I have attached one of the following forms of identification to confirm these details (please specify)

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1 SIGN UP ELIGIBILITY & REQUEST FORM Trainee & Apprentice About this application Use this Enrolment Application to apply for enrolment in a traineeship or apprenticeship. Before completing this Enrolment Application, please make sure you read and understand the program structure and requirements as outlined on our website at goodstart.edu.au. Do not complete this application if you wish to apply for Recognition of Prior Learning (RPL). To apply for RPL, please refer to the RPL application page at goodstart.edu.au. Before applying for CHCPRT001 Identify and respond to children and young people at risk, it is imperative that you are aware of and agree to the following: If you withdraw from your course at any time prior to the completion date determined within s Confirmation of Enrolment, you will be liable for any fees owing, in line with the Fee and Refund Policy and Employer Funded Study Assistance scheme (if applicable). Filling out and submitting this form Please complete all sections within this form as indicated. Make sure all information you supply is legible, accurate, and correct. Print your completed application, sign where applicable, and send the document along with any additional forms as required (eg, Employer Funded Study Assistance) by either post or . If sending via , send a scanned version of the form. Post Attn: Enrolment Applications PO Box George Street, Brisbane Qld goodstart@goodstart.edu.au Subject line: Enrolment Applications 1 About You Please enter the following details as shown on either your Australian Driver s Licence, Passport, or Australian 18+/Over 18 Card. All fields are mandatory. Title Family name Given name Middle name Gender Male Female of birth I have attached one of the following forms of identification to confirm these details (please specify) Australian Driver s Licence Passport Australian 18+/Over 18 Card Please attach a copy of your chosen form of photo identification to confirm these details 1/6

2 2 Unique Student Identifier (USI) As of 1 January 2015 all new and continuing students need to apply for a Unique Student Identifier (USI). A USI gives you access to a government online portal that will contain all of your nationally recognised training records and results from 1 January 2015 onwards. If you already have a Unique Student Identifier (USI) please enter your USI in the field below: UNIQUE STUDENT IDENTIFIER If you do not have a USI, you ll need to apply for a USI before we can complete your enrolment. You may apply directly via the USI website (usi.gov.au). Alternatively, can apply for a USI or locate your USI on your behalf. If you would like the Institute to apply for your USI, please complete the following USI application below. You ll need to supply a valid form of identification in order to process your USI application. USI application Before completing this section, please ensure you have attached a copy of one of the following forms of valid identification documents. Please tick the document you have attached below: Australian Driver s Licence Australian Medicare Card Australian Passport Valid and current Visa (with non-australian Passport) Certificate of Australian Registration by Descent Australian Birth Certificate (full certificate extracts are not accepted) ImmiCard (issued from the Department of Immigration and Citizenship) Australian Citizenship Certificate Please enter your details as they appear on your identification document: First name Middle name Family name Gender Male Female of birth Town or city of birth Country of birth I have read the USI Privacy Statement located on page 3 of this application and give my permission for Goodstart Institute to apply for a Unique Student Identifier (USI) or locate my USI on my behalf. Student signature 2/6

3 Privacy Statement Unique Student Identifier If you do not already have a Unique Student Identifier (USI) and you want to apply for a USI, or locate your USI from the Student Identifiers Registrar (Registrar) on your behalf, will provide to the Registrar the following items of personal information about you: your name, including first or given name(s), middle name(s) and surname or family name as they appear in an identification document; your date of birth, as it appears, if shown, in the chosen document of identity; your city or town of birth; your country of birth; your gender; and your contact details. When we apply for a USI on your behalf, or locate your USI, the Registrar will verify your identity. The Registrar will do so through the Document Verification Service (DVS) managed by the Attorney-General s Department which is built into the USI online application process if you have documents such as a Medicare card, birth certificate, driver licence, Australian passport, citizenship document, certificate of registration by descent, ImmiCard or Australian entry visa. If you do not have a document suitable for the DVS and we are authorised to do so by the Registrar we may be able to verify your identity by other means. If you do not have any of the identity documents mentioned above, and we are not authorised by the Registrar to verify your identity by other means, we cannot apply for a USI on your behalf and you should contact the Student Identifiers Registrar. In accordance with section 11 of the Student Identifiers Act 2014 Cth (SI Act), we will securely destroy personal information which we collect from you solely for the purpose of applying for a USI on your behalf as soon as practicable after the USI application has been made or the information is no longer needed for that purpose, unless we are required by or under any law to retain it. The personal information about you that we provide to the Registrar, including your identity information, is protected by the Privacy Act 1988 Cth (Privacy Act). The collection, use and disclosure of your USI are protected by the SI Act. If you ask to make an application for a student identifier on your behalf, or to locate your USI, of Early Learning will have to declare that has complied with certain terms and conditions to be able to access the online student identifier portal and submit this application, including a declaration that has given you the following privacy notice: is collected by the Registrar for the purposes of: applying for, verifying and giving a USI; resolving problems with a USI; and creating authenticated vocational education and training (VET) transcripts; may be disclosed to: Commonwealth and State/Territory government departments and agencies and statutory bodies performing functions relating to VET for: the purposes of administering and auditing Vocational Education and Training (VET), VET providers and VET programs; education related policy and research purposes; and to assist in determining eligibility for training subsidies; VET Regulators to enable them to perform their VET regulatory functions; VET Admission Bodies for the purposes of administering VET and VET programs; current and former Registered Training Organisations to enable them to deliver VET courses to the individual, meet their reporting obligations under the VET standards and government contracts and assist in determining eligibility for training subsidies; schools for the purposes of delivering VET courses to the individual and reporting on these courses; the National Centre for Vocational Education Research for the purpose of creating authenticated VET transcripts, resolving problems with USIs and for the collection, preparation and auditing of national VET statistics; researchers for education and training related research purposes; any other person or agency that may be authorised or required by law to access the information; any entity contractually engaged by the Student Identifiers Registrar to assist in the performance of his or her functions in the administration of the USI system; and will not otherwise be disclosed without your consent unless authorised or required by or under law. Privacy policies and complaints You can find further information on how the Registrar collects, uses and discloses the personal information about you in the Registrar s Privacy Policy or by contacting the Registrar by at usi@industry.gov.au, or by telephoning the Skilling Australia Information line on , international enquiries The Registrar s Privacy Policy contains information about how you may access and seek correction of the personal information held about you and how you may make a complaint about a breach of privacy by the Registrar in connection with the USI and how such complaints will be dealt with. You may also make a complaint to the Information Commissioner about an interference with privacy pursuant to the Privacy Act, which includes the following: misuse or interference of or unauthorised collection, use, access, modification or disclosure of USIs; and a failure by Us to destroy personal information collected by you only for the purpose of applying for a USI on your behalf. For information about how collects, uses and discloses your personal information generally, including how you can make a complaint about a breach of privacy, please refer to the Institute s privacy policy which can be found at goodstart.edu.au. 3 Contact details address Mobile number Phone number Street address Suburb State Postcode Postal address (if different from home address) Suburb State Postcode 3/6

4 4 Employment details This section is to be completed by your Centre Director/Centre Manager. Legal name of business ABN Trading name of centre (eg, Goodstart Fortitude Valley) Centre address Suburb State Postcode Centre Director s/centre Manager s name Phone number Of the following categories, which best describes the applicant s employment status? Full time Part time Casual Typical hours applicant works per week applicant commenced employment I have assessed the staffing level within my centre and understand the requirements of taking on a trainee/apprentice. Signature 5 Education Have you successfully completed any qualifications? No Yes. If Yes, please provide details below: Qualification gained Institution attended Year qualified Qualification gained Institution attended Year qualified Do any of the following apply to you? Your qualification cannot be used to due to injury/disability No Yes You are an intensive assistance client No Yes You are currently registered as unemployed and have been so for 12 months No Yes 4/6

5 In what year did you complete high school? Have you previously worked as an apprentice or trainee? No Yes Are you currently undertaking any other study? No Yes. If Yes, please provide details below: What qualification level are you currently studying? Name of institution Name of qualification State, Territory or Country of study Year of commencement 6 Qualification to be studied CHC30113 Certificate III in Early Childhood Education and Care CHC50113 Diploma of Early Childhood Education and Care Declaration By signing this form I confirm this information may be used by an Australian Apprenticeships Centre to assess my eligibility of Australian Government Incentives for any future Australian Apprenticeships I may undertake. Candidate signature If candidate is under 18 years of age Parent/guardian signature If you have any questions about the enrolment application process, please contact the Institute on , or goodstart@goodstart.edu.au. 5/6

6 Notification of Collection Statement This is the Notification of Collection Statement that Goodstart Early Learning Limited ABN , trading as is required to provide you with at the time of obtaining your personal information. This forms part of The Institute s Privacy Policy, available at goodstart.edu.au. Purpose collects and holds personal information about you for the purposes of delivering training and assessment services under/in line with the VET Quality Framework for Registered Training Organisations (RTO). Sensitive Information In some circumstances may seek to collect personal information that is sensitive. This may include information such as any physical or mental illnesses or disabilities you may have, your language, and literacy and numeracy (LLN) level. We collect this information as it is reasonably necessary to enable to provide training and assessment services to cater for your individual needs and requirements. For example, you may have difficulty reading and/or writing and Goodstart Institute may need to provide additional assistance or tailored assessment methods to suit your needs. will only collect your sensitive information with your consent and will ensure that it is stored securely. If you do not wish for your sensitive information to be collected by of Early Learning, you should discuss this with a member of of Early Learning s Student Services team. s employees will act strictly in accordance with this policy and will be happy to discuss the reasons for seeking to collect your sensitive information. They will also discuss with you any consequences of not providing your sensitive information which may include an effect on the services can provide to you. Failure to Provide Information If you do not wish for your personal information to be collected you should discuss this with a Student Services team member. of Early Learning s employees will act strictly in accordance with s Privacy Policy and will be happy to discuss the reasons for seeking to collect your personal information. They will also discuss with you any consequences of not providing your personal information, or providing incomplete or inaccurate personal information, which may include an effect on what services can provide to you. Use and Disclosure will only use or disclose your personal information for the purpose it was collected or a reasonably expected or related secondary purpose. Personal information of students is ordinarily used or disclosed for the primary purposes of: providing training and assessment services; assessing eligibility of traineeships or apprenticeships; relevant State and Federal Government reporting of students and their academic progress were required under law; providing you with information about our organisation, and activities via letters, , sms, telephone and other organisation communication channels; and requesting information from you about our organisation via surveys. We may disclose personal information about you to: third party service providers, who assist us in operating our business (including credit reporting bodies, collection agencies, legal advisors and technology service providers). We will take all reasonable steps to ensure these service providers do not breach the Australian Privacy Principles. These providers may be based overseas or use overseas infrastructure to perform services for us, including in the USA, Singapore and New Zealand a purchaser of the assets and operations of our business or a part of it, provided those assets and operations are purchased as a going concern (i.e. the purchaser buys the whole business of of Early Learning) State and Federal Government departments, ministries, agencies, councils, or authorities where reporting of students and their academic progression and results is required by law for to continue operating as a Registered Training Organisation (RTO). will not otherwise use or disclose personal information to a third party for any other purpose without your consent unless it is authorised or required by law. Access and Correction You may request access to your personal information. Ordinarily The Goodstart Institute will require you to make a request for access in writing to the Privacy Officer. s employees other than the Privacy Officer are not generally able to provide you with access. If at any time you believe s record of your personal information is incorrect, please let of Early Learning know. We will take reasonable steps to correct the information so that it is accurate, complete and up to date. In some circumstance which are prescribed by the Privacy Act 1998 (Cth), such as where to do so might put a person at risk of harm or have an unreasonable impact on the privacy of others, The Institute may decline access to personal information. If your request for access is denied, Goodstart Institute may tell you why. Complaints and Feedback If you wish to make a complaint about a breach of the Privacy Act, Australian Privacy Principles or a privacy code that applies to us, please contact us as set out below and we will take reasonable steps to investigate the complaint and respond to you. If you are not happy with our response, you may complain directly to the Australian Information Commissioner. If you have any queries or concerns about our privacy policy or the way we handle your personal information, please contact the Privacy Officer at: Postal Address Attention: Privacy Officer PO Box George Street Brisbane Qld Address privacy@goodstart.edu.au Telephone More Information For more information about privacy in general, you can visit the Australian Information Commissioner s website at oaic.gov.au. 6/6