Domestic Student Enrolment Form

USE THIS FORM TO ENROL IN A COURSE AS AN AUSTRALIAN BASED (DOMESTIC) STUDENT.

Please fill in the form below and hit submit.

Personal Details

Other (if applicable)

First Name *

Middle

Surname *

Maiden Name (if applicable)

Date of Birth *

Email Address *

Gender *

Male Female Indeterminate/ Intersex/ Unspecified Other

Other (if applicable)

Which qualification are you enrolling into? *

Are you enrolling into a workplace-based Traineeship or Apprenticeship? *

YesNo

Select yes if you have discussed your traineeship/apprenticeship with your workplace and an Australian Apprenticeship Support Network (AASN) representative. (E.g. Busy@Work, Mas Experience, Apprenticeships Australia)

Are you associated with any Employment Services Provider or other Agencies assisting you with your studies??

PROMO CODECheck out our promotions on our social media for exclusive deals on Fee For Service qualifications. NOT APPLICABLE TO STUDENTS ENROLING UNDER QLD GOVERNMENT FUNDING.

Workplace Details (if applicable)

Are you currently employed? *

Yes No

Company Name

Job Role

Workplace AddressAddress Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Manager/Supervisor Name

Employer/Supervisor Email Address

Work Number

Personal Details

Mobile Number *

Phone (home) If you do not have a home phone number, please enter your best contact number

Home Address *Address Line 1

Address Line 2

City *

State / Province / Region *

Postal Code *

Country *

Is your postal address different to your home address? *

Yes No

Postal Address (if different from above) *Address Line 1

Address Line 2

City *

State / Province / Region *

Postal Code *

Country *

Citizenship/Visa Details

Country of Birth *

City of Birth *

Are you an Australian or New Zealand citizen/resident? *

Yes No

Other Visa (please specify) *

Visa Number *

Passport Number *

Indigenous Status *

Yes, Aboriginal Yes, Aboriginal and Torres Strait Islander Yes, Torres Strait Islander No, neither Aboriginal or Torres Strait Islander

Employment Status *

Full-time Employee Part-time Employee Employed – unpaid worker in a family business Self-employed – employing others Self-employed - not employing others Unemployed – Seeking full-time work Unemployed – Seeking part-time work Unemployed – Not seeking employment

What language do you speak most often? *

Do you require English Assistance? *

Yes No

Proficiency in spoken English *

Very Well Well Not Well Not at All

Schooling

If you are currently enrolled in secondary education, the Highest school level completed refers to the highest school level you have 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.

Highest Level of Secondary Schooling completed *

Year of highest level of secondary school completed: (e.g. 1996) *

Are you currently attending secondary school? *

Yes No

Name of school you are currently attending *

Do you hold any Qualifications? (E.g. Certificate III, IV, Diploma, Bachelor. Masters etc.) *

Yes No

Qualification Recognition *

Australian Qualification Australian Equivalent Qualification International Qualification Other

Other (if applicable)

Funding Eligibility - Are you currently enrolled in any training or qualifications at another recognised educational facility (RTO, University, school, etc.) *

Yes (Cannot access funding) No

In relation to Certificate 3 Guarantee, Higher Level Skills, Boost or RSIS funding types.

Recognition of Prior Learning

Are you interested in RPL? (Recognition of Prior Learning) *

Yes No

Approximately, how many years/months experience do you have? *Experience is in relation to the vocation of your qualification you are enrolling into. E.g. Individual Support (Aged Care) or Hospitality

Disability Status

Do you consider that you have a disability, impairment / long term condition that may affect your participation in the course? *

Yes No

Other (if applicable)

We are required, by law, to verify your Unique Student Identifier (USI) upon enrolment

What is your USI? ( Unique Student Identifier)We are required, by law, to verify your Unique Student Identifier (USI) upon enrolment From 1 January 2015, we College Australia 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). In addition, we are required to include your USI in the data we submit to NCVER. If you have not yet obtained a USI you can apply for it directly at https://www.usi.gov.au/students/create-your-usi/ on computer or mobile device. Enter your Unique Student Identifier (USI) below (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/i-have-forgotten-my-usi/

Your USI *

I authorise Real Group to create or obtain a USI on my behalf. *

(If you do not have a USI, please complete these details) Town/City of Birth(please write the name of the Australian or overseas town or city where you were born) If you would like us Real Group to apply for a USI on your behalf you must authorise us to do so and declare that you have read the privacy information at: http://www.usi.gov.au/Documents/Student-Identifiers-Registrar-privacy-policy-v1.1.pdf

I have read and I consent to the collection, use and disclosure of my personal information (which may include sensitive information) pursuant to the information detailed at https://www.usi.gov.au/documents/privacy-notice-when-rto-applies-their-behalf. *

In accordance with section 11 of the Student Identifiers Act 2014, College Australia will securely destroy personal information which we collect from individuals solely for the purpose of applying for a USI on their behalf as soon as practicable after we have made the application or the information is no longer needed for that purpose.

LUI (QLD School Students Only)Learner Unique Identifier - usually located on your school ID. Please leave blank if not applicable to you.

Emergency Contact Details

Contact Name *

Contact Number *

Relationship *

Email *

Qualification / Course Details

Fees

Do you hold a concessional Card? (E.g. Pensioner or Health Care Card) *

Yes No

Who is responsible for arranging payment for your enrolment? *

Self Employer Other

• Invoices/receipts will be raised and sent within 7 days of enrolment date. • Payment must be made before commencement of course. • The course fees are payable immediately. If applicable. • Cancellation fees may apply, refer to refund policy.

Do you require a payment plan? *

Yes (student services will contact you for further information) No

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If possible, please provide forms of identification - such as Driver licence, Medicare Card, Concessional Card etc. If you are unable to provide these at this point in time, please email a clear, coloured photograph of your identification to info@collegeaustralia.edu.au

Signature *

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By signing this form, I agree that all the information provided is true and correct and any untrue information may delay my enrolment process.

CRICOS PROVIDER: 03513F | RTO NO. 31222

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