COURSE & QUALIFICATION CODE*
—Please choose an option—AHC30921 Certificate III In Landscape ConstructionCPC30220 Certificate III In CarpentryCPC30620 Certificate III In Painting And DecoratingCPC31020 Certificate III In Solid PlasteringCPC31220 Certificate III In Wall And Ceiling LiningCPC31320 Certificate III In Wall And Floor TilingCPC32620 Certificate III In Roof Plumbing

Preferred Campus Location
—Please choose an option—CURRUMBINWEST IPSWICHNO PREFERENCE/EITHER

PERSONAL DETAILS

Title*
MrMrsMsMissOther

Family Name*

First Name*

Middle Name
I do not have a middle name

Are you a concession card holder?*
YesNo

Age*

Date of Birth*

Gender*
MaleFemaleOther

CONTACT DETAILS

Student's Personal Email*

Alternative Email

Mobile Number*

Work Phone Number

Home Phone Number

ADDRESS

Home Address*

Postal AddressSame as Home AddressNot the same

CULTURAL DIVERSITY & CITIZENSHIP

Are you of Aboriginal or Torres Strait Islander origin?*(Tick all that apply)
AboriginalTorres Strait IslanderNone of these

Where you born in Australia?*
YesNo

City of birth*

EMPLOYMENT

What is your current employment status?*Please select one of the below

LANGUAGE

Do you speak a language other than English at home?*
NoYes

SCHOOLING

Are you currently attending school?*
YesNo

DISABILITY

Do you consider yourself having a disability, impairment or long term condition?*
YesNo

PREVIOUS QUALIFICATIONS ACHIEVED

Have you successfully completed any qualifications?*
YesNo

UNIQUE STUDENT IDENTIFIER

From 1 January 2015, Gold Coast Trades College/Queensland Trades College are unable to issue you with a nationally recognised VET qualification or statement of attainment when you complete your course if you do not have a Unique Student Identifier (USI). If you have not yet obtained a USI you can apply for it directly at http://www.usi.gov.au/create-your-USI/. Please note that if you would like to specify your gender as ‘other’ you will need to contact the USI Office for assistance.

Enter your Unique Student Identifier (USI) (if you already have one) or reset your password if you forgot your USI

STUDY REASON

What is your main reason for enrolling in this program?
It was a requirement of my employmentOther

EMERGENCY CONTACT

Contact Name*

Contact Phone Number*

Relationship*

PERMISSION TO PUBLISH YOUR WORK OR IMAGES

(Please refer to the Student Handbook for more information on what may be done with videos and images.)

Do you give permission for video or photographic images of you/your work to be taken and published?*
YesNo

HOW DID YOU HEAR ABOUT US?

Print/Advert

Facebook

Instagram

Google+

LinkedIn

Cold Call

Other

Please rate yourself on a scale of 1-5 in the following areas (1 is low and 5 is high)

My ability to speak English*

12345

My ability to read English*

12345

My ability to write English*

12345

My numeracy/mathematics skills*

12345

Do you require assistance because of language, literacy or numeracy issues?*

YesNo

PLEASE READ CAREFULLY AND SIGN THE PRIVACY STATEMENT AND STUDENT DECLARATION

Privacy Notice
Under the Data Provision Requirements 2012, Gold Coast Trades College / Queensland Trades College 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 and your training activity data) may be used or disclosed by Gold Coast Trades College / Queensland Trades College for statistical, administrative, regulatory and research purposes. Gold Coast Trades College / Queensland Trades College disclose your personal information for these purposes to third parties, including:

• School –if you are a secondary student undertaking VET, including a school-based apprenticeship or traineeship;

• Employer –if you are enrolled in training paid by your employer;

• Commonwealth and State or Territory government departments and authorised agencies;

• NCVER;

• Organisations conducting student surveys; and

• Researchers.

Personal information disclosed to NCVER may be used or disclosed 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 a student survey which may be administered by a government department or 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).

Student Declaration and Consent
I declare that the information I have provided to the best of my knowledge is true and correct.
I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above.
I have received a copy of the Gold Coast Trades College / Queensland Trades College's Student Handbook and I acknowledge it is my responsibility to read, understand and follow the terms and conditions it sets out, and that this does not cancel my rights as applicable according to state and/or federal law.
By signing this document, I give permission for Gold Coast Trades College / Queensland Trades College to access my Unique Student Identifier for the purpose of my training and if I do not have a USI, I authorise Gold Coast Trades College / Queensland Trades College to apply, pursuant to sub-section 9(2) of the Student Identifiers Act 2014, for a USI on my behalf.
I understand the Apprentice Progression Schedule (Quarterly) and will work with the Employer and GCTC/QTC Trainers & Assessors to arrange site visits and attend workshops as required.
I am committed to completing the requirements for the Apprenticeship.
I understand I need to advise the College of any changes to the details provided in this agreement.
I understand if I do not meet progression requirements of this Apprenticeship it may incur cancellation.
The Apprentice fees have been explained to me in full.

Student Signature*
Please put your signature in the space below.

DATE*