferPay in Instalments via Direct Debit

STUDENT DECLARATION
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.*

Yes

STUDENT APPLICATION 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 authorise 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.
- I acknowledge that I have received, read, and understood the information provided to me regarding my course, policies, and responsibilities as a student.
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
Name*

First NameLast Name
Signature*

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COURSE POLICY AND PROCEDURE INFORMATION

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

Yes, I have read and understood the Student Handbook in FullNo
Have you received and understood the course fact sheet for your course in full?*

Yes, I have read and understood the Course Fact SheetNo
Name*

First NameLast Name
Signature*

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APPLICANT NAME

APPLICANT INFORMATION

UNIQUE STUDENT IDENTIFIER (USI)

OBTAIN AND PROVIDE A USI

Can you confidently do the following?

🗣️ Tell Us More (Optional)

QUEENSLAND GOVERNMENT FUNDING ELIGIBILITY QUESTIONS

GOVERNMENT FUNDING ELIGIBILITY DOCUMENTS

TRAINING PREFERENCE QUESTIONS

WORK PLACEMENT PREFERENCE

SUITABILITY FOR INDUSTRY

SPECIALISATIONS

WORK PLACEMENT

HOW DID YOU FIND OUT ABOUT APEX?

PAYMENT METHOD

STUDENT DECLARATION

COURSE POLICY AND PROCEDURE INFORMATION