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COURSE NAME & TRAINING DATE*
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PERSONAL DETAILS
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Title*
MrMrsMsMissOther
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Family Name*
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First Name*
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Middle Name
I do not have a middle name (please tick)
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Previous Name/s
I do not have a previous name (please tick)
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Date of Birth*
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Gender*
MaleFemaleOther
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Are you a concession card holder?*
YesNo
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CONTACT DETAILS
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Home Phone
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Work Phone
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Mobile Phone*
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Email*
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Alternative Email
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Home Address*
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Postal AddressSame as Home AddressNot the same
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CULTURAL DIVERSITY & CITIZENSHIP
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Are you of Aboriginal or Torres Strait Islander origin?*(Tick all that apply)
AboriginalTorres Strait IslanderNone of these
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Where you born in Australia?*
YesNo
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City of birth*
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What is your citizenship status?*Please select one of the below
Australian CitizenTemporary Resident VisaNew Zealand CitizenAustralia Permanent ResidentStudent VisaVisitor’s VisaOther
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EMPLOYMENT
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What is your current employment status?*Please select one of the below
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LANGUAGE
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Do you speak a language other than English at home?*
NoYes
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SCHOOLING
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Are you currently attending school?*
YesNo
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What is your LUI (Learning Unique Identifier)?
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DISABILITY
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Do you consider yourself having a disability, impairment or long term condition?*
YesNo
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PREVIOUS QUALIFICATIONS ACHIEVED
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Have you successfully completed any of the following qualifications?*
YesNo
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STUDY REASON
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What is your main reason for enrolling in this program?*
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UNIQUE STUDENT IDENTIFIER
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From 1 January 2015, PPS College/Gold Coast Trades Collegeare 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 notyet 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)
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EMERGENCY CONTACT
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Contact Name*
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Contact Phone Number*
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Relationship*
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PERMISSION TO PUBLISH YOUR WORK OR IMAGES
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(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
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HOW DID YOU HEAR ABOUT US?*
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PPS StaffPPS WebsiteFriendFamilySchoolCareer ExpoJob AgencyApprenticeship CentrePrint/AdvertFacebookInstagramGoogle+LinkedInCold CallOther
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Please rate yourself on a scale of 1-5 in the following areas (1 is low and 5 is high)
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My ability to organise my time and resources
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12345
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My ability to read English
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12345
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My ability to write English
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12345
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My ability to speak English
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12345
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My numeracy/mathematics skills
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12345
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Do you need assistance because of language, literacy or numeracy issues?
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YesNo
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PLEASE READ CAREFULLY AND SIGN THE PRIVACY STATEMENT AND STUDENT DECLARATION
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Privacy Notice
Under the Data Provision Requirements 2012, PPS College/Gold Coast Trades College(PPS/GCTC)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 PPS/GCTC for statistical, administrative, regulatory and research purposes. PPS/GCTC may disclose your personal information for these purposes to third parties, including:
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School –if you are a secondary student undertaking VET, including a school-based apprenticeship or traineeship;
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Employer –if you are enrolled in training paid by your employer;
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Commonwealth and State or Territory government departments and authorised agencies;
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NCVER;
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Organisations conducting student surveys; and
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Researchers.
Personal information disclosed to NCVER may be used or disclosed for the following purposes:
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populating authenticated VET transcripts;
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facilitating statistics and research relating to education, including surveys and data linkage;
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pre-populating RTO student enrolment forms;
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understanding how the VET market operates, for policy, workforce planning and consumer information; and
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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
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I declare that the information I have provided to the best of my knowledge is true and correct.
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I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above.
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I have received a copy of the PPS/GCTC Student Handbook. I acknowledge it is my responsibility to read, understand and follow the terms and conditions it sets out. I understand this does not cancel my rights as applicable according to state and/or federal law.
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By signing this document, I give permission for PPS/GCTC to access my Unique Student Identifier for the purpose of my training and if I do not have a USI, I authorise PPS/GCTC to apply, pursuant to sub-section 9(2) of the Student Identifiers Act 2014, for a USI on my behalf
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