WA Enrolment Form | Infection Control Skillset

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First Name *

Last Name *

Gender *

Residential Address(PO box not accepted) *

Suburb/Town: *

Post Code *

Phone Number *

E-Mail *

Date of Birth *

Country Of Birth *

Year of Arrival in Australia *

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Unique Student Identifier Number (USI) *

Note: A Unique Student Identifier (USI) is required for all nationally recognised training Australia-wide. This must be supplied to be recorded for a qualification to be issued. Creating a USI will only take a few minutes and is free. Once created, your USI will stay with you for life. Go to https://www.usi.gov.au/ to create a USI.

Are you of Aboriginal or Torres Strait Islander Origin? *

How well do you speak English *

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

Do you speak a language other than English at home? (please specify) *

Do you have a disability, impairment or a long term condition? *

Do you have a disability, impairment or a long term condition? (please specify) *

Highest completed school level *

Which of the following qualifications have you SUCCESSFULLY completed in the past? *

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Reason for Study (select ONE only of the below): *

Of the categories above, which BEST describes you:

Current Employment Status (select ONE only of the below): *

Of the categories above, which BEST describes you:

Please enter the company name you currently work for *

Choose Your Course *

Participant Eligibility for Funded Training Program

To be eligible to receive Government Funding under the Funded Training Program, prospective students must meet the below eligibility criteria: Please select each relevant option and attach copies of indicated documents and sign the declaration below. Note: All sections MUST be completed in full for enrolment to be completed.

The WA Eligibility requirements under “Fee-Free PIT Funding”

Do you live in Western Australia? *

Are you currently working? *

Are you a secondary school student? *

Are you (choose one) *

Upload Documents *
Photograph ID showing proof of address (Driver’s Licence/Proof of Age Card), Green Medicare Card, Letter of Employment.
Files must be less than 5 MB.
Allowed file types: gif jpg jpeg png pdf doc docx dmg rar zip.

PRIVACY NOTICE

Under the Data Provision Requirements 2012, Capital Training Institute 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 Capital Training Institute for statistical, administrative, regulatory and research purposes. Capital Training Institute may disclose your personal information for these purposes to:

Commonwealth and State or Territory government departments and authorised 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 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 https://ncver.edu.au/).

For more information about NCVER's Privacy Policy go to https://www.ncver.edu.au/privacy.

By checking this box, you confirm that the information contained on this enrolment form is correct and current. *

Signature *

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Your Input

First Name:

Last Name:

Gender:

Residential Address:

Suburb/Town:

PostCode:

Phone Number:

Email:

Date of Birth:

Country Of Birth:

Year of Arrival:

Unique Student Identifier Number (USI):

Are you of Aboriginal or Torres Strait Islander Origin?:

How well do you speak English:

Do you speak a language other than English at home?:

Do you speak a language other than English at home? (please specify):

Do you have a disability, impairment or a long term condition?:

Do you have a disability, impairment or a long term condition? (please specify):

Highest completed school level:

Which of the following qualifications have you SUCCESSFULLY completed in the past?:

Reason for Study:

Current Employment Status:

Please enter the company name you currently work for:

Choose Your Course:

Do you live in Western Australia?:

Are you currently working?:

Are you a secondary school student?:

Are you:

Signature: