Application for Enrolment Form

Intended course of study

Select the course you are enrolling in

Course Location

Course Date

Personal Details

Please write the name that you used when you applied for your Unique Student Identifier (USI), including any middle names. If you do not yet have a USI please write your name exactly as written in the identity document you choose to use.

Title

Given name

Middle Name/s

Family name

Gender

Date of Birth

Month

Day

Year

Phone

What is the address of your usual residence?

Please provide the physical address (street number and name not post office box) where you usually reside rather than any temporary address at which you reside for training, work or other purposes before returning to your home.

If you are from a rural area use the address from your state or territory’s ‘rural property addressing’ or ‘numbering’ system as your residential street address.

Building/property name is the official place name or common usage name for an address site, including the name of a building, Aboriginal community, homestead, building complex, agricultural property, park or unbounded address site.

Residential Address

Postal address is the same as above

Postal Address (if different from above)

Emergency Contact Person & Relationship

Emergency Contact Phone Number

Do you have any injuries, health issues or medical conditions which would affect your participation in the course?

This course has physical activity such as basic water rescues and swimming

Language and Cultural Diversity

In which country were you born?

Do you speak a language other than English at home?

Are you of Aboriginal or Torres Strait Islander origin?

Disability

Do you consider yourself to have a disability, impairment or long-term condition?

Schooling

Are you still enrolled in secondary or senior secondary education?

Yes

Which year did you complete this level of schooling?

Employment

Of the following categories, which BEST describes your current employment status?

Full-time employee

Employed – unpaid worker in a family business

Part-time employee

Unemployed – seeking full-time work

Self-employed – not employing others

Self-employed – employing others

Unemployed – seeking part-time work

Not employed – not seeking employment

Employer

For casual, seasonal, contract and shift work, use the current number of hours worked per week to determine whether full time (35 hours or more per week) or part-time employed (less than 35 hours per week).

Study Reason

Unique Student Identifier (USI)

Enter your USI number below

From 1 January 2015, Active Training can be prevented from issuing 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/ on computer or mobile device. 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

In providing my USI, I confirm Active Training is authorised to collect, use and disclose my student identifier for the purposes required under the Student Identifiers Act 2014.

I understand that I will receive a notice regarding Active Training’s use of this information to confirm my USI.

I understand that Active Training’s name included in the notice may be different to the name they are familiar with – the name of the organisation verifying my USI is Active Training.

Marketing Consent

I give Active Training and Aquatic Education permission to use photos in public material and social media (including any photos where I may be recognised) as may be useful. I authorise images of my participation in training to be used by Active Training for future marketing and business purposes.

I understand that I retain the right to withdraw my consent at any time by sending written notification.

Privacy Notice

Under the Data Provision Requirements 2012, Active Training 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 Active Training for statistical, administrative, regulatory and research purposes. Active Training 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 www.ncver.edu.au).

Active Training retains a record of personal information about all individuals with whom we undertake any form of business activity. Active Training must collect, hold, use and disclose information from our clients and stakeholders for a range of purposes.

As a government registered training organisation, regulated by the Australian Skills Quality Authority, Active Training is required to collect, hold, use and disclose a wide range of personal and sensitive information on Students in nationally recognised training programs. This information requirement is outlined in the National Vocational Education and Training Regulator Act 2011 and associated legislative instruments.

Active Training must require and confirm identification however in services delivery to individuals for nationally recognised course programs. We are authorised by Australian law to deal only with individuals who have appropriately identified themselves. That is, it is a Condition of Registration for all RTOs under the National Vocational Education and Training Regulator Act 2011 that we identify individuals and their specific individual needs on commencement of services delivery, and collect and disclose Australian Vocational Education and Training Management of Information Statistical Standard (AVETMISS) data on all individuals enrolled in nationally recognised training programs. Other legal requirements, as noted earlier in this policy, also require considerable identification arrangements.

For information about how Active Training collects, uses and discloses your personal information generally, including how you can make a complaint about a breach of privacy, please refer to Active Training’s privacy policy which can be found on the web at https://www.activetraining.net.au/policies/policies/

This Privacy Policy contains information about how individuals may access and seek correction of the personal information held by us, and how to complain about a breach of privacy, and how we will deal with such a complaint.

In providing your personal information as requested you are confirming your receipt of, and understanding of these details, and providing your consent for the collection, storage, use and disclosure of your personal information as outlined.

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