DOMESTIC STUDENT ENROLMENT APPLICATION AND ELIGIBILITY FORM

Technical Institute of Victoria Level 4, 260 La Trobe Street Melbourne, Victoria 3000 Phone: (+61 3) 9639 1199 Fax: (+61 3) 9639 1155 Email: [email protected]

CANDIDATE TO COMPLETE ALL SECTIONS AND QUESTIONS (USE BLOCK LETTERS ONLY) PERSONAL DETAILS – LEGAL NAME MUST BE USED. DO NOT USE ABBREVIATED OR ALTERNATIVE GIVEN NAMES)

Student Personal Details 1.

Family Name

2. 3.

Given Name Date of Birth (Day / Month / Year) Current Residential Address which you usually live?

4.

(Please provide the physical address where you usually reside rather than any temporary address at which you reside for training, work or other purposes before returning to your home; cannot be a PO Box number.)

Building / Property Name:_______________ Flat / Unit Detail:_____

Contact Detail

Suburb:___________________ State / Territory: __________

Postcode:_________

 Fax:

 Mobile:  Email Address: Building / Property Name:_______________ Flat / Unit Detail:_____

Postal Address same as Residential Address: YES  NO  (If No, please fill the section)

Street no:__________

Street Name:__________________________________________________________________

 Home Phone: 5.

 Male  Female

4. Gender

Street no:__________

6.

Street Name:__________________________________________________________________

Suburb:___________________ State / Territory: __________ Name: 7.

Emergency Contact/Next of Kin

Postcode:_________

Relation: Home Phone:

 Mobile:

Email Address:

8.

Residency Status

 An Australian citizen  An Australian permanent residence  VISA/Temp Permit: If on VISA/Temp Permit state code/ Description:______________________________

9.

Health Cover Detail

 Medicare No  Health Care Card No Other, please specify:

10. If you are aged 24 or below at time of enrolment, please provide your Victorian Student Number:

Are you new to the Victorian Education system or do not have your Victorian Student Number? Yes, I am new to the Victorian Education System. I have never attended a Victorian school, TAFE or other training provider 11. Do you wish to apply for RPL  Credit Transfer   No - Go to Personal Details Section  Yes – Go to Personal Details Section. Also complete a separate RPL/CT form available from Administration officer via [email protected]

Employment 12. Of the following categories, which BEST describes your current employment status (Tick ONE only)

 Full-time employee  Self-employed – not employing others  Employed – unpaid worker in a family business  Unemployed – seeking part-time work

 Part-time employee  Employer  Unemployed – seeking full-time work  Not employed – not seeking employment

Employment Details (If employed) Employer/ Company (Full Name):________________________________________________________________________ Address: ____________________________________________________________________________________________ Ph:__________________________ Email:_________________________________________________________________ Domestic Student Enrolment Application and Eligibility Form Spice Telecom Australia Pty Ltd ABN 63 121 460 704 RTO 21994 Trading as Technical Institute of Victoria

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Technical Institute of Victoria Level 4, 260 La Trobe Street Melbourne, Victoria 3000 Phone: (+61 3) 9639 1199 Fax: (+61 3) 9639 1155 Email: [email protected]

Schooling  No  Yes  Year 12 or equivalent  Year 11 or equivalent  Year 10 or equivalent  Year 09 or equivalent  Year 08 or below  Never attended school

13. Are you still attending secondary school?

14. What is your highest completed school level

15. In which YEAR did you complete that school level?

__________________________

16. In which country were you born

 Australia  Other, please specify:__________________________

Previous Qualifications Achieved 17. Have you successfully completed a qualification in Australia?

 No – Go to Question 18  Yes – Go to Question 20

18. Have you successfully completed a qualification Overseas?

 No – Go to Question 21  Yes – Go to Questions 19

19. Is your overseas qualification assessed and recognised in Australia?

 No  Yes

20. Highest Qualification achieved

 Bachelor degree or higher  Advanced diploma or associate degree  Diploma or associate diploma  Certificate IV or advanced certificate / technician  Certificate III or trade certificate  Certificate II  Certificate I  Certificates other than the above

Language and Cultural Diversity 21. Do you speak language other than English at home?

 No, English only  Other, please specify:__________________________________________

22. How well English?

 Very well

do

you

speak

 Well

 Not well

 Not at all

Disability 23. Do you consider yourself to have disability, impairment or long-term condition?

 No – Go to Question 25  Yes

24. Please indicate the areas of disabilities, impairment or long-term condition (You may indicate more than one area)

 Hearing / deaf  Physical  Intellectual  Learning  Mental illness

25. Are you Aboriginal or Torres Strait Islander origin

 No  Yes, Aboriginal

 Acquired brain impairment  Vision  Medical condition Other,please specify:________________________  Yes, Torres Strait Islander

Study Reason

26. Of the following categories, which BEST describes your main reason for undertaking this course / traineeship / apprenticeship? (Tick ONE only)

Domestic Student Enrolment Application and Eligibility Form Spice Telecom Australia Pty Ltd ABN 63 121 460 704 RTO 21994 Trading as Technical Institute of Victoria

 To get a job  To develop my existing business  To start my own business  To try for a different career

 To get a better job or promotion  It was a requirement of my job  I wanted extra skills for my job  To get into another course of study  For personal interest or selfdevelopment  Other, please specify:______ _________________________

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Technical Institute of Victoria Level 4, 260 La Trobe Street Melbourne, Victoria 3000 Phone: (+61 3) 9639 1199 Fax: (+61 3) 9639 1155 Email: [email protected]

Course Options Tuition Fee 

Course Code

SIT30813 SIT40413 SIT50313 AHC30610 AHC31110 AHC40310 AHC50310 BSB40212 BSB51107

Course Name

Certificate III in Commercial Cookery Certificate IV in Commercial Cookery Diploma of Hospitality Certificate III in Production Horticulture Certificate III in Production Nursery Certificate IV in Production Horticulture Diploma of Production Horticulture Certificate 1V in Business Diploma of Management

(Tuition Fee) Government Funded Students

(Tuition Fee) Fee for service

Admin fee ( Applicable to All Domestic students)

Resources Fee (Optional to students ) (students can buy on their own)

AUD$0.00

11,000

AUD$ 250

500

AUD$0.00

16,000

AUD$ 250

500

AUD$0.00 AUD$0.00

16,000 11,250

AUD$ 250 AUD$250

500 500

AUD$0.00

11,750

AUD$250

500

AUD$0.00

11,250

AUD$250

500

AUD$0.00

13,500

AUD$250

500

AUD$0.00 AUD$0.00

3,500 3,500

AUD$250 AUD$250

500 500

Terms & Conditions

Technical Institute of Victoria (TIV) Responsibilities

Student Responsibilities

is required to provide the Victorian Government, with student and training activity data which may include information provided by the student in this enrolment form.

1. In the event of any change in contact details, the student will notify TIV immediately by completing Change of Details Form and providing this to TIV Administration Department.

1. Technical Institute of Victoria (TIV)

is carried out in an ethical and responsible manner. Individual interviews are conducted to ensure applicants meet the entry requirements, are well informed about our courses and provide the opportunity to identify any special requirements the applicant may have. All successful applicants must complete the orientation program to familiarise themselves with the college’s services, facilities and procedures. 2. Selection and enrolment at TIV

2. All students enrolled in and participating in programs or using the services of TIV are expected to maintain appropriate standards of conduct at all times. Where behaviour is deemed to be improper or inappropriate, TIV will take appropriate action as outlined in the TIV’s Student Code of Conduct. 3. For all fee refunds, the student must notify the Institute in writing following the refund policy and procedure available from administration officer up on request to [email protected]

3. TIV endeavours to create a positive learning environment and provide student

4. A successful application for RPL may mean that a student is entitled to a refund of the tuition fees they have already paid for hours of tuition they no longer need.

support services which are free of coercion, unfair treatment and harassment of students. Students are encouraged to achieve their personal best through the provision of valid learning and assessment tools and methods that are most suited to their diverse needs. TIV has a fair and open Complaints and Appeals Policy to address student complaints and appeals, and ensures all outcomes are on record in writing.

Pre Enrolment Conditions Applicant to read and understand the terms and conditions of enrolment outlined above.

4. All staff at TIV abides by the principles of access and equity and ensures that

they behave in a non-discriminatory manner as outlined in the Staff hand book. Equity issues are discussed and consolidated at a management level whilst updates and changes to equity legislation are communicated at manager’s meetings. Where a student has a concern regarding their treatment, the student should refer to the Student Complaints and Appeals Procedure 5. TIV will issue refunds as per the conditions outlined in refund policy and procedure. To apply for a refund, please submit a completed Refund Application Form. 6. TIV must, during the course of delivering the training:

monitor and record training progress against the Training Plan, at least, monthly; document and provide support services and appropriate assistance to students with special learning or employment needs in accordance with the results of the Pre-Training Review, and as required by the student ; advise the Apprentice or Trainee and his/her employer, that an application for an extension to the term of the Training Contract must be made if they are unable to complete the Structured Training prior to the nominal completion date of the Training Contract (this application should be lodged via the relevant AAC); and make all reasonable provisions for the Apprentices or Trainees to achieve all competencies required for the Structured Training identified in the approved training scheme within the term of the Training Contract.. 7. TIV is committed to protecting an individual’s right to privacy in accordance with Privacy Act2001.

Domestic Student Enrolment Application and Eligibility Form Spice Telecom Australia Pty Ltd ABN 63 121 460 704 RTO 21994 Trading as Technical Institute of Victoria

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Technical Institute of Victoria Level 4, 260 La Trobe Street Melbourne, Victoria 3000 Phone: (+61 3) 9639 1199 Fax: (+61 3) 9639 1155 Email: [email protected] Privacy Statement and Declarations (To be completed by Applicant)

I understand that: Technical Institute of Victoria is required to provide the Victorian Government, through the Department of Education and Early Childhood Development, with student and training activity data which may include information I provide in this enrolment form. Information is required to be provided in accordance with the Victorian VET Student Statistical Collection Guidelines (which are available at http://www.education.vic.gov.au/training/providers/rto/Pages/datacollection.aspx). The Department may use the information provided to it for planning, administration, policy development, program evaluation, resource allocation, reporting and/or research activities. For these and other lawful purposes, the Department may also disclose information to its consultants, advisers, other government agencies, professional bodies and/or other organisations. I have been advised by the training organisation that I may be contacted and requested to participate in a National Centre for Vocational Education Research survey or a Department-endorsed project or audit or review. The Education and Training Reform Act 2006 requires Technical Institute of Victoria to collect and disclose my personal information for a number of purposes including the allocation to me of a Victorian Student Number and updating my personal information on the Victorian Student Register. Use and disclose: Technical Institute of Victoria may engage third party service providers to perform audits, assessments, training delivery consultation, and the provision of statistical data information to industry training bodies, therefore disclosures of information may be necessary. All personal information we provide to them is kept secure, is only used to perform the task for which we have engaged them and is handled in accordance with the National Privacy Principles. Information will only be used or disclosed for the purpose for which it was collected (the primary purpose) or for a secondary purpose that an individual would reasonable expect. Information can also be disclosed if required or authorized under law. For more information in relation to how student information may be used or disclosed please Technical Institute of Victoria’s Admin on Phone: +61 3 9639 11 99 or Email: [email protected] Applicant’s Signature:_______________________________ Applicant’s Name: ____________________________________ Date: ___/___/___________

APPLICANT SELF DECLARATION To be completed by all applicants -

-

-

I have read and understood and consent to the privacy statement and declaration and have completed all questions and details on the enrolment and eligibility forms. I declare that the information herein provided to TIV in my application for study is to the best of my knowledge true, correct and complete at the time of my enrolment/application (including information provided to assess my eligibility for government subsidised training under the Victorian Training Guarantee). I acknowledge that providing any false information and/or failing to disclose any information relevant to my application for enrolment and/or failure to complete an application/enrolment form may result in the withdrawal of any offer, particularly as it relates to my eligibility to obtain an offer for government subsided training, and/or cancellation of enrolment at the discretion of TIV.I understand that, it is a criminal offence to provide false and misleading information. I understand that it is my responsibility to provide all relevant and required documentation I understand that at the end of the course I may receive an NCVR survey NCVER and/or invitation to participate in a Victorian department endorsed project or be contacted by NCVER I have read and understood all the terms and conditions.

Applicant’s Name:

Applicant’s Signature:

_____________________________________

_______________________________________________ Date: ____/____/___________

Domestic Student Enrolment Application and Eligibility Form Spice Telecom Australia Pty Ltd ABN 63 121 460 704 RTO 21994 Trading as Technical Institute of Victoria

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Technical Institute of Victoria Level 4, 260 La Trobe Street Melbourne, Victoria 3000 Phone: (+61 3) 9639 1199 Fax: (+61 3) 9639 1155 Email: [email protected]

VICTORIAN TRAINING GUARANTEE 2014 EVIDENCE OF STUDENT ELIGIBILITY AND STUDENT DECLARATION Section A - To be completed by an authorised delegate of the RTO

Evidence of citizenship/residency and age I confirm that in relation to____________________________________________________________________ (Student’s full name) I have sighted one of the following original, or a certified photocopy of the original, documents: an Australian Birth Certificate (not Birth Extract)

a current Australian Passport

a current New Zealand Passport

a naturalisation certificate

a current green Medicare Card

a signed declaration by a relevant referee

formal documentation issued by the Australian Department of Immigration and Citizenship confirming permanent residence and if the student’s age is relevant to their eligibility and the document produced from the list above does not include a date of birth: a current drivers licence, or

a current learner permit, or

a Proof of Age card, or

a ‘Keypass’ card

Section B - To be completed by the student Q1. The highest qualification I currently hold is: _____________________________________________________________________________________ (Include full title of qualification, eg. Certificate III in Aged Care)

Q2. Not including the course/s you are seeking to enrol in now, how many other government subsidised courses have you enrolled to undertake this year? Include training you have enrolled in to undertake at this and other training providers but not yet started.

0

1

2

3

4+ (circle number)

Q3. Not including the course/s you are seeking to enrol in now, how many other government subsidised courses are you undertaking training in at the moment?

0

1

2

3

4+ (circle number)

Q4. In your lifetime, how many government subsidised courses have you started (commenced) that are at the same level as the one you are applying for now? Don’t answer this question if you are seeking to enrol in a course on the Foundation Skills List.

0

1

2

3

Domestic Student Enrolment Application and Eligibility Form Spice Telecom Australia Pty Ltd ABN 63 121 460 704 RTO 21994 Trading as Technical Institute of Victoria

4+ (circle number)

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Technical Institute of Victoria Level 4, 260 La Trobe Street Melbourne, Victoria 3000 Phone: (+61 3) 9639 1199 Fax: (+61 3) 9639 1155 Email: [email protected]

VICTORIAN TRAINING GUARANTEE 2014 EVIDENCE OF STUDENT ELIGIBILITY AND STUDENT DECLARATION Section B - continued

Student declaration I

, in seeking to enrol in (Student’s full name)

___________________________________________________________________________________________________________ (Include full title of qualification/s in which you are seeking to enrol)

declare the following to be true and accurate statements: a. I AM / AM NOT enrolled in a school, including government, non-government, independent, Catholic or home school. (circle appropriate response) b. I AM / AM NOT enrolled in the Commonwealth Government’s Skills for Education and Employment program. (circle appropriate response): c.

I understand that my enrolment in the above qualification/s is being subsidised by the Victorian and Commonwealth Governments under the Victorian Training Guarantee. I understand that enrolling in the above qualification/s may affect my future training options and eligibility for further government subsidised training under the Victorian Training Guarantee.

Signed:

Date:

Section C – To be completed by an authorized delegate of the RTO

Number of courses student is currently eligible for:

1

2

RTO declaration Based on discussion with the student, the above evidence I have sighted in Section A, and the information provided to me by the student in Section B of this form I believe that the above individual satisfies the Victorian Training Guarantee eligibility criteria as set out in the VET Funding Contract and is eligible for funding under the Victorian Training Guarantee for the following qualification/s: _

_

_________________________________________________________

(Include full title of qualification/s in which the student is seeking to enrol) Authorised RTO delegate: Name: Signed:

__________________________

Position:

________________________Date:__________________________

Domestic Student Enrolment Application and Eligibility Form Spice Telecom Australia Pty Ltd ABN 63 121 460 704 RTO 21994 Trading as Technical Institute of Victoria

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Technical Institute of Victoria Level 4, 260 La Trobe Street Melbourne, Victoria 3000 Phone: (+61 3) 9639 1199 Fax: (+61 3) 9639 1155 Email: [email protected]

TO BE COMPLETED BY REPRESENTATIVE OF Technical Institute of Victoria I confirm that the applicant has been informed of eligibility requirements for the government subsidised and training under Victorian Training Guarantee, and the applicant is aware of the consequences arising from a false, misleading or an incomplete declaration. Authorised TIV Delegate: _____________________________________________________ Authorised TIV Delegate Signature :__________________________Date___/___/_______

For Office Use Only

REFERRAL ELIGIBILITY Is the candidate eligible for VTG funding? Proof of eligibility provided: Proof of concession eligibility provided: Enrolment Fee: $ Paid Date:

Yes 

No 

Yes  Yes 

No  No 

(if No, candidate needs to pay full course fee)

Not Applicable  Invoice No:

Paid course fee (if not eligible form VTG Funding): $ __________ Is payment plan done for candidate if not eligible Yes  No  FUNDING SOURCE  General (not Apprentice/Trainee) – meets VTG eligibility criteria  Apprentice/Trainee – meets VTG eligibility criteria  Asylum Seeker or Victim of Human Trafficking (not Apprentice/Trainee) VTG Enrolment  Asylum Seeker or Victim of Human Trafficking Apprentice/Trainee VTG Enrolment  Workers in Transition Program – General (not Apprentice/Trainee)  Workers in Transition Program – Apprentice/Trainee  Single and Teenage Parents Training Initiative – General (not Apprentice/Trainee) – meets the Guaranteed Access Cohort eligibility criteria  Single and Teenage Parents Training Initiative –Apprentice/Trainee – meets the Guaranteed Access Cohort eligibility criteria  Single and Teenage Parents Training Initiative – General (not Apprentice/Trainee) – meets the VTG eligibility criteria REFERRAL ELIGIBILITY  Fee for service – domestic full fee paying students

Not Applicable  P L ASP ASL WTP WTL NGP

NGL NSP

S

APPRENTICE ONLY (CODE L)

APPS Centre:

DELTA No:

Domestic Student Enrolment Application and Eligibility Form Issue History June 2014 Changed format and SIT codes 1 Oct 2014 Changed logo; reformatted; number 4 with additional explanation; changed minor grammatical forms (capitalisation, bold,etc)

Domestic Student Enrolment Application and Eligibility Form Spice Telecom Australia Pty Ltd ABN 63 121 460 704 RTO 21994 Trading as Technical Institute of Victoria

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