Enrolment Form

Enrolment Form

• Course Enrolling Into

• Student Id Number

Personal Details

• Surname

• Given Names

• Preferred Name

• Date of Birth

  Date

• Sex

  Male

  Female

• Title

  Mr

  Mrs

  Ms

  Miss

  Other

Address of usual place of residence

• Property Name

• No and Street

• Town / Suburb

• Post Code

• Telephone

• Home

• Work

• Mobile

Postal Address

• Property Name

• No. & Street

• Town / Suberb

• Post Code

Emergency Details /Next of Kin

• Contact Name

• Contact Name

• Relationship

• Telephone

• Home

• Work

• Mobile

• Contact Name

Proof of Identity

• Select Birth Certificate Drivers Licence Passport Other

  • Birth Certificate
  • Drivers Licence
  • Passport
  • Other

• Add media

  Media

Language and Cultural Diversity

• Are you an Australian citizen, permanent resident or East Timorese Asylum seeker?

  Yes

  No

• If NO, what type of Visa do you hold?

• Do you speak a language other than English at your permanent home residence?

  No, English only

  Yes

• If Yes, please specify - if more than one language, indicate the one that is spoken most often

• In which country were you born?

  Australia

  Other

• If other please specify

• if born outside of Australia, what year did you arrive in Australia?

• How well do you speak english?

  1. Very well

  2. Well

  3. Not well

  4. Not at all

• Are you of Aboriginal or Torres Strait Islander Origin?

  1 Yes, Aboriginal

  2. Yes, Torres Strait Islander

  4. No

Assistance Needed

• Do you need help with Literacy, Numeracy or Language?

  Yes

  No

• Are you a person with disability, impairment or long term condition?

  Yes

  No

• If Yes, then please indicate the areas of disability, impairment or long term condition? (you may indicate more than one area)

  Select 11 Hearing / Deaf 12 Physical 13 Intellectual 14 Learning 15 Mental Illness 16 Acquired brain impairment 17 Vision 18 Medical Condition 19 Other

  • 11 Hearing / Deaf
  • 12 Physical
  • 13 Intellectual
  • 14 Learning
  • 15 Mental Illness
  • 16 Acquired brain impairment
  • 17 Vision
  • 18 Medical Condition
  • 19 Other

• If other please specify

Previous Qualifications achieved

• Have you SUCCESSFULLY COMPLETED any Australian Qualifications?

  Yes

  No

• If YES please select the level of your qualification (you may tick more than one box)

  Select 008 Bachelor Degree or higher 410 Advanced Diploma or Associate Degree 420 Diploma or Associate Diploma 511 Certificate IV or Advanced Certificate/Technician 514 Certificate III or Trade Certificate 521 Certificate II 524 Certificate I 990 Certificates other than those above

  • 008 Bachelor Degree or higher
  • 410 Advanced Diploma or Associate Degree
  • 420 Diploma or Associate Diploma
  • 511 Certificate IV or Advanced Certificate/Technician
  • 514 Certificate III or Trade Certificate
  • 521 Certificate II
  • 524 Certificate I
  • 990 Certificates other than those above

• Name of your highest successfully completed Australian Qualification

Marketing Source

• How did you hear about this course? (tick one box only)

  Select 01 Web site 02 Careers officer/school 03 VTAC/UAC 04 Course guide 05 Open day 06 Newspaper 07 Radio 08 Television 09 Workplace 10 Direct mail 11 Careers expo 12 Information session 13 School visit 14 Yellow pages 15 International agent 16 Other

  • 01 Web site
  • 02 Careers officer/school
  • 03 VTAC/UAC
  • 04 Course guide
  • 05 Open day
  • 06 Newspaper
  • 07 Radio
  • 08 Television
  • 09 Workplace
  • 10 Direct mail
  • 11 Careers expo
  • 12 Information session
  • 13 School visit
  • 14 Yellow pages
  • 15 International agent
  • 16 Other

• Please send information to me about other TAFE courses relevant to the one I am studying

  Yes

  No

• If YES, preferred method of receiving information?

  Select Email Mail Phone Mobile SMS

  • Email
  • Mail
  • Phone
  • Mobile SMS

Employment

• Of the following categories, which BEST describes your current employment status (tick one box only)

  Select 01 Full time employee 02 Part time employee 03 Sel employed, not employing others 04 Employer 05 Employed, unpaid worker in family business 06 Unemployed, seeking full time work 07 Unemployed, seeking part time work 08 Not employed, not seeking employment

  • 01 Full time employee
  • 02 Part time employee
  • 03 Sel employed, not employing others
  • 04 Employer
  • 05 Employed, unpaid worker in family business
  • 06 Unemployed, seeking full time work
  • 07 Unemployed, seeking part time work
  • 08 Not employed, not seeking employment

Sponsor Details

• Sponsor Name

• contact person

• Property name

• No. & street

• Town/suburb

• Post code

• I hereby consent to Wodonga TAFE providing my sponsor(s) with result information, and/or copies of Certificates and/or Statements of Attainment (if requested)

• Signature

  Sign

• Select date

  Date

Schooling

• Have you attended any Victorian school since 2009 or done any training with a vocational education and training (VET) registered training organisation and/or Adult and Community Education provider in Victoria since 2011?

  Select 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 Yes - I have participated in training at a TAFE or other training organisation since the beginning of 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
  • Yes - I have participated in training at a TAFE or other training organisation since the beginning of 2011.

• If Yes above, enter the name of the most recent Victorian school attended

• If Yes above, list the most recent training organisation with which you have participated in training in Victoria since 2011. (List up to 3 training organisations(

• Enter your Victorian Student Number (VSN)

• Are you still attending secondary school?

  Yes

  No

• What is your highest COMPLETED school level? (tick one box only)

  Select 12 Completed year 12 11 Completed year 11 10 Completed year 10 09 Completed year 9 08 Completed year 8 02 Did not go to school

  • 12 Completed year 12
  • 11 Completed year 11
  • 10 Completed year 10
  • 09 Completed year 9
  • 08 Completed year 8
  • 02 Did not go to school

• In which year did you complete that school level?

Study Reason

• Of the following categories, which BEST describes your main reason for undertaking this course/traineeship/apprenticeship? (tick one box only)

  Select 01 Find a job 02 Develop my existing business 03 Start my own business 04 Start a different career 05 Find a better job or promotion 06 Requirement of my job 07 Need extra skills for my job 08 Enter a different course of study 11 other reasons 12 Personal interest or self development

  • 01 Find a job
  • 02 Develop my existing business
  • 03 Start my own business
  • 04 Start a different career
  • 05 Find a better job or promotion
  • 06 Requirement of my job
  • 07 Need extra skills for my job
  • 08 Enter a different course of study
  • 11 other reasons
  • 12 Personal interest or self development

For Diploma and Advanced Diploma only

• Which one of the following best describes your highest level of educational achievement? (tick one)

  Select 02 Completed higher education postgraduate level course 03 Completed higher education bachelor level course 04 Completed higher education sub-degree level course 05 Incomplete higher education course 07 Completed final year of secondary education course (Yr 12) either at school or RTO 08 Other qualification 09 No prior educational attainment 10 Completed VET award course 11 Incomplete Vocational Education & Training award course

  • 02 Completed higher education postgraduate level course
  • 03 Completed higher education bachelor level course
  • 04 Completed higher education sub-degree level course
  • 05 Incomplete higher education course
  • 07 Completed final year of secondary education course (Yr 12) either at school or RTO
  • 08 Other qualification
  • 09 No prior educational attainment
  • 10 Completed VET award course
  • 11 Incomplete Vocational Education & Training award course

• In which year did you attain the education level selected above

• What was the post code of your residential address at the time if you completed year 12?

• Q1. Are you applying to use Vet Fee Help to assist with your tuition fees?

  Yes (go to Q2)

  No (go to declaration)

• Q2. Will you be residing in Australia for the duration of this course?

  Yes (go to Q3)

  No (if No, you are not eligible for Vet Fee Help - go to declaration)

• Q3. Do you have, or have you applied for, a tax file number?

  Yes

  No

Privacy Statement and Declaration

• I understand that Wodonga Institute of TAFE is required to provide the Victorian Government, through the Department, with student and training activity data which may include information that I provide in this enrolment form. Information is required to be provided in accordance with the Victorian VET Student Statistical Collection Guidelines (which are available at http://www.skills.vic.gov.au/pages/skills_corporate/providers/data-collection/default.aspx). The Department may use
  the information provided to it for planning, administration, policy development, program evaluation, resource allocation, reporting and/or research activities. For these and other lawful purposes, the Department may also disclose information to its consultants, advisors, other government agencies, professional bodies, and/or other organisations.
  The Education and Training Reform Act 2006 requires Wodonga Institute of TAFE to collect and disclose any personal information for a number of purposes including the allocation to me of a Victorian Student Number and updating my personal information on the Victorian Student Register. Wodonga Institute of TAFE is also obliged to provide information when requested to other government agencies, including Centrelink.
  
  For students eligible for VET Fee Help, the following privacy statement also applies:
  
  Wodonga Institute of TAFE is collecting the information in this form for the purpose of assessing my entitlement to Commonwealth assistance under the Higher Education Support Act 2003 and allocation of a Commonwealth Higher Education Student Support Number (CHESSN) to me. Wodonga Institute of TAFE will disclose this information to the Department of Education, Employment and Workplace Relations (DEEWR) for those purposes. DEEWR will store the information securely in the Higher Education Information Management System. DEEWR may disclose the information to the
  Australian Taxation Office. Wodonga Institute of TAFE and DEEWR will not otherwise disclose the information without my consent unless required or authorised by law.
  
  

• I acknowledge and agree to the terms described in this privacystatement.For more information in relation to how student information may be used or disclosed contact Wodonga TAFE’s Privacy Officer, on
  (02) 6055 6600 or email privacyofficer@wodongatafe.edu.au or by writing to The Privacy Officer, Wodonga Institute of TAFE, PO Box 963,
  Wodonga Vic 3689.
  • I agree to be bound by all Wodonga Institute of TAFE rules and regulations and to abide by the Wodonga TAFE Student Charter.
  • I agree to pay all fees and charges applicable to, and arising from, this enrolment (please refer to Fees, Charges and refund Flyer).
  • While Wodonga TAFE will endeavour to run all courses and classes as promoted, I acknowledge the right of the Institute to _
  cancel or amalgamate classes if necessary.
  • I authorise Wodonga Institute of TAFE, or its agent, in the event_of illness or accident during any Institute-organised activity, and where next of kin cannot be contacted within reasonable time, to seek ambulance, medical or surgical treatment at my cost.
  • I also authorise Wodonga Institute of TAFE to release information to state and commonwealth government departments, and/or apprenticeship authorities (if requested).
  • I acknowledge that providing any false information and/or failing to disclose any information relevant to my application for
  enrolment and/or failure to complete an application/enrolment form may result in the withdrawal of any offer, particularly as it
  relates to my eligibility to obtain an offer for government subsided training, and/or cancellation of enrolment at the discretion of Wodonga Institute of TAFE.
  • I understand that it is my responsibility to provide all relevant and required documentation.
  • I authorise Wodonga Institute of TAFE to check all available records to confirm that information provided is correct, particularly information pertaining to my eligibility for the Victorian Training Guarantee.
  • I confirm that the details provided on this form are true and correct to the best of my knowledge.
  

• I also declare:

• a. I have commenced or I am scheduled to commence government subsidised course/s at any RTO in Victoria in this calendar year. Course titles / codes (if applicable)

• b. I am currently undertaking government subsidised course/s at any RTO in Victoria. Course titles / codes (if applicable)

• Client signature

  Sign

• Date

  Date

Credit Card Payment

• Card Type

• Master Card

• Visa

• Card Number:

• Verification code (last three digits on signature panel)

• Expiry Date

  Date

• Signature

  Sign