Fillable 371308 New Student Personal Details (Australian Correspondence Schools)

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371308 New Student Personal Details (Australian Correspondence Schools)

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PLEASE PROVIDE AN ANSWER TO
ALL
QUESTIONS ON THIS FORM - PLEASE USE BLOCK LETTERS
1. Student Details
2. Contact Details
Preferred Name (if different from above) Previous Last Names (if any - e.g. maiden name)
First Name
Last Name
The name recorded above should be as shown on the following documents - Australian Passport, Australian Driver Licence, Australian Birth Certificate, Medicare Card, Visa (with Non-
Australian Passport); for international students (Certificate of Registration by Descent, Citizenship Certificate, ImmiCard).
Home Address (If you are an overseas student you need to supply your overseas address in this section)
City / Suburb State Country Postcode
Mail Address (Please state 'as above' if same)
City / Suburb State Country Postcode
Temporary Study Address (If you are an overseas student you must provide your Australian address in this section)
Effective
from
to
City / Suburb State Country Postcode
Home
Email
Work
Email
Home Phone
Work PhoneMobile
Gender
Male
Female
D
M
Y
Y
D
M
Y
Y
Date of Birth
3. Cultural Diversity and Citizenship
Do you identify yourself with any of the following ethnic groups?
Select one of the following to identify your citizenship status
Aboriginal
Torres Strait Islander
Both Aboriginal / Torres Strait Islander
None of These
Student
- Personal Details
TAFE Student Number (if known)
Learner Unique Identifier (if known)Unique Student Identifier (if known)
For more information visit www.qcaa.qld.edu.auVisit www.usi.gov.au to apply for your USI
What is your country of citizenship if entering Australia on visa?
Australian Citizen
New Zealand Citizen
Australian Permanent Resident
Student Visa
Temporary Resident Visa
Visitor Visa
Business Visa
Holiday Visa
Other Visa (please specify)
ISAS348 Ver 1 (7/2016)
Town/City of Birth
Country of Birth
Middle Name/s
5. Language
Do you speak other language/s at home apart from ENGLISH?
No
(Go to Question 6) Yes
Please specify the main language spoken at home
Where English is NOT the main language spoken at home, please clarify how well you speak English? (Tick the relevant box below)
Very well
Well
Not well Not at all
Is English language assistance required? No
Yes
(If assistance is required contact TAFE Queensland to discuss your needs)
Employed full time by someone else
Employed part time or casual by someone else or school based apprentice
Self employed - not employing other people
Employer - someone who employs other people
Employed unpaid family worker
Unemployed - looking for full time work
Unemployed - looking for part time work
Not employed - not looking for employment
1
4
3
5
6
8
7
4. Employment
Employment Status – Of the following categories, which best describes your current employment status? (Tick ONE box only)
Employer Details
Queensland Government Certificate 3 Guarantee and Higher Level Skills Programs Eligibility (IMPORTANT - Please read carefully)
7. Previous Qualifications Achieved (Please read carefully)
Have you successfully completed any of the following qualifications?
No
Yes
(If yes, tick all that apply)
Bachelor Degree or Higher Degree
Advanced Diploma or Associate Degree
Diploma or Associate Diploma
Certificate IV or Advanced Certificate
Certificate III or Trade Certificate
Certificate II
Certificate I
Certificates other than above
6. Schooling
What is your highest completed school level?
If yes, provide grade and name of school –
In which year did you complete that school level?
Are you still attending secondary school? No
Yes
Year 12 Year 11 Year 10 Year 9 or equivalent Year 8 or lower Did not go to school
Y
Y
Y
Y
Name of school
Grade
Company Name Company Contact
Company Email
Address City / Suburb
State Postcode Phone Fax
2
Under the Certificate 3 Guarantee and Higher Level Skills Programs, the Queensland Government provides a subsidy for selected Certificate I, II, III,
Certificate IV or higher level qualifications or priority Skills Sets aligned to critical occupations identified by government and industry.
To be eligible individuals must:
1. be aged 15 years or over, and no longer at school
2. permanently reside in Queensland
3. be an Australian citizen, Australian permanent resident (includes humanitarian entrant), temporary resident with the necessary visa and work
permits on the pathway to permanent residency, or a New Zealand citizen
4. when enrolling into a Certificate III or below you must not hold, and not be enrolled in, a Certificate III or higher-level qualification (including an
Apprentice or Traineeship), not including qualifications completed at school and foundation skills training or:
5. when enrolling into a Higher Level Skills Programs you must not hold, and not be enrolled in, a Certificate IV or higher-level qualification
6. specific restrictions may apply to participation in certain subsidised qualifications you will be advised of any restrictions prior to enrolments.
I confirm that I am not currently enrolled in any other qualifications which would result in me not being eligible for this enrolment to proceed.
(refer to points 4 and 5 above)
Yes
No
If enrolling into a Certificate III or below, I confirm that I do not already hold a Certificate III or higher level qualification.
(refer to point 4 above)
Yes
No
If enrolling into a Certificate IV or higher level qualification, I confirm that I do not already hold a Certificate IV or higher level qualification.
(refer to point 5 above)
Yes
No
False or misleading information concerning your prior qualifications or not advising of any current enrolments may result in being withdrawn or being liable
for further financial outlay for this enrolment.
Within three months of completing or discontinuing this qualification you will be required to complete a Student Employment Survey.
ISAS348 Ver 1 (7/2016)
9. Disclosure
Educational authorities - such as TAFE Queensland, research organisations contracted by TAFE Queensland, and the National Centre for
Vocational Education Research - conduct surveys of past and existing students for customer satisfaction, improvement and marketing purposes.
If you have any objections to being contacted, please tick here.
Privacy Statement
TAFE Queensland is collecting your personal information in accordance with the TAFE Queensland Act 2013 to manage your enrolment, training progress,
and administration. For specific cohorts of students and as a matter of routine, your personal information (including attendance details, progress, and
results) will be disclosed to the following people and organisations:
• If you are a school-based apprentice or trainee or VET in schools student – your school, the Queensland Curriculum and Assessment Authority, and
the Queensland Tertiary Admissions Centre (for your results only).
• If you are an apprentice or trainee or enrolled in training paid for by your employer, or in which you consent to release information to your employer
– your employer/host employer.
• If you are enrolled with TAFE Queensland and undertaking training with another organisation (including other training providers, community
organisations, schools or universities ) – the organisation with which you are undertaking training.
• If you are enrolled in a program eligible for university articulation through one of our higher education delivery partners, i.e. University of Canberra and/
or intend to continue study via a pre-arranged articulation pathway, for example, you are studying a dual qualification with TAFE Queensland and a
University.
• If you are under the age of 18 – your parent/guardian (unless you have formally advised TAFE Queensland not to provide this information).
• If you are an international student – the parties outlined in the terms and conditions agreed upon accepting a place with TAFE Queensland.
• All students – The National Centre for Vocational Education Research and the Department of Industry in accordance with the National Vocational
Educational and Training Regulator Act 2011 for the purposes of national statistical data collection, and to provide information for your Unique Student
Identifier account; and the national VET and higher education regulators in accordance with the Standards for Registered Training Organisations 2015
and Higher Education Standards Framework (Threshold Standards) 2011 to assist with the monitoring and regulation of the vocational education and
training and higher education sectors.
Personal information collected may also be disclosed to third parties with your consent or as permitted or required by law.
Your information will be stored securely. If you wish to access or correct any of your information, discuss how it has been managed, or have a concern
or complaint about the way your personal information has been collected, used, stored, or disclosed, please contact TAFE Queensland customer services
or your teacher.
For those students who require assistance in reading and understanding this Privacy Statement, please contact TAFE Queensland Customer Service
Centres prior to enrolling.
8. Study Reason
To get a job
To develop my existing business
To start my own business
To try for a different career
To get a better job or promotion
It was a requirement of my job
I wanted extra skills for my job
To get into another course of study
For personal interest or self-development
Other reasons
What Program/Course are you enrolling into?
Of the following options listed below which BEST describes your main reason for undertaking this training? Tick ONE box only.
11. Emergency Contact (Person you want us to contact in an emergency)
First Name
Relationship to student (e.g. Parent, Friend)
Email
Home Phone
Work PhoneMobile
10. Disabilities (Answering these questions will not affect your enrolment)
Do you consider yourself to have a disability, impairment or long-term condition?
Yes
No
(Go to Question 11)
If yes, please indicate the areas of disability, impairment or long-term condition:
Yes
No
Would you like to receive advice on support services, equipment and facilities which may assist (if applicable)?
If you have indicated Yes then evidence may be required.
Hearing / Deafness
Physical
Intellectual
Learning
Mental Illness
Acquired Brain Impairment
Vision
Medical Condition
Other (please specify)
ISAS348 Ver 1 (7/2016)
Last Name
Issues may arise beyond TAFE Queensland’s control which affect its ability to deliver programs. Whilst every effort will be made to conduct all programs as
advertised, TAFE Queensland reserves the right to change or otherwise revise any program-related issues including programs offered, class timetables, class
locations and teacher allocations. TAFE Queensland will make every reasonable attempt to advise students of any changes made to their selected program.
The details in this document are correct at the time of printing.
NEW students enrolling with TAFE Queensland may be requested to complete an identification check. If requested, please provide the documents
listed below to a total of 100 points.
100 Point Identification Check completed and the identification documents have been sighted and ticked off above.
Student's
Signature:
Date: Date:
Parent/Guardian's Signature
(if student is under 18 years)
Student Declaration (Please read carefully)
• I agree to abide by TAFE Queensland rules, regulations and policies and acknowledge that facilities made available for my use will
be used only in accordance with the principles of proper use and relevant rules.
• I confirm the accuracy of the information contained within this form and where necessary identification documents provided.
• I have sought information and understand my eligibility for any fee subsidy (if applicable). I also understand that I must provide
evidence of subsidy and/or concession eligibility at the time of enrolment, and that subsequent evidence will not be accepted.
• I have supplied my USI
If NO then I give permission to TAFE Queensland to apply for a USI on my behalf (if applicable). I have provided the relevant
documents to support this requirement.
If you are under the age of 18 years, this form must be signed by a parent/guardian to complete this enrolment. This includes consent for the
student to have access to the Internet through TAFE Queensland.
Office Use Only – Identification Check
For internal use only
Yes
No
Primary Identification Documents
Please provide one of the following:
• Passport (current or expired within the last two years, but not cancelled) 100 Points
• Birth Certificate/Extract 100 Points
• Citizenship Certificate 100 Points
• Current Licence issued under Australian Law (e.g. Driver Licence or other government-issued licence) 100 Points
Secondary Identification Documents
You may use several of the following documents which may verify your identity by photograph and full name:
• Government-issued Proof of Age or Photo Card 60 Points
• Government authority or public service employee’s ID Card 60 Points
• Secondary or Tertiary Education Institution ID Card 60 Points
Documents which may verify your full name and/or address:
• Current Social Security, Health Care or Pension Card 40 Points
• Council rates (issued within the preceding 12 months) 40 Points
• Australian Driver Licence issued on paper 40 Points
• Medicare Card 40 Points
• A bank/credit union/building society passport, statement or debit/credit card 40 Points
The documents below must have been issued within the preceding 3 months:
• An account (e.g. Mobile Telephone or Pay TV) 40 Points
• Utility bill (e.g. Water, Electricity, Gas or Landline Telephone) 40 Points
• Pay Slip 40 Points
Operator Name
Operator Initials
ISAS348 Ver 1 (7/2016)
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371308 New Student Personal Details (Australian Correspondence Schools)

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Completed 18 July 2020

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