National Recognition RPL Application Form

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1 Application Process Prior to completing and submitting this application you should meet with your trainer / assessor to familiarise yourself with the process moving forward and to also get a better understanding of your chances of your application being successful. You should discuss in detail with your trainer / assessor all of the relevant documentation and instructions contained within the Recognition / RPL Kit. The trainer / assessor will provide valuable guidance and examples of the documentation you will require to submit as evidence. Student Details Name: Residential Address: State: Mobile Phone No: Post Code: Home Phone No: Address: Course Details: Qualification Code: Qualification Title: I am applying for: (tick one option) National Recognition (no fees applicable) Recognition of Prior Learning (RPL) (fees are applicable) List the Qualification or Units of Competency for which you are seeking recognition Please Note: QTHC charges a fee to assess students for RPL and this is dependent on the selected units of competency. The RPL fee will be advised upon receipt of your application and must be paid before your application will be processed. Qualification / Unit Code Qualification / Unit Title Version: 1.0 Approved Page 1 of 5

2 List the Qualification or Units of Competency for which you are seeking recognition Please Note: QTHC charges a fee to assess students for RPL and this is dependent on the selected units of competency. The RPL fee will be advised upon receipt of your application and must be paid before your application will be processed. Qualification / Unit Code Qualification / Unit Title Important Information National Recognition the trainer / assessor will review your application and the notated copies of certificates, statement of attainments & academic transcripts submitted. The evidence will be validated and authenticated by the trainer / assessor in order for National Recognition to be granted. RPL - the trainer / assessor will review your application and evidence submitted. A judgement will be made as to your competency. The evidence you supply must match the course learner outcomes and fully satisfy the assessor that you genuinely have the skills and knowledge you are presenting for recognition. If your application for recognition is assessed as unfavourable, you will have the opportunity to appeal the decision as per QTHC s Complaints and Appeals Policy. Employment Details Employer: Address: State: Contact Name: Business Phone No: Post Code: Position: Mobile Phone No: Address: Version: 1.0 Approved Page 2 of 5

3 List the relevant Certificates, Statement of Attainments & Academic Transcripts you are submitting as evidence Qualification / Course Code Qualification / Course Title Organisation (TAFE / University / Company / Private Provider) Qualification / Course Duration (hours / weeks / years) Date Issued List the relevant Units of Competency / Subjects you are submitting as evidence Unit / Subject Code Unit / Subject Title Unit / Subject Description & Key Areas Covered Version: 1.0 Approved Page 3 of 5

4 List the relevant Units of Competency / Subjects you are submitting as evidence Unit / Subject Code Unit / Subject Title Unit / Subject Description & Key Areas Covered List details of your Employment History Name of Company Position and Duties Performed Employment Duration (dates from until & full time or part time) Version: 1.0 Approved Page 4 of 5

5 List the Supporting and Additional Evidence you are submitting Evidence / Supporting Documents Attached Detailed Resume / Curriculum Vitae Third Party Report Work Experience Examples Personal / Life Experiences Volunteer Work Verbal Assessment (carried out with the trainer / assessor) Observation / Demonstration Documentation (carried out with the trainer / assessor) Other Please Tick Applicant s Declaration I have read and understood all details regarding the National Recognition Policy RPL Application. I hereby declare that all details and documents that I am submitting are true and accurate and are notated copies of my own original documents / work. Name of Participant: Participant Signature: Application Processing Details (office use only) Application Received by: Fees Calculated: (if applicable): Amount Applicant Notified Allocated to: (Trainer / Assessor) Application Outcome Application Approved Name of Trainer / Assessor: Trainer / Assessor Signature: Application Not Approved Documentation in Student File: Yes File Submitted for Data Entry: Yes Applicant Notified of Outcome: Yes Application Payment Received: Yes Version: 1.0 Approved Page 5 of 5

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