Electrical Group Training Ltd. Apprenticeship Application

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1 Electrical Group Training Ltd Apprenticeship Application Unit 14, 199 Balcatta Road BALCATTA WA 6021 PO Box 782 BALCATTA WA Fax: (08) Phone: (08) EGT Apprenticeship Application_GME Rev 13.docx Reviewed December /9

2 Personal Details Given Name/s: Preferred Name: Gender (circle relevant): Home Address: State/Territory: Home Phone: Surname: Date of Birth: FEMALE / MALE Suburb: Postcode: Mobile Phone: Is your postal address the same as your home address? (circle relevant) If NO, please write your postal address below: Postal Address: State/Territory: Suburb: Postcode: Citizenship/Permanent Resident (circle relevant) Are you an Australian Citizen/Permanent Resident? Are you a New Zealand Passport holder who has been in Australia for 6 months or more? Do you hold a Visa? If YES, Visa Document Number: Are you of Aboriginal or Torres Strait Islander Origin? / BOTH In which country were you born? Australia Other - Please Specify: Licences & Permits (circle relevant) Applicants will be required to travel to various worksites. A current driver s licence and own transport is highly desirable. Applicants without a driver s licence, transport, EWP or WSAH will still be considered. Own Transport? Mode of Transport: Current Driver s Licence? Driver s Licence Class: Elevated Work Platform (EWP)? Date Issued: / /20 Working Safely at Heights (WSAH)? Date Issued: / /20 EGT Apprenticeship Application_GME Rev 13.docx Reviewed December /9

3 Information (circle relevant) How did you find out about EGT Apprenticeships? Website Family/Friend School Expo Newspaper Other (please specify): Why do you want an Electrical Apprenticeship with EGT? Do you have a Unique Student Identifier (USI) Number? If Yes, Unique Student Identifier Number: If No, Applicant is required to obtain a USI prior to submitting this application. Please visit the USI Registry System Pre-Apprenticeship (circle relevant) Applicant is required to provide copy of their Academic Statement & Certificate submitted by the Registered Training Organisation (RTO). Have you completed OR are you attending a Certificate II in Electrotechnology? CET / TAFE WA / RTO attended: Completion Date OR Due to Complete date? / /20 Currently or Previously Registered as an Electrical Apprentice Applicant is required to provide documentation from their State Government - Extract of Apprenticeship (if applicable). If currently or previously registered in Western Australia, please contact the Department of Training and Workforce Development Apprenticeship Office on Currently Registered Are you currently registered as an Electrical Apprentice? If YES, what year apprentice are you currently? 1 st 2 nd 3 rd 4 th Are you currently undertaking study in Certificate III in Electrotechnology? If YES, which CET / TAFE WA / RTO are you attending? Previously Registered Were you previously registered as an Electrical Apprentice? If YES, what year in your apprenticeship were you at that time? 1 st 2 nd 3 rd 4 th EGT Apprenticeship Application_GME Rev 13.docx Reviewed December /9

4 Education - Secondary Studies (circle relevant) Applicant is required to provide Statement of Results for their highest completed year level. Are you still attending high school? High school attending/attended: What is your CURRENT year level? Year 10 Year 11 Year 12 What is your highest COMPLETED year level? Year 10 Year 11 Year 12 What year did you complete that level? If you have completed Year 12, you are required to attach a copy of your Statement of Results & Certificate issued from the School Curriculum and Standards Authority. Prior Training & Qualifications (Including Pre-Vocational Training / Certificates / Diplomas etc relevant to the electrical trade) Applicant is required to provide a copy of Academic Statement/s and Certificate/s that they list on this application. Course Title and Certificate Level: Training Institute: Commencement Date: / / Completion Date: / / Course Title and Certificate Level: Training Institute: Commencement Date: / / Completion Date: / / Course Title and Certificate Level: Training Institute: Commencement Date: / / Completion Date: / / Pre-Arranged Placement with an Electrical Contractor (circle relevant) Do you know an Electrical Contractor that is interested in hosting you through EGT? Contact Name: Contact Number (Business Hours): Electrical Contractors Number: EC Current Employment Address: Position Held: Date Commenced: / / Description of Duties: EGT Apprenticeship Application_GME Rev 13.docx Reviewed December /9

5 Previous Employment Position Held: Reason for Leaving: Address: Period Employed: Description of Duties: Relevant Work Experience (With a Licenced Electrical Contractor or Work on a Construction Site) Ensure to submit a Letter of Reference from your work experience company (explaining what type of work you were doing and how well you went etc). Supervisor: Address: Phone: Commencement Date: / /20 Completion Date: / /20 Total Number of Days: Description of Duties: Other Work Experience Supervisor: Address: Phone: Commencement Date: / /20 Completion Date: / /20 Total Number of Days: Description of Duties: Drugs and Alcohol To maintain the safety of apprentices and other people in the workplace, EGT will request a drug and alcohol screen prior to commencement of employment and at any time during your apprenticeship. This is in accordance with EGT s Drug and Alcohol Policy. Do you consent to participate in, or provide a drug and alcohol screen YES NO when requested by EGT? Please note that applicants who do not consent to, or do not pass a Drug and Alcohol screen will not be considered for an apprenticeship position. EGT Apprenticeship Application_GME Rev 13.docx Reviewed December /9

6 National Police Certificate (must have been obtained within the last 3 months) Many apprentices may work on jobs that involve working in people s homes or working on projects which require a National Police Certificate. Do you have any CURRENT charges? YES NO Do you have any PENDING charges against your name to disclose? YES NO If YES, please list details: Construction Induction Training (White Card) Main contractors, employers and people in control of construction work have the obligation to ensure that workers don t undertake construction work without completing the training. Employees and self-employed people should ensure that they complete the training. If you are offered a position with EGT, it is mandatory that you have completed the Construction Induction Training. Have you completed Construction Induction Training? YES NO If YES, please provide the following details: Card Number: Date Issued: / /20 Energise Oz - National Readiness Assessment Applicant is required to sit the National Readiness Assessment if they have not successfully completed a Certificate II in Electrotechnology. Have you completed the National Readiness Assessment? YES NO If YES, please attach the National Readiness Assessment Certificate to your application. If NO, book your National Readiness Assessment (NRA) on line at Once completed, please attach the National Readiness Assessment Certificate to your application. Note: A fee will be applicable for the Readiness Assessment, which will need to be paid on the day of your scheduled Assessment. Please contact College of Electrical Training for charges. Colour Vision Testing - Ishihara Test Applicant is required to provide evidence that they have undergone colour vision testing (Ishihara Test) at any optometrist or doctor. The cost of the Ishihara Test is to be paid by the applicant. EGT Apprenticeship Application_GME Rev 13.docx Reviewed December /9

7 Medical History & Disclosure EGT maintains a duty of care to ensure apprentices meet their Occupational Safety and Health obligations and can undertake the obligations and duties involved in the trade in a safe and healthy manner at all times. Answering YES to any of the following will not necessarily preclude you from a position but may require you to attend a fitness test to ensure you are able to undertake the physical work required in the electrical industry. An apprenticeship involves physical duties including: - Repetitive bending - Working in confined spaces - Heavy lifting - Working with hazardous chemicals - Standing for long periods of time - Working with hand and electrical power tools - Working at heights - A high degree of manual and physical dexterity Do you have a disability, injury or physical ailment that may prevent or influence your ability to undertake these types of duties? YES NO If YES, please provide details: Have you ever had a Worker s Compensation Claim? YES NO If YES, please provide details of the nature of the claim (i.e. date, injury etc.): Do you suffer from any of the following? YES NO - Back injury - Shoulder injury - Knee injury - Neck injury - Other (please specify): Have you ever suffered a sporting injury? YES NO If YES, please provide details (i.e. date, injury etc.): Have you ever been involved in a car accident? YES NO If YES, please provide details: Do you currently or have you ever suffered from any of the following? YES NO - Epilepsy - Skin conditions - Diabetes - Anxiety/Depression - Asthma - Allergies: Do you have any ongoing physical or psychological condition that requires regular visits to the doctor? YES NO If YES, please provide details: Are you taking any form of medication? If YES, please provide details: YES NO EGT Apprenticeship Application_GME Rev 13.docx Reviewed December /9

8 Parent/Legal Guardian Contact Details (required if applicant is under the age of 18 years) Relationship to Applicant: Name: Phone: Important Information Leaving school BEFORE the end of Year 10 A parent/legal guardian of a student who seeks an exemption must make application through the school to the Department of Education Services. The main grounds for granting an exemption are for the student to commence full-time employment, a traineeship or an apprenticeship. For more information please contact the Department of Education Services on (08) Leaving school DURING Years 11 and 12 (including leaving at the end of a fully completed Year 10) A parent/legal guardian is required to complete and submit the Notice of Arrangements form on behalf of their child direct to the Department of Education. For more information please contact the Department of Education on (08) Electrical Group Training Ltd - Privacy Policy Electrical Group Training Ltd maintains all personal information in accordance with its Privacy Policy and the Australian Privacy Principles in the Privacy Act 1988, which regulates how Electrical Group Training Ltd collects, uses and keeps secure your personal information. Electrical Group Training Ltd s Privacy Policy is available on request. We have collected your information in order to assess your application for a position with Electrical Group Training Ltd. If you are unsuccessful your information will be disposed of. We may disclose your personal information relating to your application and apprenticeship to a third party (i.e. Government Agencies). You may access personal information we hold about you, subject to Australian Privacy Principle 12 of the Privacy Act If you provide us with the personal information of others, you must inform them that you are disclosing that information to us and why, and the relevant matter in this notice. Declaration I confirm that the information given in this form is true and correct. I am aware that by signing this application, I am agreeing to comply with Electrical Group Training Ltd s requirements to participate in a medical screen by a doctor of Electrical Group Training Ltd s choice if required, and that I am required to disclose any medical information that may influence my ability to meet the requirements of an apprenticeship position. I consent to Electrical Group Training Ltd contacting my referees and using, disclosing and storing the information obtained from me, my referees and this application, to assess my suitability for employment with Electrical Group Training Ltd and related purposes. Applicant s Signature: Date: / /201 Applicant s Parent/Legal Guardian: (required if applicant is under the age of 18 years) Date: / /201 Electrical Group Training Ltd - Contact Details Street Address: Unit 14, 199 Balcatta Road BALCATTA WA 6021 Postal: PO Box 782 BALCATTA WA 6914 Phone: (08) Fax: (08) Website: EGT Apprenticeship Application_GME Rev 13.docx Reviewed December /9

9 Documents to be attached to your application YOUR APPLICATION WILL NOT BE CONSIDERED IF YOU HAVE NOT PROVIDED COPIES OF ALL DOCUMENTS LISTED BELOW - IF APPLICABLE. APPLICANT S CHECKLIST COPIES ATTACHED Australian Citizenship/Permanent Resident (one of the following must be provided in colour) Australian Citizen Documentation (Birth Certificate, Passport or Australian Citizenship Certificate) New Zealand Passport Visa Documents (Showing approval as Permanent Resident) Licences & Permits (if applicable, copies to be in colour front and back) Drivers Licence/Learners Permit Elevated Work Platform (EWP) Working Safely at Heights (WSAH) Pre-Apprenticeship - Certificate II in Electrotechnology (if applicable) Academic Statements Certificate OFFICE USE ONLY ( / N/A) Currently or Previously Registered as an Electrical Apprentice - Certificate III in Electrotechnology (if applicable) Extract of Apprenticeship (from Government Agency) Current Academic Statement Current Timetable Education - Academic Statements (at least the highest level completed - academic statement to be provided) Year 10 Year 11 Year 12 Notice of Arrangement (if applicable) Leaving school before the end of Year 10 Leaving school during Years 11 & 12 (including leaving at the end of a fully completed Year 10) Statement of Results & Certificate from the School Curriculum and Standards Authority (applicable if completed Year 12) Unique Student Identifier (USI) (must be provided with application) Prior Training & Qualifications Academic Statements & Certificates Letter of Reference - Work Experience National Police Certificate (must be provided in colour) Construction Induction Training (White Card - if applicable copies to be in colour front & back) Energise Oz - National Readiness Assessment (required if applicant has not successfully completed a Certificate II in Electrotechnology) Certificate of Results Colour Vision Certificate (must be provided) OFFICE USE ONLY Pre-Arranged Placement with EGT Host Employer: / N/A SHA Duration: months Other Details: EGT Host Employer: EGT Apprenticeship Application_GME Rev 13.docx Reviewed December /9

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