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1 1. Personal Details Title: Mr Mrs Ms Miss Other: Gender: Male Female First Name: Middle Name: Family Name: Date of Birth (DD/MM/YY): - - Home Address Flat/Unit Details: Street or Lot Number (e.g. 205 or Lot 118) : Street Name: Suburb, Locality or Town: State/Territory: postcode: Postal Address (Mark As Above if same as home address) Building/Property Name: Flat/Unit Details: Street or Lot Number (e.g. 205 or Lot 118) : Street Name: Suburb, Locality or Town: State/Territory: Contact Details Home Phone: Mobile: Emergency Contact Details Emergency/Next of Kin Name: Relationship: Work Phone: Day & time: phone: postcode: 2. Citizenship, Ethnicity and Language Are you of Aboriginal or Torres Strait Islander origin? (tick both if applicable) Aboriginal Torres Strait Islander Neither Were you born in Australia? Town: If No, what is your country of birth? Town: Year of arrival in Australia: Nationality: Are you an Australian Citizen? Do you hold a Permanent Humanitarian Visa? Do you speak a language other than English at home? If Yes state the primary language spoken at home: How well do you speak English? Very well Well Not well Not at all 3. Enrolment Details Please choose the course/s you are applying for to study at RGIT Australia. Diploma of Business (BSB502015) Advanced Diploma of Business (BSB60207) Diploma of Information Technology Networking (ICA50411) Diploma of Software Development (ICA50711) Diploma of Management (BSB51107) Diploma of Hospitality (SIT50313) Diploma of Community Services Work (CHC50612) Commencing Intake: Course Provider Name: (if not RGIT) Campus Location: Melbourne Hobart Cairns Brisbane Sydney Toowoomba Adelaide Mode of Delivery: On Campus Blended Are you: A full-fee paying student studying a Diploma, Advanced Diploma at an approved VET FEE-HELP Provider OR A student subsidised by a state government studying a Diploma or Advanced Diploma course. Do you have, or have you had, a FEE-HELP debt (including VET FEE-HELP)? If Yes, do you have a FEE-HELP balance greater than zero? Form: Vet fee-help Enrolment Form Version: 3.2 Last Reviewed: November 2015 Page 1 of 6

2 4. Unique Student Identifier (USI) Number Do you have a Unique Student Identifier (USI) number? If Yes, please provide here If No, I will create myself (please visit 5. Education Details Are you still attending Secondary School? Please state your highest COMPLETED school level: Name of School: Student Number: Year completed: State / Country: If in Victoria, Do you have a Victorian Student Number? Enter your VSN Number: No I have not attended a Victorian school since 2009 or a TAFE or other VET training provider since 2011 Yes I have attended a Victorian School since 2009: Most recent school attended: And/or Yes I have participated in training at a TAFE or other training organisation since the beginning of 2011 (List up to 3 training organisations) What is your highest level of education PARTICIPATED? Please tick ANY applicable boxes. (Where A Australian, E Australian equivalent I International) A E I - Cert I A E I - Cert II A E I - Cert III (or Trade Certificate) A E I - Cert IV (or Advanced Certificate/Technician) A E I - Advanced diploma or associate degree A E I - Diploma (or associate diploma) A E I - Postgraduate A E I - Bachelor A E I - Higher Education sub-degree course A E I - Other qualification, please specify: Have you completed the above level of education? Year of attendance/completion: Attended Higher Education Provider: 6. Credit Transfer and Recognition of Learning (RPL) Are you applying for Credit Transfer or RPL for the units successfully completed at another provider? If Yes, please complete Credit Transfer or RPL application form and submit it to the Student Administration with supporting documents such as official transcript or statement of attainment. 7. Employment Details Do you have valid Tax File Number (TFN)? Yes Which of the following best describes you? Full-Time Employee Part-Time Employee Self-Employed - not employing others Employer Unemployed - seeking full-time work Unemployed - seeking part-time work Not Employed - not seeking work Employed - unpaid worker in a family business No Do you have an employment history? If Yes, please state below: Industry of Employment: A - Agriculture, Forestry and Fishing B - Mining C - Manufacturing D - Electricity, Gas, Water and Waste Services E - Construction F - Wholesale Trade G - Retail Trade H - Accommodation and Food Services I - Transport, Postal and Warehousing J - Information Media and telecommunications K - Financial and Insurance Services L - Rental, Hiring and real Estate Services M - Professional, Scientific and Technical Services N - Administrative and Support Services O - Public Administration and Safety Form: Vet fee-help Enrolment Form Version: 3.2 Last Reviewed: November 2015 Page 2 of 6

3 P - Education and Training Q - Health Care and Social Assistance R - Arts and recreation Services S - Other Services, please specify: Name of the Employer : Occupation: 1- Manager 2 - Professionals 3 - Technicians and Trades Workers 4 - Community and personal Service Workers 5 - Clerical and Administrative Workers 6 - Sales Workers 7 - Machinery Operators and Drivers 8 - Labourers 9 - Other, please specify: Duration of Employment : Duties i. ii. iii. 9. Reason for Course Of the following categories, which BEST describes your main reason for undertaking this course/traineeship/apprenticeship? (Tick ONE box only) To get a job It was a requirement of my job To develop my existing business I want additional skills for my job To start my own business To get into another course of study To try for a different career For personal interest or self development To get a better job or promotion Other reasons: How did you hear about us? Advertising Online Student referral Friend Recruitment Agent Other, please specify: 8. Payment Options I am choosing the following payment option: VET FEE-HELP (Full) VET FEE-HELP (Partial) Full Fee I will be paying Full/Partial fee in Cash EFTPOS Credit Card Agent Details If the applicant was referred by a Recruitment Agent, the below details are to be completed by the Agent. Name of the Recruitment Agent: Name of the Recruitment Firm the agent is representing: Signature of the Agent Date (dd/mm/yyyy) Form: Vet fee-help Enrolment Form Version: 3.2 Last Reviewed: November 2015 Page 3 of 6

4 evidence of Entry Requirements To enrol into RGIT Australia s Diploma courses, applicants will need to meet the entry requirements and provide supporting evidence. Please R the appropriate box below. Age over 18; and Successfully completed the equivalent of Australian Year 12 or Certificate IV or higher; or I have not completed Year 12 or Certificate IV or higher, I will demonstrate through an enrolment interview, either in person or by phone that I have the skills and ability to succeed in the chosen course. I am an Australian citizen or hold a permanent humanitarian visa. Additional Entry Requirement for all Advanced Diploma Courses Successfully completed a diploma course or higher Computer Skills Checklist: Please tick (P) the appropriate box. Basic Computer Operations I can: Competent Need Further Training No Experience Start up or shut down a computer and related equipment (printer, scanner, etc.) Initialise disks, drives and other media Switch Wi-Fi on/off Folder Management Create, delete, copy, rename a folder Save documents in a folder Word Processing (Microsoft Word) Enter and edit text and use the following function: clipboard, cut, copy, paste, delete, and insert Change text format and styles, margin, line spacing, tabs, etc Create a header or a footer Insert date, time, and page number Insert and edit a table Add clip art and other graphic images to the document Internet Understand the general structure of a web address Access and use resources on the Internet and World Wide Web using a web browser Download information from the internet Copy or save images from a web page Comply with copyright and educational fair use policies for using any images or content you save Create new account Use compose, send, retrieve, read, reply to, forward, save, print, and delete messages Upload a text file (e.g. resume) and send as an attachment Form: Vet fee-help Enrolment Form Version: 3.2 Last Reviewed: November 2015 Page 4 of 6

5 Student Training Needs Survey : Questionnaire Thank you for your interest in enrolling into our VET FEE-HELP approved course. We are committed to providing quality education and training to our students in the most effective and professional way possible. Every individual has different learning styles. As a provider we endeavour and cater to different learning needs. This survey helps us to identify ways in which learning can be made easier and more enjoyable for you and ensure you have opportunities to learn in the way that suits you best. Please select by ticking as many relevant reasons that are applicable to you. If you have any clarification queries, please do not hesitate to talk to our staff. 1. Do you have any disabilities, impairments, long-term medical conditions or any other special needs that may make it difficult for you to succeed in the course? Yes (please indicate below) No Hearing Vision Physical Mobility Medical Learning Intellectual Mental illness Acquired brain impairment Other, please specify: If you answered Yes, would you like to discuss about receiving support services, equipment and facilities which may assist you? 2. Which learning environment do you prefer? Practical / Hands-on learning Theory / Classroom Both 3. What could be included to make your learning environment the best it can be for you? (E.g. starting with a particular class each morning with a class activity) 4. What aspects of the training environment could make you uncomfortable? (E.g. presenting in front of the class or being singled out to answer questions.) Provider Declaration Gurkhas Institute of Technology Pty Ltd trading as RGIT Australia and/or its Training Representative collects the information in this form for the purpose of assessing student eligibility for the Higher Education Loan Program (HELP) under the Higher Education Support Act RGIT students personal information will be collected by fair and lawful means which is necessary for the purpose of enrolment and function of RGIT. RGIT is committed to ensuring the confidentiality and security of the information provided. This policy is issued in accordance with the Higher Education Support Act 2003 (HESA) and the Privacy Act (1988). Form: Vet fee-help Enrolment Form Version: 3.2 Last Reviewed: November 2015 Page 5 of 6

6 Student Declaration (please read carefully) I, the applicant, acknowledge and agree to the terms of RGIT Australia s VFH Privacy Policy. I certify that the information supplied by me in all parts of this form is complete and true. I declare that the information I have provided, including evidence to confirm my date of birth, is true and accurate. I declare that, the contact details; , phone number and address provided by me in this application are valid and can be used for all correspondences during my course duration with the institute. Any changes to the above will be informed in writing to RGIT. I declare that, to the best of my knowledge and after consultation with RGIT Australia and/or its Training Representative, I meet the VET FEE-HELP entitlement/eligibility criteria. I understand that RGIT Australia may refuse, vary, reverse or terminate my enrolment on the basis of untrue, misleading or incomplete information. I have been made aware of and advised about RGIT Australia s Policies and Procedures which are available on the website and I agree to be bound by them. I am aware of RGIT Australia s VET FEE-HELP student handbook available online I agree to abide by RGIT s rules and regulations and Institute policies and acknowledge that facilities made available for my use will be used only in accordance with the principles of proper use and relevant rules. I give permission for the information contained in this enrolment form to be released to the Department of Education for use in the Higher Education Information Management System. If under work placement, I, the applicant, give permission for the trainer/college representative to discuss my training program, development and evidences with my employer, other trainers or supervisors. A monthly session report will be reviewed by my designated supervisor. I declare that I have viewed a copy of RGIT Australia s Schedule of VET Tuition Fees and understand the costs associated with, and duration of, my course/s. I understand that if I choose to change my mode of study I will need to meet the entry requirements specific to that mode of study and this request will be accommodated prior to crossing census for that Unit of Study. I understand that I am required to give written, SMS or phonecall notice of my non-attendance at class, and if applicable written notice of my intention to withdraw from my course at RGIT Australia and/or its Training Representative. I understand that, if my course is in the community service sector, I must complete a Police Check and/or Working with Children s Check (dependent on the course in which I am enrolled) in order to undertake work placement as part of my training. I understand that it is my responsibility to ensure that my workload and choice of study complies with Youth Allowance/ Austudy/Abstudy, if I am applying for any of these payments. I understand and acknowledge that RGIT Australia will provide all reasonable care while students are on an excursion. I discharge RGIT Australia from responsibility and liability for personal injury and loss or damage of property during excursions. I authorise RGIT Australia or its representative to obtain medical treatment for me in the event of an emergency on campus. I indemnify RGIT Australia or its representative against any expense, loss or liability as a result of obtaining emergency medical treatment. MEDIA CONSENT From time to time, RGIT staff may request to take photographs/ videos or verbal/written interviews/testimonials of students at RGIT or at places where the student is involved in an activity. These creations may be used in a classroom or on-the-job work activities or could be published by RGIT in print, digital or broadcast media such as documents, student magazine, website, RGIT TV, newsletters, displays, journals, professional development materials for trainers and marketing collateral. Staff may also at times request students provide any of the above of the students own creation for the same purposes. I do not consent to RGIT Australia using any of the above materials involving me for the purposes outlined above. Student Name Student Signature Date (dd/mm/yyyy) If under 18 years of age at time of application, signature of a parent or guardian is required. Parent/Guardian Name Parent/Guardian Signature Date (dd/mm/yyyy) This includes consent for the student to have access to the internet on campus. Office Use Only: Assessed by : Date : Entered into : RTO LMS Student Ref. : Form: Vet fee-help Enrolment Form Version: 3.2 Last Reviewed: November 2015 Page 6 of 6

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