CHCPRT001 Identify and respond to children and young people at risk

Transcription

1 Enrolment Application Form CHCPRT001 Identify and respond to children and young people at risk PO Box George Street Brisbane Qld 4003 About this Application Use this Enrolment Application to apply for enrolment in CHCPRT001 Identify and respond to children and young people at risk. Before completing this application, please make sure you read and understand the program structure and requirements as outlined on our website at goodstart.edu.au. Do not complete this application if you wish to apply for Recognition of Prior Learning (RPL). To apply for RPL, please refer to the RPL application page at goodstart.edu.au. Filling out this Application This Enrolment Application contains nine sections you are required to complete: 1 About you 4 Cultural background 7 Reason for studying 2 Contact details 5 Disability 8 Terms and conditions 3 Employment details 6 Education Please complete all sections within this document as indicated. Make sure all information you supply is legible, accurate, and correct. 1 About you Please enter the following details as shown on either your Australian Driver s Licence, Passport, or Australian 18+/Over 18 Card.. Title (please select) Miss Mrs Ms Mr Dr Family Name Given Name Middle Name Gender Male Female Date of Birth / / I have attached one of the following forms of identification to confirm these details (please specify) Australian Driver s Licence Passport Australian 18+/Over 18 Card Please attach a copy of your chosen form of photo identification to confirm these details 2 Contact details Address Mobile Number Phone Number Enrolment Application CHCPRT001 Identify and respond to children and young people at risk Goodstart Institute of Early Learning 1

2 Home Address Suburb State Post Code Postal Address (if different from home address) Suburb State Post Code I wish to receive course materials via (please select): Post (printed copy) 3 Employment details Employer Name Employer Address Phone number Of the following categories, which best describes your current employment status? Full time Part time Casual Not employed (not seeking employment) Not employed (seeking employment) Are you a Goodstart Early Learning employee? Yes No If Yes, please enter your KRONOS number/employee ID: 4 Cultural background What nationality do you identify yourself as? (eg, Australian, British, etc.) In which country were you born? Which best describes your current citizenship/residency status? (please select from the following) Australian Citizen Australian Permanent Resident NZ Passport holder who has resided in Australia for 6 months or longer Other Current visa document holder (please specify) If you have specified you were not born in Australia, please provide a Justice of the Peace-certified copy of your passport and visa, residency information, or proof of citizenship along with this Enrolment Application. What is the main language you speak at home? (If more than one language, indicate the one that is spoken most often) English only Language other than English (please specify): How well do you speak English? Very well Well Not well Not at all Are you of Aboriginal and/or Torres Strait Islander origin? Aboriginal Torres Strait Islander Both Neither Enrolment Application CHCPRT001 Identify and respond to children and young people at risk Goodstart Institute of Early Learning 2

3 5 Disability Do you consider yourself to have a disability, impairment or long-term condition? Yes No If Yes, then please indicate the areas of disability, impairment or long-term condition: (select all that apply) Hearing/Deaf Physical Intellectual Learning Mental Illness Acquired Brain Impairment Vision Medical Condition Other (please specify): 6 Education What is your highest completed school level? (tick one box only) Year 12 or equivalent Year 11 or equivalent Year 10 or equivalent Year 9 or equivalent Year 8 or below Never attended school (please proceed to Previous Qualifications) In which year did you complete that school level? Are you still attending secondary school? Yes No Have you successfully completed any of the following qualifications? Yes No If Yes, tick any applicable boxes: Bachelor (or higher) Degree Diploma (or Associate Diploma) Advanced Diploma/Associate Degree Certificate IV (or Advanced Certificate/Technician) Certificate III (or Trade Certificate) Certificate II Certificate I Certificates other than the above Please provide details for your qualifications below: Qualification Gained Institution Attended Year Qualified Qualification Gained Institution Attended Year Qualified Qualification Gained Institution Attended Year Qualified Do you wish to apply for Credit Transfers? Yes No If Yes, please provide a Justice of the Peace-certified copy of a relevant qualification with this Enrolment Application Form. Enrolment Application CHCPRT001 Identify and respond to children and young people at risk Goodstart Institute of Early Learning 3

4 7 Reason for studying Of the following categories, which best describes your main reason for undertaking this course? (please tick one box only) To get a job To try for a different career To develop my existing business To get a better job or promotion To start my own business It was a requirement of my job I wanted extra skills for my job To get into another course of study Personal interest/self development Other reasons (please specify) 8 Language, Literacy and Numeracy (LLN) Good skills in reading, writing, oral language, and numeracy are necessary foundational skills required to be employed within the early learning sector, however it is not assumed that you, the learner, already possess these skills upon enrolment. It is the responsibility of all teaching and assessing staff to ensure they are considerate of individual learning needs when assessing, facilitating workshops and/or delivering content, and will adapt the learning and assessment methods to suit the individual needs of their learners. Please indicate below if you would like additional support from your Professional Learning Consultant in the following areas: Reading Writing Oral Communication Learning Numeracy I do not require additional support in any of these areas 9 Terms and conditions Enrolment into this program will be assessed on the information you have provided on this form. You will be notified by Student Services on the status of this application once your eligibility has been assessed. I acknowledge: 1. I have read the Student Guide located at goodstart.edu.au. 2. I have read the Institute s Privacy Statement located at goodstart.edu.au. 3. I have read the Notification of Collection Statement on page 6 of this enrolment application. 4. I may receive newsletters and other general communications via which I may opt out of at any time. 5. Information such as my academic progression, enrolment information, and results may be shared with government departments and/or my employer where it relates to legislative requirements. Enrolment Application CHCPRT001 Identify and respond to children and young people at risk Goodstart Institute of Early Learning 4

5 Declaration I understand the information I have supplied on this form is, to the best of my understanding and belief, complete and correct. I understand that the giving of false, incomplete, or misleading information may lead to the refusal of my application or cancellation of enrolment at any time. I give permission to obtain official records from any educational institution attended by me. I also authorise The Goodstart Institute of Early Learning to supply any relevant official records to education institutions to which I am seeking admission and to government bodies/institutions and to my employer. By signing this form I confirm that I have supplied all the relevant information required; I have read and understood the declaration above; and I accept the terms and conditions of this application. Candidate Signature Parent/guardian Signature* Date (DD/MM/YYYY) Date (DD/MM/YYYY) * if candidate is under 18 years of age Submitting this Application Once you have completed all the sections of this application, print the document, sign where applicable, and send the completed document along with any additional forms as required (eg, Employer Funded Study Assistance) to either of the addresses below: Via to Via post to info@goodstart.edu.au Goodstart Institute of Early Learning Attn: Enrolment Applications PO Box George Street Brisbane Qld 4003 If you have any question about the enrolment application process, please contact the Institute on , or info@goodstart.edu.au. Enrolment Application CHCPRT001 Identify and respond to children and young people at risk Goodstart Institute of Early Learning 5

6 ! Notification of Collection Statement This is the Notification of Collection Statement that Goodstart Early Learning Limited ABN , trading as Goodstart Institute of Early Learning (The Institute) is required to provide you with at the time of obtaining your personal information. This forms part of The Institute s Privacy Policy, available at goodstart.edu.au. Purpose The Institute collects and holds personal information about you for the purposes of delivering training and assessment services under/ in line with the VET Quality Framework for Registered Training Organisations (RTO). Sensitive Information In some circumstances The Institute may seek to collect personal information that is sensitive. This may include information such as any physical or mental illnesses or disabilities you may have, your language, and literacy and numeracy (LLN) level. We collect this information as it is reasonably necessary to enable The Institute to provide training and assessment services to cater for your individual needs and requirements. For example, you may have difficulty reading and/or writing and The Institute may need to provide additional assistance or tailored assessment methods to suit your needs. The Institute will only collect your sensitive information with your consent and will ensure that it is stored securely. If you do not wish for your sensitive information to be collected by The Institute, you should discuss this with a member of The Institute s Student Services team. The Institute s employees will act strictly in accordance with this policy and will be happy to discuss the reasons for seeking to collect your sensitive information. They will also discuss with you any consequences of not providing your sensitive information which may include an effect on the services The Institute can provide to you. Failure to Provide Information If you do not wish for your personal information to be collected you should discuss this with a Student Services team member. The Institute s employees will act strictly in accordance with The Institute s Privacy Policy and will be happy to discuss the reasons for seeking to collect your personal information. They will also discuss with you any consequences of not providing your personal information, or providing incomplete or inaccurate personal information, which may include an effect on what services The Institute can provide to you. Use and Disclosure The Institute will only use or disclose your personal information for the purpose it was collected or a reasonably expected or related secondary purpose. Personal information of students is ordinarily used or disclosed for the primary purposes of: providing training and assessment services; assessing eligibility of traineeships or apprenticeships; relevant State and Federal Government reporting of students and their academic progress were required under law; providing you with information about our organisation, and activities via letters, , sms, telephone and other organisation communication channels; and requesting information from you about our organisation via surveys. a purchaser of the assets and operations of our business or a part of it, provided those assets and operations are purchased as a going concern (i.e. the purchaser buys the whole business of Goodstart Institute of Early Learning) State and Federal Government departments, ministries, agencies, councils, or authorities where reporting of students and their academic progression and results is required by law for The Institute to continue operating as a Registered Training Organisation (RTO). The Institute will not otherwise use or disclose personal information to a third party for any other purpose without your consent unless it is authorised or required by law. Access and Correction You may request access to your personal information. Ordinarily The Institute will require you to make a request for access in writing to the Privacy Officer. The Institute s employees other than the Privacy Officer are not generally able to provide you with access. If at any time you believe The Institute s record of your personal information is incorrect, please let The Institute know. We will take reasonable steps to correct the information so that it is accurate, complete and up to date. In some circumstance which are prescribed by the Privacy Act 1998 (Cth), such as where to do so might put a person at risk of harm or have an unreasonable impact on the privacy of others, The Institute may decline access to personal information. If your request for access is denied, The Institute may tell you why. Complaints and Feedback If you wish to make a complaint about a breach of the Privacy Act, Australian Privacy Principles or a privacy code that applies to us, please contact us as set out below and we will take reasonable steps to investigate the complaint and respond to you. If you are not happy with our response, you may complain directly to the Australian Information Commissioner. If you have any queries or concerns about our privacy policy or the way we handle your personal information, please contact the Privacy Officer at: Postal Address: Address: Goodstart Institute of Early Learning, Attention: Privacy Officer, PO Box George Street, Brisbane, Qld, 4003 privacy@goodstart.edu.au Telephone: More Information For more information about privacy in general, you can visit the Australian Information Commissioner s website at oaic.gov.au. We may disclose personal information about you to: third party service providers, who assist us in operating our business (including credit reporting bodies, collection agencies, legal advisors and technology service providers). We will take all reasonable steps to ensure these service providers do not breach the Australian Privacy Principles. These providers may be based overseas or use overseas infrastructure to perform services for us, including in the USA, Singapore and New Zealand Enrolment Application CHCPRT001 Identify and respond to children and young people at risk Goodstart Institute of Early Learning 6