Enrolment and Eligibility Form - Quality Service Skills

Course Information

Program

Course Location

Personal Details

Name

Prefix First Middle Last

Sex

Date of Birth

Mobile

Home Phone

Work phone

Email

Residential Address

Street Address Address Line 2 City State Postcode Country

Is your residential address the same as your postal address?

Yes
No

Postal Address

Street Address Address Line 2 City State Postcode Country

Indigenous Status

Aboriginal and Torres Strait Islander
Aboriginal
Torres Strait Islander
Neither

Country of Birth

Australia

Australian Citizen

Yes
No

Permanent Resident

Yes
No

Humanitarian Visa Holder

Yes
No

Language spoken at home

English

How well do you speak English?

Very well
Well
Not well
Not at all

Do you consider yourself to have a disability?

Yes
No

If yes, then please indicate the area of disability, impairment or long-term condition (you may indicate more than one area)

Hearing / deaf
Mental Illness
Learning
Intellectual
Medical Condition
Vision
Physical
Acquired brain impairment
Other (specify)

Please specify the area of disability, impairment or long-term condition

Emergency Contact

Name

First Last

Relationship

Phone

Employment

Employed Full time
Employed Part time
Seeking part time work
Employer of other staff
Seeking full time work
Not seeking work
Unpaid worker in family business
Self-employed (not employing others)

Industry

You selected Employment Full Time, Part Time or Self-Employed, please select the Industry employed in:

And in what role (Occupation Identifier):

You selected Employment Full Time, Part Time or Self-Employed, please select the role for the Industry you're employed in:

Manager
Professional
Technician and Trade Worker
Community and Personal Service Worker
Clerical and Administrative Worker
Sales Worker
Machinery Operators and Driver
Labourer
Other

Education and Qualifications

Are you enrolled in secondary or senior education?

Yes
No

What is the highest completed school level?

If you are still in school, it is the level you have completed and not the level you are in this year.

Previous qualifications achieved

Have you successfully completed qualification/s either in Australia or overseas?

Yes (indicate below)
No

What is the highest completed school level?

If you are still in school, it is the level you have completed and not the level you are in this year.

Bachelor Degree or Higher Degree
Advanced Diploma or Degree
Diploma or Associate Diploma
Certificate IV or Advanced Certificate / Technician
Certificate III or Trade Certificate
Certificate II
Certificate I
Other education (including certificates or overseas qualifications not listed above)

Study Reason

Identification

Identification Upload (max file size 5MB)

To ensure that all Statements of Attainment and/or Certificates are awarded to the correct person, it is a requirement of Quality Service Skills to confirm your identity. This may be completed by uploading a selfie of yourself holding a formal item of identification (drivers licence, passport etc). Please ensure that you are in a well lit area, and both your face and the identification is clear.

Accepted file types: jpg, jpeg, png, Max. file size: 5 MB.

USI - Unique Student Identifier*

From Jan 1st, 2015 all students across Australia are required to be issued a Unique Student Identifier (USI) for all accredited training. This Identifier will allow you to access all of your Vocational Training Records from a central data-base, run by the Federal Government. You can create a USI at www.usi.gov.au and you only need to do so once. (Please note enrolment cannot commence until USI number is provided. Please ensure the USI is legible and accurate as it cannot be validated otherwise)

Thank you for completing this enrolment form. Please take a moment to re-check all sections to ensure you have:

Correctly spelled your name as you would like it printed on your Statement and/or Certificate
Provided a current postal (or residential) address for posting your Statement and/or Certificate

Quality Service Skills are required under the Standards for Registered Training Organisations 2015 to issue your Statement or Certificate within 30 days of completion of the training program, on the assumption that:

Your fees are paid in full
All assessments are completed and submitted, and you have been deemed Competent by your trainer

If any of your contact details change between filling out this form, and issuing of your Statement or Certificate, contact Quality Service Skills by emailing info@qss.edu.au or calling 0438 848 850 to update your records.

Student Declaration

Signature*

I declare that the information I have provided to the best of my knowledge is true and correct.

Please Print Name

Date

Parent/Guardian Signature

Parental/Guardian Consent is required for students under 18

Please Print Name

Date

Privacy Notice

Under the Data Provision Requirements 2012, Quality Service Skills is required to collect personal information about you and to disclose that personal information to the National Centre for Vocational Education Research Ltd (NCVER).
Your personal information (including the personal information contained on this enrolment form) may be used or disclosed by Quality Service Skills for statistical, administrative, regulatory and research purposes. Quality Service Skills may disclose your personal information for these purposes to:

Commonwealth and State or Territory government departments and authorized agencies; and
NCVER

Personal information that has been disclosed to NCVER may be used or disclosed by NCVER for the following purposes:

Populating authenticated VET transcripts;
Facilitating statistics and research relating to education, including surveys and data linkage;
Pre-populating RTO Student Enrolment Forms;
Understanding how the VET market operates, for policy, workforce planning and consumer information; and
Administering VET, including program administration, regulation, monitoring and evaluation

You may receive an NCVER student survey which may be administered by an NCVER employee, agent or third-party contractor or other authorised agencies. Please note you may opt out of the survey at the time of being contacted.

NCVER will collect, hold, use and disclose your personal information in accordance with the Privacy Act 1988 (Cth), the National VET Data Policy and all NCVER policies and protocols (including those published on NCVER’s website at www.ncver.edu.au)

Please Note: As of January 1st, 2019, students are no longer required to complete a declaration and consent statement relating to the above Privacy Notice. More information is available at https://www.ncver.edu.au/privacy or on the Quality Service Skills website at https://qss.edu.au/information/#student