TRAINING ENROLMENT FORM 1. PERSONAL DETAILS 2 ...

TRAINING ENROLMENT FORM
Please fill in all sections clearly by writing in block letters
Information requested on this form is for national database and tracking purposes and assists in
ongoing qualification issuance as required.
All data is confidential and is not forwarded to any other party with the sole exception of the national
statistical database to inform future federal funding in Vocational Training.
1. PERSONAL DETAILS
Mr. Mrs. Ms. Miss.
Family Name:
Given Names:
Date of Birth:
Phone Numbers:
Email Address:
Emergency Details:
______________________________________________________________
______________________________________________________________
___________________________________ Gender: ___________________
(H) _______________ (W) __________________ (M)___________________
______________________________________________________________
Name ______________________________ Phone Number: _____________
Mob: ____________________ Relationship:______________________________________________
Residential Address:
______________________________________________________________
Suburb: ___________________________________________________________Postcode: _______
Postal Address: _______________________________Suburb________________Postcode: _______
2. COURSE DETAILS (GROUP)
Course/qualification:
Date of Enrollment:
______________________________________________________________
______________________________________________________________
3. EMPLOYMENT DETAILS
Business Name:
______________________________________________________________
Contact/Supervisor Name:____________________________________________________________
Address: ______________________________________Suburb:_____________________________
Postcode: ________Email:____________________________________________________________
Phone Number: ___________________Fax Number: __________________Mob:________________
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4. LANGUAGE & CULTURAL DIVERSITY
Are you Aboriginal or Torres Straight Islander?
No Yes, Aboriginal Yes, Torres Straight Islander
Were you born in Australia? Yes No
If not, please specify:
______________________________________________________________
Do you speak another language other than English at home?
No
Yes
If yes, please specify: _____________________________________
If yes, how well do you speak English?
Very Well
Well
5. EDUCATION
.
Are you attending Secondary School? Yes Which School? ___________________ No
What is your highest completed level/year of school?
Completed year 12
Completed year 11
Completed year 10
Completed year 9 or equivalent
Completed year 8 or lower
In which year did you complete this level?
At which school/college did you complete this level ______________________________________
6. REFERRAL SOURCE
How were you referred to us?
Advertisement
Existing Customer
Internet
Job Services
Other
Word of Mouth
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7. DISABILITY
Do you have a disability or long term condition? YES NO (Please circle)
If so, please specify:
(eg. Visual, intellectual, physical)
______________________________________________________________
8. LABOUR STATUS
Of the following, which best describes you current employment status?
(Tick one box only)
Full Time
Part Time
Self employed, not employing others
Employer
Employed (un-paid worker in family business)
Unemployed (seeking full time position)
Unemployed (seeking part time position)
Unemployed (not seeking employment)
9. PRIOR EDUCATION
Have you completed any of the following qualifications? YES NO (Please circle)
Bachelor Degree or Higher Degree
Advanced Diploma or Associate Degree
Diploma Level
Certificate IV
Certificate III
Certificate II
Certificate I
Miscellaneous Education
Please specify: _________________________________________________________________
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10. REASON FOR STUDY
Of the following categories, which best describes your main reason for undertaking this course/
traineeship/ apprenticeship? (Tick one box only)
For personal interest or self development
I wanted extra skills for my job
It was a requirement of my job
Other reasons
To develop my existing business
To get a better job or promotion
To get a job
To start my own business
To try for another career
11. SUPPLY AND VERIFICATION OF INFORMATION
Our quality assurance program asks that we randomly contact other training suppliers to
verify documentation.
I, ........................................................................................... hereby give permission to The
Training and Business Company to contact Registered Training Organisations named on
documents I am supplying for Recognition of Prior Learning or Credit Transfer purposes.
I also authorise said Registered Training Organisations to provide to the Training and
Business Company details of my qualifications and or verification of same.
12. DECLARATION
I understand that information obtained in this form may be provided to State and Commonwealth
agencies and research organisations and I consent to that occurring. I certify that all details provided
on these forms are correct.
Students Signature: _________________________________ Date: __________________
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