New employer registration application form (PDF) - SA.Gov.au

Application form:
New Employer Registration
Note
Information indicated with an asterisk (*) together with your registration status will be available on the
Employer Register at www.tasc.sa.gov.au
1. Employer details
Legal name*:
ABN:
Legal entity type:
Trust
Sole proprietor
Partnership
Public company
Private company
State government agency
Local government agency
Federal government agency
Nature of business:
Physical address:
Postcode:
Postal address (if different to physical address):
Postcode:
2. Primary contact person details – must be located in South Australia
Contact name:
Position:
Phone no:
Mobile no:
Email:
3. Nominated Australian Apprenticeships Centre – if applicable
4. Worksite details
Trading name*:
Worksite address (if different to physical address above):
Postcode:
Postal address (if different to postal address above):
Postcode:
Contact person:
Position:
Email:
Phone no:
Mobile no:
Application Form - New Employer Registration – Version 1.1 – 28/06/2013 Page 1 of 2
www.skills.sa.gov.au/apprentices

5. Registration details
List the trades/vocations you wish to register for, and details for each supervisor. You may attach further
information if necessary.
Trade/Vocation name*:
Qualification name/code*:
Supervisor details
Supervisor name
Licence (if
applicable)
Years of
experience
Supervisor’s courses and qualifications
Trade/Vocation name*:
Qualification name/code*:
Supervisor details
Supervisor name
Licence (if
applicable)
Years of
experience
Supervisor’s courses and qualifications
6. Signature
I wish to become a registered employer to allow my business to undertake Training Contracts in accordance with
the Training and Skills Development Act 2008. I agree to discuss this application with an officer representing the
Training and Skills Commission.
Employer signature:
Print name: Date: / / (DD/MM/YY)
You are advised to retain a copy of this form for your records.
Please return this form to:
Traineeship and Apprenticeship Services
Post: GPO Box 320, Adelaide SA 5001
For more information:
Phone: 1800 673 097
Website: www.skills.sa.gov.au/apprentices
Fax: 08 8124 1401
Email: dfeesttasemployer@sa.gov.au
Application Form - New Employer Registration – Version 1.1 – 28/06/2013 Page 2 of 2
www.skills.sa.gov.au/apprentices