Smart and Skilled Training Enrolment Form

Application for Pre-Enrolment

**Please fill the application for pre-enrolment form below to assess the prospective student’s suitability.
Academy of Workplace Learning | RTO#40603 | V 2.0 September 2024 | AOWL-001
Section A

To check your eligibility for subsidised training under Smart and Skilled Training and to help Academy of Workplace Learning obtains a quote for your student fees from the NSW Government, please fill in the details.
Personal details
Name

First NameLast Name
Second given name (middle)
Please note:

*Please type 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 Academy of Workplace Learning to apply for a USI on your behalf, you must type 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 in the form for a detailed explanation.
Date of Birth (dd/mm/yyyy)
Gender (Tick ONE box only)

MaleFemaleOther
E-mail
example@example.com
Alternative email address (optional)
example@example.com
Mobile
Work Phone
Address (Please indicate your residential address at the time of this training)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency / Guardian or Parent Contact Name :
Relationship :
Contact Mobile/Phone :
Unique Student Identifier (USI) *if known
I give permission for Academy of Workplace Learning to locate my USI in the instance one may already exist.I authorise Academy of Workplace Learning to apply pursuant to sub-section 9 (2) of the student identifiers Act 2024 for a USI on my behalf.
I therefore provide the following details:

Driver's licese numberState
Medicare card No:Ref
Passport or Australian Birth Certificate NumberTown of birth
Signature

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Date

MonthDayYear
Date
Information Regarding Unique Student Identifier

From 2015, school students participating in nationally recognised training must have a Unique Student Identifier (USI). The USI will provide students with the ability to obtain a complete record of their Vocational Education and Training (VET) enrolments and achievements from a single online source. Students often need to provide evidence of their academic achievement to enrol in further training or need to show a future employer for example when applying for a job or to undertake further study. The USI enables students to obtain a full transcript of all the accredited VET training they have undertaken from the time the USI comes into effect, or an extract showing the achievements they wish to see.

A student must provide their USI to their training provider , schools or training can also on behalf of students.

More information regarding the USI can be find here: https://www.usi.gov.au/
Residency Status
Australian CitizenPermanent Australian ResidentNew Zealand CitizenProtection visaHumanitarian visaOther
Please specific your visa (Please provide evidence of your visa status. List of accepted visas is outlined in Appendix 1: Refugee and Asyum seekers)
Course/Qualification of Interest
CHC33021 Certificate III in Individual SupportCHC43015 Certificate IV in Ageing SupportCHC43121 Certificate IV in Disability SupportCHC43315 Certificate IV in Mental HealthCHC30125 Certificate III in Early Childhood Education and CareCHC50125 Diploma of Early Childhood Education and CarePart QualificationsHLTAID011 Provide First AidHLTAID009 Provide cardiopulmonary resuscitationHLTAID012 Provide First Aid in an education and care settingCPCWHS1001 Prepare to worksafely in the construction industryCHCPRT025 Identify and report children and young people at riskOther
Please specific the Course/Qualification
Location

HaymarketOther
Please specifc the campus
Recognition of Prior Learning (RPL) / Credit Transfer (CT)

(f applicable)
Do you wish to apply for RPL/CT for any of the units of competency offerred by Academy of Workplace Learning?

NoYes - You will be contacted by a trainer/assessor who will provide further information
Secondary Education
Please tick the highest level achieved

Year 12 or equivalentYear 11 or equivalentYear 10 or equivalentYear 9 or equivalentYear 8 or belowNever attended school
In which YEAR did you complete that school level?
Are you still attending secondary school?

NoYes
Reason For Study - which BEST describes your main reason for undertaking this course/traineeship/apprenticeship? Please tick only one.

To get a jobTo develop my existing businessTo start my own businessTo try for a different careerTo get a better job or promotionIt was a requirement of my jobI wanted extra skills for my jobTo get into another course of studyFor personal interest or self-developmentOther reasons
Have you achieved any qualification since turning 17?

Yes, while still at secondary/high schoolYes, after leaving secondary/high schoolNO
What is the highest level of any post shcool qualification achieved? (Including of the qualification achieved from oversea)

FoundationCertificate ICertificate IICertificate IIICertificate IV & above (e.g. Diploma, Bachelor, Masters, PhD)Certificate IV or above with Acquired Disability
Tertiary Education
Have you SUCCESSFULLY completed any of the following qualifications? if YES, please tick all applicable boxes.

Bachelor degree or higher degreeAdvance diploma or associate degreeDiploma (or associate Diploma)Certificate IV (or advanced certificate /technician)Certificate III (or trade certificate)Certificate IICertificate IOther education (including certificates or overseas qualification not listed above)None
Employment Status - Which BEST describes your current employment status? Please tick one 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-time employed (less than 35 hours per week)

Full time employeePart-time employeeSelf-employed (Not employed others)Self employed ( Employed others)Employed ( Unpaid worker in a family business)Unemployed ( Seeking full-time work)Unemployed (Seeking part-time work)Not employed (Not seeking employment)
Language and Cultural Diversity

Please tick relevant boxes:
Are you of Aboriginal or Torres Strait Islander origin?

NoYes, AboriginalYes, Torres Strait Islander
In which country were you born?

AustraliaOther (Please specific)
Please specific the country you were born.
Main Language Spoken at Home.
Disability
Do you consider yourself to have a disability, impairment or long-term condition?*

NoYes
If you indicated that presence of a disability, impairment or long-term condition, please select the area (s) in the following list: (You may indicate more than one area) Please refer to the Disability supplement for an explanation of the following disabilities.

Hearing /deafPhysicalIntellectualLearningMental illnessAcquired brain impairmentVisionMedical conditionOther (Please specify)
Please indicate disability assessment type: Please bring evidence of your disability status. List of accepted evidence is outlined in Acceptable evidence for fee exemptions and concessions of the Smart and Skilled Fee Administration Policy.

Recipient of disability support pensionAssessed by specialist support professional as a student with disability
Have you undertaken any other Smart and Skilled Qualification this calendar year? ( Are currently undertaking or are enrolled in but have not yet commenced or have completed this year)

YesNo
Welfare status

Please indicate your welfare status
Are you a Welfare Recipient?

I am not a welfare recipientYesI am a dependent child or spouse of a welfare recipient
Please specify
List of Welfares eligible for concession fee: Please bring evidence of your welfare status. List of accepted evidence is outlined in the appendix 2: Acceptable evidence for fee exemptions and concessions of the Smart and Skilled Administration Policy.

Aged PensionAustudyCarer Payment (Not Carer Allowance)Exceptional Circumstance Relief PaymentFamily Tax Benefit Part A (Please only select if on the maximum rate)Farm Household AllowanceJobSeeker AllowanceNewstart AllowanceParenting Payment - Single Parent (Please only select if you are a Single Parent)Sickness AllowanceSpecial BenefitVeterans 'Affairs PensionsVeterans' Children Education SchemeWidow AllowanceWindow B PensionWife PensionYouth Allowance
Are you an Employment Service Provider client?

NoYes ( If yes. Plesae fill in your Employment Service Provider details:
Employment Service Provider - Organisation name
Client ID or Centrelink CRN number
Were you referred to this training by an Employment Service Provider client?

NoYes, please specify your Employment Service Provider referral ID
Employment Service Provider Details
Do you have evidence of long-term unemployment status?

NoYes (with appropriate proof)
Section B Consent to use and Disclosure of Personal Information
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of birth
PRIVACY NOTICE
Understand and agree that, under the National Vocational Education and Training Regulator (Data Provision Requirements) Instrument 2020, Academy of Workplace Learning Pty Ltd. registered as Academy of Workplace Learning is required to collect personal information (information or an opinion about me) , collected from me, my parent or guardian, such as my name , Unique Student Identifier, date of birth, contact details , training outcomes and performance, sensitive personal information (including my ethnicity or health information) and other enrolment and training activity - related information (together Personal Information) and disclose that Personal Information to the National Centre for Vocational Education Research Ltd (NCVER).

My Personal Information (Including the personal information contained on my enrolment form and my training activity data) may be used or disclosed by Academy of Workplace Learning Pty Ltd. for statistical , regulatory and research pupose. Academy of Workplace Learning Pty Ltd. may disclose my personal information for these purposes to third parties , including:
- School - if i am a secondary student undertaking VET, including a school - based apprenticeship or traineeship.
- Employer - if i am enrolled in training provider paid by my employer.
- Commonwealth and State or Territory government departments and authorised agencies, including the NSW Department of Education (Department) ;
- NCVER , Organisation (including the Department) conducting student ; and Researchers.
Personal Information disclosed to NCVER may be used or disclosed for the following purposes:
- issuing a VET Statement of Attainment or VET Qualification and populating Authenticated VET Transcripts.
- facilitating statistics and research relating to education, including surveys.
- undestanding how the VET market operates, for policy , workforce planning and evaluation.
- administering VET, including program administration, regulation, monitoring and evaluation.
I may receive an NCVER student survey which may be administered by an NCVER employee , agent or third - party contractor. I may opt out the survey at the time of being contacted. The information from the Smart and Skilled enrolment / Consent form NCVER will collect, hold use and disclose my 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

The Department may disclose my Personal Information to other Australian governmen agencies , including those located in States and Territories outside New South Weales. The above government agencies may use Personal Information for any purpose relating to the exercise of their government functions, including but not limited to the evaluation and assessment of my training, the determination of my eligibility to recieve subsidised training or for any Fee Exemptions or Concessions.

My Personal Information may also disclosed to other third parties if required by law. I also acknowled and agree that the Department may contact me by telephone, email or post during or after I have ceased subsidised training with Academy of Workplace Learning for the purposes of evaluating and assessing my subsidised training.
DECLARATION
I understand that there is a cooling-off period of fourteen (14) calendar days during which this application of enrolment can be withdrawn by all parties involved (RTO/Learner/Employer/ Relevant Government Departments) with full refund or any fees paid up in advance, on the condition that I return all course materials , resources and other RTO property to Academy of Workplace Learning in its original condition.

I declare that the information I have provided to the best of my knowlede is true and correct. I consent to the collection, use and disclosure of my Personal Information in the manner outlined above. I also declare and confirm that:

- All information I have provided to Academy of Workplace Learning in connection with the Notification of Enrolment process is true, accurate, complete and not misleading in any way.

- A Notification of Enrolment process has not concurrently been completed for the same qualification and /or same units of competency for the same or other qualification (s)

- I am aware of any third-party arrangements (if applicable)

- I have been provided with the details of the Fee chargeable and the Student Information, available on Academy of Workplace Learning's website.
Name

First NameLast Name
Signature

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Date

MonthDayYear
Date
Note: if under 18 years of age at the time of giving consent, then the consent of their guardian is required.
Name of Guadian:

First NameLast Name
Date

MonthDayYear
Date
Relationship with the student
Enrolment Document Checklist
We are obliged to demonstrate that we have confirmed your identity, We kindly ask you to provide the following, where applicable.

Photo ID i.e. Driver's license or passportEvidence of residency / Proof of the Citizenship status i.e. Green Medicare Card or the Citizenship Certificate, Australia Passport, ImmiCardProof of the current address i.e. Driver's lincese or the utilities bill like electricty , water, gas, mobile phone, internet bill, bank statement , credit card statement, government tax letter.Fee Waiver, Regugee or Asylum Seeker (and thier Partner) (if applicable) i.e. Relevant visa documentation, or ImmiCard (where appropriate) Note: Eligible Partner must also provide evidence that their visa sponsor holds or held one of the eligible humanitarian visas.Proof of a Commonwealth Government benefit recipient. (If applicable) i.e. A current concession card that shows the CRN and clearly shows the benefit or allowance category or a current Centrelink income statement that clearly shows the CRN and the benefit or allowance category, A letter from the department of Human Services (Centrelink) confirming receipt of the benefit.Proof of the previous qualification with the student declaration/signature at the enrolment. ( If applicable)Academic transcript & Certificate or the VET transcript records.Proof of Long-term unemployment status ( if applicable)A letter from the Employment Service Provider is required (if applicable)Proof of the fee Exemption: Pension with Disability ( if applicable) i.e. A current Disability Pensioner Concession card that shows the CRN or a current Centrelink income statement for the Disability Support Pension which clearly shows that income is for the disability pension and also shows the CRN, A letter or statement from a Mecical practitioner or an appropriate government agency such as a Veteran's affair, Disability Services Provider or a specialist allied health professional.
Please upload your enrolment documents:

Cancelof
Should be Empty:

Application for Pre-Enrolment

Section A

Please note:

Residency Status

Course/Qualification of Interest

Recognition of Prior Learning (RPL) / Credit Transfer (CT)

Secondary Education

Tertiary Education

Language and Cultural Diversity

Disability

Welfare status

Section B Consent to use and Disclosure of Personal Information

PRIVACY NOTICE

DECLARATION

Note: if under 18 years of age at the time of giving consent, then the consent of their guardian is required.

Enrolment Document Checklist