Fillable Enrolment Form Application for Enrolment (Marcus Oldham College)

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Enrolment Form Application for Enrolment (Marcus Oldham College)

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Enrolment Form
Kingsway College RTO: 45693 CRICOS: 03916J
Address: G08&G09/22 St Kilda Road, St Kilda VIC 3182 | Phone: +61 3 9240 5072 | Email: info@kingswaycollege.vic.edu.au
SC6.2-I - Enrolment Form for International Students V2.0.docx Page 1
Application for Enrolment
Which course would you
like to enroll into?
☐
BSB40520 Certificate IV in Leadership and
Management (105942C)
☐
BSB50420 Diploma of Leadership and
Management (105943B)
Preferred start date:
☐As soon as possible ☐ From: ____/____/____
Have you ever studied with Kingsway College before?
☐Yes ☐No
Do you wish to apply for Credit?
If YES, certified copies of transcripts from previous qualifications must be
provided with this form, along with a Credit Application Form
☐
Yes
☐
No
☐Maybe - I’d like more information
Do you wish to apply for Recognition of Prior Learning?
If you indicate YES, you will be contacted to discuss this further
☐Yes ☐No
☐Maybe - I’d like more information
For international students: Are you applying for a Course Transfer
(from another Australian registered CRICOS provider)?
If you indicate YES, a Course Transfer form must accompany this application.
If you are transferring prior to completing 6 months of your principal course of
study, you must provide a letter of release except in certain conditions (see our
Student Handbook for more detail).
☐
Yes
☐
No
☐Maybe - I’d like more information
Application Checklist
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:
☐
Valid passport copy
☐Valid visa (if you have one)
☐High School certificate or other relevant certificates
☐Proof of English Language Proficiency (i.e. test results)
☐Any other relevant documents to support your application
(e.g. resume)
Personal Details
1. Enter your full name
☐
Single Name only (Tick this box if you have one name only that cannot be written in the following format. Write
your single name in the ‘Family name section).
Family name (surname):
First given name:
Second given name (middle):
Please write the name that you used when you applied for your Unique Student Identifier (USI), including any middle names. See USI section of
this form for more information.
2. Enter your birth date
Day/month/year: ___ / ___ / ___
3. Gender
(Tick ONE box only)
☐
Male
☐
Female
☐
Other
4. Enter your contact details
Home phone:
Work phone:
( )
Mobile:
Email address:
Alternative email address
(optional):
5. What is the address of your usual residence?
Please provide the physical address (street number and name, not post office box) where you usually reside rather than any temporary address
at which you reside for training, work or other purposes before returning to your home.
If you are from a rural area use the address from your state’s or territory’s ‘rural property addressing’ or ‘numbering’ system as your residential
street address.
Building/property name is the official place name or common usage name for an address site, including the name of a building, Aboriginal
community, homestead, building complex, agricultural property, park or unbounded address site.
Building/ property name
Flat/unit details:
Street or Lot Number (e.g. 205 or Lot
118):
Street name:
Suburb, locality or town:
State/territory:
Postcode:
6. What is your postal address (if different from above)?
Enrolment Form
Kingsway College RTO: 45693 CRICOS: 03916J
Address: G08&G09/22 St Kilda Road, St Kilda VIC 3182 | Phone: +61 3 9240 5072 | Email: info@kingswaycollege.vic.edu.au
SC6.2-I - Enrolment Form for International Students V2.0.docx Page 2
Personal Details
Building/ property name:
Flat/unit details:
Street or Lot Number
(e.g. 205 or Lot
118):
Street name:
Suburb, locality or town:
State/Territory:
Postcode:
Language and cultural diversity
7. In which country were you born?
☐
Australia
☐ Other, please specify: ___________________
8. Do you speak a language other than English at home?
(If more than one language, indicate the one that is spoken most
often)
☐
No, English only
☐ Yes, other, please specify: ___________________
9. Are you of Aboriginal or Torres Strait Islander origin?
(For persons of both Aboriginal and Torres Strait Islander origin, mark
both ‘Yes’ boxes)
☐
No
☐ Yes, Aboriginal
☐ Yes, Torres Strait Islander
Disability
10. Do you consider yourself to have a disability, impairment or long-term
condition?
☐
Yes
☐
No –
go to question 12
11. If you indicated the 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 (at the back of this form) for an explanation of the following
disabilities.
☐Hearing/deaf
☐
Physical
☐
Intellectual
☐Learning
☐
Mental Illness
☐
Acquired brain impairment
☐Vision
☐
Medical Condition
☐
Other
Schooling
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 are currently undertaking. For example, if you are currently in Year 10 the Highest school level completed is Year
9.
☐Year 12 or equivalent
☐
Year 11 or equivalent
☐
Year 10 or equivalent
☐Year 9 or equivalent
☐
Year 8 or below
☐
Never attended school
Go to question 14
13. Are you still enrolled in secondary or senior secondary education?
☐
Yes
☐
No
Previous qualifications achieved
14. Have you SUCCESSFULLY completed any of the qualifications
listed in question 15?
☐
Yes –
indicate below Question 15
☐ No – Go to Question 16
15. If yes, tick ANY applicable boxes
Please indicate one of these Prior Education Achievement Recognition Identifiers any applicable qualification level A – Australian E– Australian
equivalent I – International Note: If you have multiple Prior Education Achievement Recognition Identifiers for any one qualification, use the following
priority order to determine which identifier to use:
1. A – Australian
2. E– Australian equivalent
3. I – International
☐ A/E/I
Bachelor degree or higher degree
☐
A/E/I
Certificate III (or trade certificate)
☐ A/E/I
Advanced diploma or associate degree
☐
A/E/I
Certificate II
☐ A/E/I
Diploma (or associate diploma)
☐
A/E/I
Certificate I
☐ A/E/I
Certificate IV (or advanced
certificate/technician)
☐
A/E/I
Other education (including certificates or overseas
qualifications not listed above)
Enrolment Form
Kingsway College RTO: 45693 CRICOS: 03916J
Address: G08&G09/22 St Kilda Road, St Kilda VIC 3182 | Phone: +61 3 9240 5072 | Email: info@kingswaycollege.vic.edu.au
SC6.2-I - Enrolment Form for International Students V2.0.docx Page 3
Employment
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-time employed (less than 35 hours per week).
☐
Full-time employee
☐
Part-time employee
☐
Self-employed – not employing others
☐
Self-employed – employing others
☐
Employed – unpaid worker in a family
business
☐
Unemployed – seeking full-time work
☐
Unemployed – seeking part-time work
☐
Not employed – not seeking employment
Study reason
17. Of the following categories, select the one which BEST describes your main reason for undertaking this
course/traineeship/apprenticeship? (Tick one box only)
☐
To get a job
☐
It was a requirement of my job
☐
To develop my existing business
☐
I wanted extra skills for my job
☐To start my own business ☐To get into another course of study
☐
To try for a different career
☐
For personal interest or self-development
☐
To get a better job or promotion
☐
To get skills for community/voluntary work
☐
Other reasons
Next of kin/emergency contact
These are people that Kingsway College may need to contact in an emergency during your participation in training Please ensure that the people
named are aware that they have been nominated as emergency contacts and agree to their details being provided to Kingsway College
Name:
Relationship to you:
Address:
Home phone:
( )
Work:
( )
Mobile:
Email:
Employment Details
Not applicable for class based students or Kingsway College employees – skip section if not applicable
Employer’s legal name:
Your position:
Business address:
Phone:
( )
Email:
Supervisor:
Position:
Victorian Student Number
To be completed by all Victorian students aged up to 24 years
A Victorian Student Number (VSN) is allocated to all school and VET students up to 24 years of age upon their first enrolment in a Victorian school from
2009 or their first enrolment in a VET training provider from 2011.
18. Enter your Victorian Student Number (VSN)
19. Have you attended any Victorian school since 2009 or done any training with a vocational education and training
(VET) registered training organisation or an Adult and Community Education provider in Victoria since 2011?
☐
No - I have not attended a Victorian school since 2009 or a TAFE or other VET training provider since the beginning of 2011.
☐
Yes - I have attended a Victorian school since 2009.
Most recent Victorian school attended:
☐
Yes – I have participated in training at a TAFE or
other training organisation since the beginning of 2011.
List the most recent training organisations with which you have
participated in training in Victoria since 2011. (List up to 3 training
organisations)
1
2
3
Enrolment Form
Kingsway College RTO: 45693 CRICOS: 03916J
Address: G08&G09/22 St Kilda Road, St Kilda VIC 3182 | Phone: +61 3 9240 5072 | Email: info@kingswaycollege.vic.edu.au
SC6.2-I - Enrolment Form for International Students V2.0.docx Page 4
Unique Student Identifier (USI)
From 1 January 2015, Kingsway College can be prevented from issuing you with a nationally recognised VET qualification or statement of attainment
when you complete your course if you do not have a Unique Student Identifier (USI).
Applying for an USI: If you have not yet obtained a USI you can apply for it directly at https://www.usi.gov.au/your-usi/create-usi on computer or mobile
device.
If you already have one: You may already have a USI if you have done any nationally recognised training, which could include training at work,
completing a first aid course or RSA (Responsible Service of Alcohol) course, getting a white card, or studying at a TAFE or training organisation. It is
important that you try to find out whether you already have a USI before attempting to create a new one. You should not have more than one USI. To
check if you already have a USI, use the ‘Forgotten USI’ link on the USI website at https://www.usi.gov.au/faqs/find-your-usi
20. Enter your unique student identifier
If you already have one or have applied for one.
If you already have an USI, but unable to provide it, you may opt to authorize us using the Location USI function in the system based on
information provided in the application.
By signing this agreement, you acknowledge that using the Locate USI function requires the USI Account Holders permission. you also understand that
this will generate a text message or email to the USI Account Holder notifying them that Kingsway College Pty Ltd has searched and confirmed your
USI number.
PRIVACY NOTICE
Under the Data Provision Requirements 2012, Kingsway College 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 enrolment form) may be used or disclosed by Kingsway College
for statistical, administrative, regulatory and research purposes Kingsway College may disclose your personal information for these purposes to
third parties, including: Commonwealth and State or Territory government departments and authorised agencies;
− NCVER;
Personal information that has been disclosed to NCVER may be used or disclosed for the following purposes:
− populating authenticated VET transcripts;
− facilitating statistics and research relating to education, including surveys and data linkage
− pre-populating RTO student enrolment forms;
− understanding how the VET market operates, for policy, workforce planning and consumer information; and
− administering VET, including program administration, regulation, monitoring and evaluation.
You may receive an NCVER student survey which may be administered by an NCVER employee, agent or third party contractor or other authorised
agencies You may opt out of the survey at the time of being contacted.
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
).
INTERNATIONAL STUDENT INFORMATION
Kingsway College is required to collect personal information and information about course enrolment and course progress for all international students
which may be shared with the Australian Government including the Department of Education, Skills and Employment and the Department of Home
Affairs as well as the Tuition Protection Service as relevant for the purposes of:
− promoting compliance with the ESOS Act and the National Code
− assisting with the regulation of providers
− promoting compliance with the conditions of a particular student visa or visas, or of student visas generally
− or facilitating the monitoring and control of immigration.
VICTORIAN GOVERNMENT VET STUDENT ENROLMENT PRIVACY NOTICE
The Victorian Government, through the Department of Education and Training (the Department), develops, monitors and funds vocational education and
training (VET) in Victoria. The Victorian Government is committed to ensuring that Victorians have access to appropriate and relevant VET services.
Any personal information collected by the Department for VET purposes is protected in accordance with the Privacy and Data Protection Act 2014 (Vic)
and the Health Records Act 2001 (Vic).
COLLECTION OF YOUR DATA
Kingsway College is required to provide the Department with student and training activity data. This includes personal information collected in the
Kingsway College enrolment form and unique identifiers such as the Victorian Student Number (VSN) and the Commonwealth’s Unique Student
Identifier (USI).
Kingsway College provides data to the Department in accordance with the Victorian VET Student Statistical Collection Guidelines, available at
http://www.education.vic.gov.au/training/providers/rto/Pages/datacollection.aspx
.
USE OF YOUR DATA
The Department uses student and training data, including personal information, for a range of VET purposes including administration, monitoring and
planning.
A student’s USI may be used for specific VET purposes including the verification of student data provided by Kingsway College; the administration and
audit of VET providers and programs; education-related policy and research purposes; and to assist in determining eligibility for training subsidies.
DISCLOSURE OF YOUR DATA
As necessary and where lawful, the Department may disclose VET data, including personal information, to its contractors, other government agencies,
professional bodies and/or other organisations for VET-related purposes. In particular, this includes disclosure of VET student and training data to the
Commonwealth and the National Centre for Vocational Education Research (NCVER).
LEGAL AND REGULATORY
The Department’s collection and handling of enrolment data and VSNs is authorised under the Education and Training Reform Act 2006 (Vic). The
Department is also authorised to collect and handle USIs in accordance with the Student Identifiers Act 2014 (Cth) and the Student Identifiers
Regulation 2014 (Cth).
SURVEY PARTICIPATION
You may be contacted to participate in a survey conducted by NCVER, Kingsway College’s registering body, Australian Skills Quality Authority (ASQA)
or a Department-endorsed project, audit or review relating to your training. If you participate you may choose to keep your responses confidential. This
provides valuable feedback on the delivery of VET programs in Victoria.
Please note you may opt out of the NCVER survey at the time of being contacted.
CONSEQUENCES OF NOT PROVIDING YOUR INFORMATION
Failure to provide your personal information may mean that it is not possible for you to enrol in VET and/or to obtain a Victorian Government VET
subsidy.
ACCESS, CORRECTION AND COMPLAINTS
You have the right to seek access to or correction of your own personal information. You may also complain if you believe your privacy has been
breached.
For further information, please contact Kingsway College’s Privacy Officer in the first instance by writing to info@kingswaycollege.vic.edu.au.
FURTHER INFORMATION
Enrolment Form
Kingsway College RTO: 45693 CRICOS: 03916J
Address: G08&G09/22 St Kilda Road, St Kilda VIC 3182 | Phone: +61 3 9240 5072 | Email: info@kingswaycollege.vic.edu.au
SC6.2-I - Enrolment Form for International Students V2.0.docx Page 5
For further information about the way the Department collects and handles personal information, including access, correction and complaints, go to
http://www.education.vic.gov.au/Pages/privacypolicy.aspx
For further information about Unique Student Identifiers, including access, correction and complaints, go to
http://www.usi.gov.au/Students/Pages/student-privacy.aspx
.
Student Declaration and Consent
Please ensure all mandatory questions are complete and legible and then complete the below (please tick all):
☐I acknowledge that I have read the Victorian Government’s VET Student Enrolment Privacy Notice.
☐I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above.
☐I declare that the information I have provided to the best of my knowledge is true and correct.
Student Name: Date: / /
Student Signature:
Parent/Guardian approval
Required If you are under 18 years of age at time of application
Parent/Guardian Signature: Date: / /
Parent/Guardian Name:
DISABILITY SUPPLEMENT
The purpose of the Disability supplement is to provide additional information to assist with answering the disability question.
If you indicated the presence of a disability, impairment or long-term condition, please select the area(s) in the following list:
Disability in this context does not include short-term disabling health conditions such as a fractured leg, influenza, or corrected physical conditions such as
impaired vision managed by wearing glasses or lenses.
‘11 — Hearing/deaf’
Hearing impairment is used to refer to a person who has an acquired mild, moderate, severe or profound hearing loss after learning to speak,
communicates orally and maximises residual hearing with the assistance of amplification. A person who is deaf has a severe or profound hearing loss
from, at, or near birth and mainly relies upon vision to communicate, whether through lip reading, gestures, cued speech, finger spelling and/or sign
language.
‘12 — Physical’
A physical disability affects the mobility or dexterity of a person and may include a total or partial loss of a part of the body. A physical disability may have
existed since birth or may be the result of an accident, illness, or injury suffered later in life; for example, amputation, arthritis, cerebral palsy, multiple
sclerosis, muscular dystrophy, paraplegia, quadriplegia or post-polio syndrome.
‘13 — Intellectual’
In general, the term ‘intellectual disability’ is used to refer to low general intellectual functioning and difficulties in adaptive behaviour, both of which
conditions were manifested before the person reached the age of 18 It may result from infection before or after birth, trauma during birth, or illness.
‘14 — Learning’
A general term that refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking,
reading, writing, reasoning, or mathematical abilities. These disorders are intrinsic to the individual, presumed to be due to central nervous system
dysfunction, and may occur across the life span Problems in self-regulatory behaviours, social perception, and social interaction may exist with learning
disabilities but do not by themselves constitute a learning disability.
‘15 — Mental illness’
Mental illness refers to a cluster of psychological and physiological symptoms that cause a person suffering or distress and which represent a departure
from a person’s usual pattern and level of functioning.
‘16 — Acquired brain impairment’
Acquired brain impairment is injury to the brain that results in deterioration in cognitive, physical, emotional or independent functioning. Acquired brain
impairment can occur as a result of trauma, hypoxia, infection, tumour, accidents, violence, substance abuse, degenerative neurological diseases or stroke
These impairments may be either temporary or permanent and cause partial or total disability or psychosocial maladjustment.
‘17 — Vision’
This covers a partial loss of sight causing difficulties in seeing, up to and including blindness. This may be present from birth or acquired as a result of
disease, illness or injury.
‘18 — Medical condition’
Medical condition is a temporary or permanent condition that may be hereditary, genetically acquired or of unknown origin. The condition may not be
obvious or readily identifiable yet may be mildly or severely debilitating and result in fluctuating levels of wellness and sickness, and/or periods of
hospitalisation; for example, HIV/AIDS, cancer, chronic fatigue syndrome, Crohn’s disease, cystic fibrosis, asthma or diabetes.
‘19 — Other’
A disability, impairment or long-term condition which is not suitably described by one or several disability types in combination Autism spectrum disorders
are reported under this category.
Kingsway College ADMIN ONLY:
All mandatory fields complete and legible?
☐ Yes
☐ No - comments: _________________
Date: ___________
Initial: __________
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Enrolment Form Application for Enrolment (Marcus Oldham College)

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