Student Enquiry Form

First name*

Middle Name/s

Surname*

Post Code*

Date of birth*

DayMonthYear

Gender*

Phone number*

if landline please include area code

Email address*

Confirmation Emailexample@example.com

Residential address*

Street Address

Street Address Line 2

SuburbState

Post Code

Please provide any other information that will assist us in responding to your enquiry:

In order to check your eligibility to undertake training and to identify any government-subsidised training opportunities that may apply, we will ask questions relating to your personal details and circumstances as well as your previous education. All information provided is collected in accordance with our Privacy Policy which can be found in our Student and Employer Handbook.

If you are eligible to study and choose to proceed to enrolment, we will request evidence to support your eligibility outcome as required by State and Commonwealth legislation; this may include evidence such as identification, welfare benefits, visa status, disability status, schooling or previous education and any other evidence that is required.

Do you have prior experience, training or qualifications relevant to this eligibility enquiry?*

YesNo

If yes, please provide some detail including any qualifications or units of competency you hold and what experience you have:*

Please upload or attach copies of certificates or statements of attainments for previously completed qualifications or training that are relevant to the selected qualification.

Up to a total of 20 megabyte (mb) can be uploaded

What is your residency status? *

Are you living in NSW social housing; or are you or your household on the NSW Housing Register?*

YesNo

Are you eligible and meet the 'out of home' definition?*

YesNo

Are you a refugee or asylum seeker?*

YesNo

Please choose applicable visa held*

Are you eligible to meet the 'domestic and family violence' definition?*

YesNo

Are you a school student?*

Yes, at schoolYes, home schooledNo

Have you completed any qualifications since turning 17?*

Yes, while still at schoolYes, after leaving school (post-school qualification)No

What is the highest qualification level you have achieved?*

Are you registered or intending to be registered in an apprenticeship or traineeship for this qualification in NSW?*

Yes, registeredYes, intending to be registeredNo

If yes, which type:*

New Entrant TraineeshipExisting Worker TraineeshipSchool Based Traineeship

Are you of Aboriginal and/or Torres Strait Islander origin?*

YesNo

Have you undertaken any other Smart and Skilled qualification this calendar year?*

YesNo

Indicate your disability status*

Please indicate disability assessment type*

Recipient of disability support pensionAssessed by specialist support professional as a student with disabilityOther

Are you currently receiving or are you a dependant of a person currently receiving Commonwealth Government benefit or allowance?*

Not a welfare recipientI am a welfare recipientI am the dependent child or spouse of a welfare recipient

Please indicate the Commonwealth Government payment or allowance:*

I have been unemployed for a period of 52 weeks or more (consecutively) and can provide appropriate evidence of long-term unemployed status?*

YesNo

How did you come across our organisation?*

By submitting this form, I declare:*

The information I have provided to the best of my knowledge is true and correct.The information I have provided will be used for the purposes of determining eligibility to undertake training with KARBEN Training Solutions and access government-funded training opportunities (where available).I understand I will be asked to provide evidence that supports the information provided within this form as required by State and Commonwealth legislation if I choose to proceed to enrolment.

Signature*

Date submitted*

Date

Enrolment Funding Pathway

Smart and Skilled*Fee for Service

Do Smart and Skilled conditions apply?

Quoted Course Fee

Practical/Work Placement Hours Required

Enrolment start date

Date

Days to add for enrolment END date

Enrolment end date

Date

Enrolment duration in months (used for email template in workflow)

Form Status*

OpenClosed

KARBEN Training Solutions | Registered Training Organisation (RTO) | National RTO ID 91167

Email: info@kts.edu.au | Website: www.kts.edu.au | Phone: 02 4353 7188 | Postal Address: Po Box 3380 Tuggerah NSW 2259

Student Enquiry Form

Office use section