CEG Training Partnerships Enrolment Pack...File location: I:\CEG - Training Partnerships\2016\All...

$: CEG Training Partnerships Enrolment Pack...File location: I:\CEG - Training Partnerships\2016\All Forms\FRM-EP-001 CEG TP Enrolment Pack.docx SECTION 5 UNIQUE STUDENT IDENTIFIER (USI)$
CEG – Training Partnerships Enrolment Pack

PLEASE COMPLETE AND RETURN THIS ENROLMENT FORM TO CEG – Training Partnerships Fax: 08 8645 3718 PO Box 490 Email: [email protected] Whyalla SA 5600

mailto:[email protected]

Doc No.: FRM-EP-001 Approved: Quality and Compliance Uncontrolled when printed P a g e | 2

© CEG-Training Partnerships Version No. 6 Version Date: 19/02/2016 Review Date: 19/02/2017

File location: I:\CEG - Training Partnerships\2016\All Forms\FRM-EP-001 CEG TP Enrolment Pack.docx

Prior to commencing Training the following must occur:

1. Unique Student Identifier (USI) To enhance your training experience and to meet recent government changes we ask

you provide information about the newly introduced Unique Student Identifier (USI)

Or, if you prefer, we can apply for this USI for you –appropriate information about you will need to be provided for this to occur

CEG- Training Partnerships are unable to enrol any student into their chosen course until they have a USI. The Government brought this rule in to prevent fraudulent practices.

2. Complete ALL sections of the enrolment pack

Section 1 Personal Details

Section 2 Enrolment Details

Section 3 Payment Details

Section 4 WorkReady

Section 5 Unique Student Identifier (USI)

Section 6 Student Declaration

Section 7 CEG- Training Partnerships Office Use Only

3. Attach proof of identification as per page 4

To help speed up the processing we need all requested information from you.




SECTION 1 PARTICIPANT DETAILS

Title: Mr Mrs Miss Ms Other (specify)

Surname: Given Names:

Preferred Name:

Date of Birth: _ _ / _ _ / _ _ _ _ Gender: Male Female

Town of Birth: Country of Birth:

Work Ph: Mobile: Home Ph:

Email address:

Residential Address:

Suburb: State/Territory: Post Code:

Postal Address (if different from above):


EMERGENCY CONTACT DETAILS

Name of Contact: Relationship:

Work Ph: Mobile: Home Ph:

TRAINING PROGRAM DETAILS

Training Program/Qualification Name: Qualification Code:

Start Date: Location of Training:

What is your preferred mode of study? Classroom Distance Learning Combination

Would you like to apply for Recognition of Prior Learning? Yes No

Please specify any dietary requirements for catering purposes:

EMPLOYER DETAILS

Organisation Name: ABN/ACN No:

Contact Name: Position:

Address:


Postal Address (if different from above):


Work Ph: Mobile: Email:




SECTION 2 ENROLMENT DETAILS

The Department of State Development and your State or Territory Training Authority collect the required information on this form for use by the Department of Education. This information is collected for the purposes of auditing, monitoring and reporting of training outcomes, and statistical purposes. The information you provide may be accessed by officers of these Government departments and by the National Centre for Vocational Education Research (NCVER) for the above purposes.

Country of Birth Australia Other (Please Specify):

Resident Type Australian Citizen or Permanent Resident New Zealand Citizen living in SA Overseas student or non-Australian Resident/citizen (If Visa holder, specify below) Visa Type: Expiry Date:

Indigenous Status (if Aboriginal and Torres Strait Islander select both)

Aboriginal Torres Strait Islander Neither

Main language spoken at home English Other (Please Specify):

English Proficiency Very Well Well Not Well Not at all

Do you consider yourself to have a disability, impairment or long-term condition?

No Yes – specify below

Hearing/Deaf Acquired Brain Disorder Physical Vision Intellectual Medical Condition Learning Other - please specify below:

Do you hold the appropriate Language, Literacy and Numeracy (LLN) skills to undertake this course?

No Yes

Do you require assistance/support in participating in learning activities/undertaking the assessments?

No Yes

Are you at secondary school? No Yes – please complete below Last Year Completed: (e.g. Year 10) Name of School: SACE No.:

Highest COMPLETED school level? (tick ONE only) Year 12 or equivalent Year 9 or equivalent Year 11 or equivalent Year 8 or below Year 10 or equivalent Never attended school

Year school completed (e.g. 1975) Year:

Have you SUCCESSFULLY completed any qualifications?

No Yes – please indicate from the following: If yes, please indicate what year you successfully completed the qualification Bachelor Degree or Higher __________________ Advanced Diploma or Associate Degree__________ Assoc. Diploma or Diploma_________________ Certificate IV _____________

Certificate III___________ Certificate II____________ Certificate I____________ Other (please specify) _____________________

Which of the following BEST describes your current employment status (tick ONE only)

Full-time Part-time Self-employed Employer Unpaid employment

Unemployed (Seeking full-time work) Unemployed (Seeking part-time work) Unemployed (Not seeking work)

What is your major reason for study (tick ONE only

To get a job Develop my existing business Start my own business To try a different career To get a better job or promotion

Requirement of my job Upgrade skills for my job Get into future courses Self-development Other – please specify:




ENROLMENT DETAILS CONTINUED

Is this training being conducted under the Training Guarantee for SACE Students (TGSS)?

No Yes – additional paperwork is required,

Please contact CEG for more information

Is this training school-based or being conducted under a Training Contract?

No Yes

Are you registered with Centrelink for any of the following allowances?

No Yes – please indicate from the following

Newstart Allowance Youth Allowance Age Pension Disability Support Pension Parenting Payment (single) Parenting Payment (partnered)

Do you currently hold a concession card for any of the following?

No Yes – please indicate from the following

Health Care Card Pensioners Concession Card Veterans Affairs Concession Card

Concession Expiry Date: _ _ / _ _ / _ _ _ _

***Please attach a copy of your concession card***

If registered with Centrelink, please state your Centrelink reference number (CRN): _ _ _ _ _ _ _ _ _ _ Expiry Date: __ / __ / __

Are you registered with a Job Active Provider (JA Provider)?

No Yes – please complete the below

JSA Name:__________________________________ Contact Person Name: ________________________ Contact Number:_____________________________ Email:______________________________________

Are you a prisoner? No Yes – please complete the below

Release Date: _ _ / _ _ / _ _ _ _ (if unknown, use estimated course completion date)

Were you/are you under the Guardianship of the Minister?


Guardianship of the Minister Number: _ _ _ _ _ _ _ _ _ _

Are you currently registered with Innovative Community Action Networks (ICAN)?


ICAN Number: _________________________

CERTIFICATE ADDRESS

Deliver Certificate/Statement of Attainment to: Myself Employer Job Active Provider (JA Provider)

School Other:_______________________

Postal Address for Certificate/Statement of Attainment:

Address:____________________________________ Suburb:_____________________

State:______________ Postcode:_____________

HOW DID YOU HEAR ABOUT THIS TRAINING?

Employer Website Advertisement Email Flyer Recommendation Linked In Twitter Facebook Google+ Job Active Provider (JA)




SECTION 3 PAYMENT DETAILS

Who is responsible for program payment? Self – please complete payment details below Employer A fee payment agreement is required, please contact CEG WorkReady funding A gap fee may be required for some WorkReady courses Other funding - please specify: e.g. CITB

Cost of Training Program Please contact your CEG training representative for training course costs FFS $ or Gap Fee $

Would you like to discuss a payment plan? Yes No Please contact your CEG training representative for training course costs

NOTE: Should the above specified person/entity not make a payment within the agreed terms you (the student) will be responsible for the payment of any outstanding fees

Payment Method: Invoice Credit/Debit Card (complete the below section) EFT payment (instructions below)

Visa MasterCard Amount: $

Cardholder Name: Expiry Date (Month/Year): /

Card Number:

To make a payment via EFT, please use the following details:

BSB: 805-022 Account Number: 01903472 Quote ref number: (Quote Ref number is Invoice number)

CITB FUNDING

If you hold a current CITB Training Card you may be eligible for a discounted fee for selected training. Contact your CEG - Training Partnerships representative for training course costs. Enter your CITB number below to apply for your discount

CITB Number: _____________________________________________

SECTION 4 WORKREADY

Are you applying for WorkReady funding? Yes No

If yes, complete the section below If no, please go to Section 5 of the enrolment form If you are unsure if your training is funded through WorkReady please contact your local CEG representative Photographic identification of a person’s existence is required for each student applying for WorkReady funding. Please attach a copy of one of the following acceptable sources of evidence:

Current driver’s license or learner’s permit

Current Proof of age card (issued by Services SA)

Current Australian Passport in conjunction with evidence of residential address (see below list)

Current School Student Card issued by the school where the student is currently enrolled (in conjunction with evidence of residential address if address is not identified on School Card)

If this evidence does not show your residential address then please attach a copy of acceptable evidence of residential address documents listed below. ***Please Note: If you do not have one of these forms of ID please contact CEG Training Partnerships Head Office

as other forms of ID may not be able to be used as proof of identity***

Please complete the WorkReady Participant Agreement overleaf




SECTION 5 UNIQUE STUDENT IDENTIFIER (USI)

All students in Australia, who complete their training from 1st January 2015, onwards must be issued with a Unique Student Identifier (USI). This number remains with you for life. Your USI will help keep your training records and results together in an online account controlled by you. Each time you enrol to study with us or another RTO, your USI will be used to store your training records and results. If you do not already have a USI, CEG – Training Partnerships can apply for your USI on your behalf. This is a FREE service we are providing all students. Alternately, you can elect to apply for your own USI and provide the number to us. Please note that we will not be able to issue you a certificate or statement of attainment without a valid USI.

Please read the Privacy notice below BEFORE you sign and send back this form

Privacy Notice

If you do not already have a Unique Student Identifier (USI) and you have elected to permit CEG - Training Partnerships to apply for a USI to the Student Identifiers Registrar (Registrar) on your behalf, CEG – Training Partnerships will provide to the Registrar the following items of personal information about you:

your name, including first or given name(s), middle name(s) and surname or family name as they appear in an identification document;

your date of birth, as it appears, if shown, in the chosen document of identity;

your city or town of birth;

your country of birth;

your gender; and

your contact details. When we apply for a USI on your behalf the Registrar will verify your identity. The Registrar will do so through the Document Verification Service (DVS) managed by the Attorney-General's Department which is built into the USI online application process and by using the identification document provided to us. In accordance with section 11 of the Student Identifiers Act 2014 Cth (SI Act), we will securely destroy personal information which we collect from you, solely for the purpose of applying for a USI on your behalf, as soon as practicable after the USI application has been made or the information is no longer needed for that purpose, unless we are required by or under any law to retain it. The personal information about you that we provide to the Registrar, including your identity information, is protected by the Privacy Act 1988 Cth (Privacy Act). The collection, use and disclosure of your USI are protected by the SI Act. When we make an application for a student identifier on your behalf, we will have to declare that CEG – Training Partnerships has complied with certain terms and conditions to be able to access the online student identifier portal and submit this application, including a declaration that we have given you the following privacy notice: You are advised and agree that you understand and consent that the personal information you provide to us in connection with your application for a USI is collected by the Registrar for the purposes of applying for, verifying and giving a USI; resolving problems with a USI; and creating authenticated vocational education and training (VET) transcripts, as for the VET purposes. We will not otherwise disclose your personal information without your consent unless authorised or required by or under law. By signing the declaration section overleaf you are accepting the terms and conditions specified in this privacy statement.

PLEASE SELECT your USI option from the list provided below:

☐ Option 1 - I already have a USI. My USI Number is ______________________________ Please complete using block letters

☐ Option 2 - I authorise CEG – Training Partnerships to apply for my USI on my behalf and confirm I have read the privacy

information on the next page – if this option is chosen then the below must be completed:

Preferred method of contact: Mobile Email

Town of birth:_________________________________

☐ Option 3 - I elect to obtain my own USI and confirm that I will provide this to CEG – Training Partnerships as soon as I have

obtained it – please note that your enrolment will not be secured until your USI is provided

(You will need to visit http://www.usi.gov.au/Students/Pages/default.aspx to create a USI)

PROOF OF IDENTITY Document – Please indicate which ID type you are providing with your form (photocopy or scan)

☐ Driver’s License ☐Medicare Card ☐ Australian Passport ☐ VISA & non Australian Passport

☐ Australian Birth Certificate ☐ Certificate of Registration by Descent ☐ Citizenship Certificate

☐ ImmiCard.

***Please Note: If you do not have one of these forms of ID please contact CEG Training Partnerships Head Office as other forms of ID may not be able to be used as proof of identity***

http://www.usi.gov.au/Students/Pages/default.aspx




SECTION 6 STUDENT DECLARATION

I have honestly and accurately provide information contained on this enrolment form.

I also consent to my photo being taken for card production (if applicable) required for some tickets and my photo will be securely stored with my files, in strict accordance with the Privacy Act. If a medical concern is identified that may directly impact or affect me or my peers as a prospective student in the training environment, I authorise notification to my trainer or Job Active Provider or his/her company delegate of this concern so a contingency plan and/or treatment can take place, should this become necessary.

I give permission for details/results of my training (inclusive of copies of the parchment issued to me throughout the duration of my training) to be supplied to my Job Active Provider, my school or my employer, whichever is applicable.

I understand that lateness and/or non-attendance to the scheduled training dates may result in a marking of non-competence and a full qualification may not be issued.

Student Name: ____________________________________________ Student Signature: _________________________________________ Date:____________________________________________________ Parent/Guardian Signature (If Under 18): _______________________

SECTION 7 CEG REPRESENTATIVE USE ONLY

Training Program/Qualification Name Qualification Code

Start Date Location of Training

I hereby have verified and can confirm the following documentation/information has been completed and attached where necessary Copy of correct identification has been obtained and attached to enrolment form All information has been obtained to create or confirm students Unique Student Identifier (USI) Obtained a signed Fee Agreement if required All sections of enrolment form have been completed

Verified by Signature Date

OFFICE USE ONLY

RTO Internal ID: Unique Student ID:

WorkReady Participant number: Training Contract ID:

Entered by Signature Date

CEG Training Partnerships Enrolment Pack...File location: I:\CEG - Training Partnerships\2016\All...

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