STANDARD ENROLMENT QUESTIONS - Tennis Australia · Smart Connection Company Pty Ltd t/a ... and currently filling this enrolment form, ... birth certificate, driver licence, Australian

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Smart Connection Company Pty Ltd t/a Smart Connection Training RTO no. 3910

4 Meaden St Southbank Vic 3006 Tel : 1300 184 477

http://smartconnection.com.au/ Version 12 Feb 2015

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STANDARD ENROLMENT QUESTIONS

COURSE INFORMATION

Course Code and Name :

PERSONAL DETAILS

1. Enter your full Name Full Official name as per your Identification (ID) document that you are presenting for this enrolment. Your name will be checked electronically through the Document Verification Service (DVS) which verifies common Australian forms of ID. If in your ID document that you are presenting for this enrolment have names with initial in the document, you will need to provide in the Given name below in full. NO alias, NO abbreviation, and NO initial. E.g. Mary J Smith embossed on Mary’s medicare card. In the Family Name it will be Smith and in the Given Names will be Mary Jane. Family Name (surname): Given Names :

2. Date of birth Day/month/year:

/ /

3. Gender (Tick one box

only)

Male Female

4. Contact

Home Phone : Work Phone :

Mobile :

5. Email :

6. 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’s or territory’s “rural property addressing” or “numbering” system as your residential street address.

Building / property name : Flat/unit details and Street or lot number : Street Name : Suburb, locality or town : State / territory : Postcode : Country :

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7. What is your postal address (if different from above)? Building / property name : Flat/unit details and Street or lot number : Street Name : Postal delivery information (e.g. PO Box 254) Suburb, locality or town : State / territory : Postcode : Country :

EMERGENCY CONTACT

8. Name :

9. Relationship:

10. Address:

11. Phone:

LANGUAGE AND CULTURAL DIVERSITY

12. In which country were you born?

Australia Other – please specify ____________________________________________________

13. Do you speak a language other than English at home? (If more than one language, indicate the one that is spoken most often)

No, English only – Go to question 15. Yes, other – please specify ___________________________________

14. How well do you speak English? Please tick one box.

Very Well Well Not Well Not at all

15. Are you Aboriginal or Torres Strait Islander origin? (For persons of both Aboriginal and Torres Strait Islander origin, mark both “Yes” boxes)

No Yes, Aboriginal Yes, Torres Strait Islander

DISABILITY

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

Yes No – Go to question 18

17. If you indicated the presence of a disability, impairment or long term condition, please select the area(s) in the following list : (You may indicate more than one area)

Hearing / deaf Physical Intellectual

Learning Mental Illness Acquire Brain Impairment

Vision Medical Condition Other


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SCHOOLING

18. What is your highest COMPLETED school level ? (Tick ONE box only)

Completed Year 12 or equivalent Completed Year 11 or equivalent Completed Year 10 or equivalent

Completed Year 9 or equivalent Completed Year 8 or below Never attended school

19. In which YEAR did you complete that school level? ________________________

20. Are you still attending secondary school?

Yes No

PREVIOUS QUALIFICATIONS ACHIEVED

21. Have you SUCCESSFULLY completed any of the following qualifications?

Yes No – Go to question 23

22. If yes, then tick any applicable boxes.

Bachelor degree or higher degree 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

EMPLOYMENT

23. Of the following categories, which BEST describes your current employment status? (Tick ONE box only)

Full-time employee Part-time employee Self-employed – not employing others

Employer Employed – unpaid worker in a

family business Unemployed – seeking full-time work

Unemployed – seeking part-time work Not employed – not seeking

employment

STUDY REASON

24. Of the following categories, which BEST describes your main reason for undertaking this course / traineeship /

apprenticeship? (Tick ONE box only)

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 self-development Other reasons

UNIQUE STUDENT IDENTIFIER (USI)

25. Do you have a Unique Student Identifier (USI)?

Yes, the number is , , GO TO Signatures.

No, I give permission to Smart Connection Training to apply on my behalf. I am providing you one of the following ID. Please tick ONE of the ID that you are providing as evidence. Please go to question 26.


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Personal Identification (Select ONE only) Any document chosen by the student for identification must be current and valid except Australian Passport be current or have an expiry date within the last two years. A Driver’s License must be issued by an Australian State or Territory. *Note that people with one name only will not verify with DVS using a

driver’s license so please provide a different form of ID.

Driver’s License State : License Number : A Medicare Card must be issued by Medicare Australia

Medicare Card Card Colour : Medicare Card Number : Expiry (Valid To) : Reference No. : A Passport must be issued by the Australian Government and be current or have an expiry date within the last two years.

Australian Passport Passport (Document) No. starts with a letter : The ImmiCard is issued by the Australian Government to persons on Refugee and Humanitarian grounds.

ImmiCard ImmiCard No. :

Non-Australian citizens intending to study in Australia require a Visa issued by the Australian Government. The visa must be current and valid. Visa (with Non-Australian Passport) for international students Passport No: Country of Issue : Visa No. : A Certificate of Registration by Descent is issued by the Australian Government to a person who was born outside Australia and at least one of

their parents was an Australian citizen at the time of their birth.

Certificate of Registration By Descent Acquisition Date :

Birth Certificate (Australian) *please note a Birth Certificate extract is not sufficient. A Birth Certificate can refer to either an original document or a certified copy issued by an Australian State or Territory. State : Registration Number : Date of Registration : Year of Registration: Date Printed (if applicable): Certificate No. : A Citizenship certificate is proof of citizenship for people that were born outside Australia and who have been formally accepted as Australian

citizens. This certificate is issued by the Australian Government.

Citizenship Certificate Stock No. : Acquisition Date :


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26. To create an USI on behalf of you by Smart Connection Training, the information you will need to provide by you are as below:-

a) One name (if your chosen form of ID only has one name) : ____________________________________________________

b) Town / City of birth : _________________________________________________________________

c) Country of birth : ____________________________________________________________________

d) Gender (Students who wish to have their gender recorded as ‘unspecified’ or ‘x’ must contact the USI Team on 13 38 73 or International enquiries

+ 61 3 5454 5280) :

Male Female X – Unspecified If you are physically located in another country and studying on-line with Smart Connection Training, the Country of Study is Australia. OR If you are living outside of Australian (overseas) and currently filling this enrolment form, the Country of Study is Australia.

e) Country in which, you are studying : ___________________________________________________________

f) Contact Information : You are required to provide at least one method of contact (e.g. e-mail, mobile or mail). If you have not fill in these

information in Q4, Q5 and Q6 or you prefer to have different contact information as the Q4, Q5 or Q6 please provide to the below : E-mail : _______________________________________________________________________________________ Mobile : ______________________________________________________________________________________ Mail (address) : _______________________________________________________________________________________________ If you uses ‘mail’ as your preferred contact method, you will need to access a computer to activate your USI account or change your password.

DECLARATION, PRIVACY & SIGNATURES

Privacy Notice If you do not already have a Unique Student Identifier (USI) and you want Smart Connection Training to apply for a USI to the Student Identifiers Registrar (Registrar) on your behalf, Smart Connection Training 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 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 Smart Connection Training to make an application for a student identifier on your behalf, Smart Connection Training will have to declare that Smart Connection Training 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 Smart Connection Training to has given you the following privacy notice:


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You are advised and agree that you understand and consent that the personal information you provide to us in connection with your application for a USI: 1) Is collected by the Registrar for the purposes of:

o Applying for, verifying and giving a USI; o Resolving problems with a USI; and o Creating authenticated vocational education and training (VET) transcripts;

2) May be disclosed to:

o 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;

o VET Regulators to enable them to perform their VET regulatory functions; o VET Admission Bodies for the purposes of administering VET and VET programs; o 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; o Schools for the purposes of delivering VET courses to the individual and reporting on these courses; o 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; o Researchers for education and training related research purposes; o Any other person or agency that may be authorised or required by law to access the information; o 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 o 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 (http://usi.gov.au/Pages/privacy-policy.aspx) or by contacting the Registrar at: Privacy Officer Office of the USI Registrar Canberra City ACT 2601 GPO Box 9839 Canberra ACT 2601 Email: [email protected] 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 Smart Connection Training collects, uses and discloses your personal information generally, including how you can make a complaint about a breach of privacy, please refer to Smart Connection Training privacy policy which can be found at http://smartconnection.com.au/wp-content/uploads/2014/01/Smart-Connection-Training-Handbook.pdf . This Privacy Policy contains information n 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 and signing this notice, 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. I understand that information contained in these forms may be provided to State and Commonwealth agencies and research organization. I consent to that occurring. I certify that all details provided in this form is correct and accurate.


http://smartconnection.com.au/wp-content/uploads/2014/01/Smart-Connection-Training-Handbook.pdf

http://smartconnection.com.au/wp-content/uploads/2014/01/Smart-Connection-Training-Handbook.pdf

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Signature of applicant:

Date:

Name of applicant :

(if applicant under 18 years of age) Signature of parent / guardian

Date :

Parent / Guardian Name :


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VICTORIAN TRAINING GUARANTEE / FEE FOR SERVICE

APPLICANT INFORMATION

1. Name (Legal Given Name and Surname):

2. If you are under 18 years of age you will need to provide your parent / guardian details : Parent / Guardian Name : __________________________________________________________________________ Parent / Guardian Contact Details Address : _______________________________________________________________________________________ Home Phone : ____________________________________ Mobile : _______________________________________ Email : _______________________________________________________________________________________________

COURSE INFORMATION

3. Course Code and Name :

4. Eligibility (to be completed by SCT Enrolment Officer)

Eligible for VTG Funding Not Eligible for VTG Funding – FEE for Service

EMPLOYMENT INFORMATION (IF YOU’RE EMPLOYED)

5. Current employer:

Your position held :

Workplace Address : Contact Person Name : Contact Person Position : Contact Person Phone :

Phone : Fax : Email :

STUDENT IDENTIFICATION NUMBER

6. Victorian Student Number To be completed by all students aged up to 24 years: Since 2009 in schools and since 2011 for vocational education and training (VET) organisations and Adult Community Education providers, a Victorian Student Number (VSN) has been allocated upon enrolment to each individual student aged up to 24 years. Students should report their VSN on all subsequent enrolments at a Victorian school or training organisation. In particular, all students who are currently enrolled in either a VET provider or a Victorian school (including those already participating in a VET in schools program) should obtain their VSN from their current education or training organisation and report their VSN on this enrolment form. Students who are enrolling for the first time since the VSN was introduced will get a new VSN.

Enter your Victorian Student Number (VSN)

No more questions if you provided your VSN.


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Have you attended any Victorian school since 2009 or done any training with a vocational education and training (VET) registered training organisation or an Adult and Community Education provider in Victoria since 2011?

No - I have not attended a Victorian school since 2009 or a TAFE or other VET training provider since the beginning of 2011. No more questions if you answer NO above. __________________________________________________________________________________________________________

Yes - I have attended a Victorian school since 2009: Most recent Victorian school attended ____________________________ And / or

Yes – I have participated in training at a TAFE or other training organisation since the beginning of 2011. List the most recent training organisations with which you have participated in training in Victoria since 2011 (List up to 3 training organisations) 1. ____________________________________________________________________________________ 2. ____________________________________________________________________________________ 3. ____________________________________________________________________________________

VICTORIAN VET STUDENT STATISTICAL REQUIREMENTS

7. Previous qualification achieved Have you SUCCESSFULLY completed any of the following qualifications? No – go to question 8

Yes No If Yes, please enter one of these Prior Education Achievement Recognition Identifiers any applicable qualification level. A – Australian E– Australian equivalent I – International Note: If you have multiple Prior Education Achievement Recognition Identifiers for any one qualification, use the following priority order to determine which identifier to use: 1. A – Australian 2. E– Australian equivalent 3. I – International A E I

Bachelor Degree or Higher Degree

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


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8. Employment A) Which of the following classifications BEST describes your current or recent occupation? (Tick ONE box only) If unemployed go to Question B

1 – Managers

2 – Professionals

3 – Technicians and Trade Workers

4 – Community and Personal Service Workers

5 – Clerical and Administrative Workers

6 – Sales Workers

7 – Machinery Operators and Drivers

8 – Labourers

9 – Other

B) Which of the following classifications BEST describes the Industry of your current or previous Employer? (Tick ONE box only) If unemployed go to next Question Tuition Fee Waivers / Concessions.

A - Agriculture, Forestry and Fishing

B - Mining

C - Manufacturing

D - Electricity, Gas, Water and Waste Services

E - Construction

F- Wholesale Trade

G - Retail Trade

H - Accommodation and Feed Services

I - Transport, Postal and Warehousing

J - Information Media and telecommunications

K - Financial and Insurance Services

L -Rental, Hiring and real Estate Services

M -Professional, Scientific and Technical Services

N - Administrative and Support Services

O - Public Administration and Safety

P -Education and Training

Q - Health Care and Social Assistance

R - Arts and recreation Services

S - Other Services


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TUITION FEE WAIVERS / CONCESSIONS (IF APPLICABLE)

9. Do you have Concession card or waiver? (Please tick applicable box) Appropriate RTO delegate must sight original and retain a copy either hard copy or electronically. Where a concession card is presented to the RTO via a Digital Wallet through a Centrelink Express Plus mobile application, the RTO must sight and authenticate the card by viewing the card directly through the Centrelink Express Plus mobile application on the cardholder’s mobile device. These cards may not be sighted via a screen shot of the card that is e-mailed or otherwise produced.

Yes No

Concession fees – 20% of the published standard tuition fee Waiver (no fee applies)

Health Care Card issued by the Commonwealth (Copy required) OR

Pensioner Concession Card (Copy required) OR

Dependent Spouse or Child of a card holder for either of the above(Copy required) OR

Veteran’s Gold Card (Copy required) OR

An alternative card or concession eligibility criterion approved by the Minister for the purposes of the Victorian Training Guarantee 2015 guidelines about Fees) OR

Jobseeker Referral Form (Copy required for file & copy required to be forwarded to referral agency – invoice the referring agency directly for the portion of the tuition fee not paid by Jobseeker) OR

Individual who self identifies as Aboriginal or Torres Strait Islander descent (copy of the “1 Standard Enrolment Questions” form is required as record of self-identification as Indigenous )

Individual who is from the Judy Lazarus Transition Centre (RTO must retain copy of written confirmation from the management of the Centre)

Young people on community based order - Individual who is required to take the course before (pursuant) to a community based order made under the Children, Youth and Families Act 2005. (RTO must retain a copy of written confirmation from the relevant Youth Justice unit of the Victorian Department of Human Services that the individual meets the requirements)

FEES

How will you be paying the fees?

Cash Credit Card – Smart Connection Training representative will call for your credit card details.

DECLARATION

Privacy Statement I understand that: Smart Connection Training 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 Smart Connection Training 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.


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Your information may also disclose for the purpose of 1) External audit by regulator or funding body 2) Victorian Commission for Gambling and Liquor Regulation, Department of Justice All information collected is strictly confidential and will only be used for Government required statistical purposes and or audit processes (as stated above) and as per Smart Connection Training Privacy policy retrieval and pursuant to Privacy Amendment (Enhancing Privacy Protection) Act 2012 and the Privacy Regulation 2013. For more information in relation to how student information may be used or disclosed please contact Smart Connection Training’s Privacy Officer on 1300 184 477.

I acknowledge and agree to the terms described in this privacy statement Yes No Photo Consent Smart Connection Training occasionally takes photos of students participating in classes for publicity purposes. These photos may be displayed on our website. The names and details of the people in the photos are not released or published. Staff will always announce and inform those that in the environment where photos will be taken, therefore students who don’t wish to have their photo taken can be excluded from the photo. If any one time your photo is published on the website and you have changed of mind to have it removed, we will do so within 7 working days of receiving a written request to remove it.

Do you consent to the use of your photo under these conditions? Yes No Student Handbook

I can confirm that I have received, read and understand the student handbook. Yes No Recognition of Prior Learning / Credit Transfer I confirm that I have received information regarding the RPL process / Credit Transfer as described in the Student Handbook and understand what is required to achieved RPL / Credit Transfer for unit/s of the qualification I am enrolling. I was informed of the opportunity to apply for the RPL / Credit Transfer if I choose to do so and it is recommend to do so prior my commencement of study.

Yes No Course Requirements In some courses in Community Services / Hospitality you will be required to do Work Placement activities (WPA), which are compulsory component of the course as you will require to participate and complete the necessary requirements in the work placement activities. Certificate could not be issue without the successful completion of the work placement activities. A satisfactory police check will be required before you can commence any work placement in the Community Services industry. Therefore you will be required to provide a satisfactory police check as soon as possible prior your commencement of work placement. If you are undertaking any Children Services Certificate courses, you must also obtain a Working with children (WWC) check and you must submit a copy to Smart Connection Training representatives as soon as you receive it and prior your commencement of work placement activities.

I understand and accept the course requirements Yes No N/A

SIGNATURES

I acknowledge and agree to the conditions and guidelines in this enrolment documents, and terms described in the privacy statement.

Signature of applicant:

Date:

Signature of parent / guardian : (only if the applicant is under 18 years of age):

Date:


PTR (SIS)

S m a r t C o n n e c t i o n T r a i n i n g R T O N o . 3 9 1 0

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Pre Training Review

Student Name : ____________________________________________________________

Course Code & Name : ________________________________________________________

A Pre-Training Review is conducted to ensure that the learning and assessment strategy design is able to meet

your individual needs and your workplace requirements (if you are employed). The pre-training review will ensure

that Smart Connection Training:

1. Understands your objectives for undertaking this course

2. Explores your current competencies and provides opportunities for these to be assessed through

Recognition of Prior Learning (RPL), Recognised Current Competency (RCC) or Credit Transfer (CT).

3. Ensures your Language, Literacy and Numeracy skills suit the learning and assessment strategies.

4. Provides the relevant support required for you to successfully undertake this course

Refer to the Course Information Guide for the qualification you are intending to undertake and review this in light

of your expectations and previous experience.

All questions must be answered.

1. Briefly explain why it is you are undertaking this training program.

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

Your expectations

2. What do you hope to gain from this course?

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

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3. What benefits do you think this course will provide personally and professionally?

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

Employment & Qualification

4. If employed, what type of industry do you work in, how long have you worked in this industry?

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

5. Please list any Qualifications or Statements of Attainment you have previously gained that may relate to this

qualification

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

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Credit transfer / RPL / RCC

6. After reviewing the units listed in the Course Information, are there any units you have previously completed

and can provide documented evidence? List below, if space provided in suffice, insert additional paper:

UOC Code Unit of Competency Name

7. Do you want to apply for Recognition of Prior Learning (RPL) or Recognised Current Competency (RCC)? Please

tick the relevant one that you want to apply for.

Recognition of Prior Learning (RPL) Recognised Current Competency (RCC)

Previous learning experiences:

8. In your past learning experiences, have you encountered any learning difficulties or barriers to learning?

Yes No

Yes, please explain and if no please give a brief description of your past learning experiences that you enjoy the

learning experiences:

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

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9. Please circle the description of your preferred learning method:

Tick the learning styles which has the most methods circled? Tick two boxes if 2 are the same.

Visual Auditory Kinaesthetic

All (when you have the same total of circles in all three learning style)

Student Support

10. From the information that you currently have about the course, is there anything we need to know to support

your learning?

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

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Trainer to provide and discuss with student

Item Discussed

If

covered at

pre

training

review

(By Student)

If evidence

has been

collected

/sighted

(By SCT

Representative)

FORM DETAILS

VTG 2015 Evidence of Student Eligibility and Student Declaration (including

Applicants Eligibility Assessment)

Evidence of Citizenship/Proof of age (if applicable)

Evidence of Eligibility by referral agency or exemption if applicable (detail in

comments section on the reverse of this page)

Enrolment Form & Confidentiality

Numeracy and Literacy review

CLIENT INFORMATION

Statement of Fees for Government Funded Training OR Fee for Service

Evidence of fees waiver/exemption/Concession (refer to Enrolment form for

detail)if applicable

Course Info

Student Handbook

Refund Policy

Complaint and Appeal Policy

Training & Assessment Strategies

Obligations by the Employer, the RTO and the Student

(if it is Apprenticeship / Traineeship / School Based Traineeship

RPL / RCC / CT Opportunity

Trainees Recognition of Prior Learning (RPL) / RCC Checklist if student is

applying for RPL or RCC

Does this student have Credit Transfer

Yes No

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Comments regarding any additional actions required (to be fill in by

trainer) - (if applicable) :

To be Actioned by

Student Declaration

I acknowledge that the information provided the above is true and correct. I also acknowledge that I have been

provided an opportunity to ask questions.

Student Signature : ____________________________________________

Student Name : ____________________________________________

Date : ____________________________________________

PRE-TRAINING EVALUATION - Trainer/Assessor to complete

Trainers/Assessors must use this form to evaluate students’ Pre-Training Review to determine their LLN skills level and that

the student is enrolled in a course according to their needs and abilities, and to recommend appropriate LLN, learning or

other specific support arrangements. This form may be used to record any additional pre-enrolment evaluations undertaken

(e.g. interviews).

Trainers/Assessors identify the language, literacy and numeracy information in the Training and Assessment Strategy or

Training Packages to ensure appropriate training is delivered and assessments are fair, valid, flexible and reliable. They may

also use the Australian Core Skills Framework as guidelines for their evaluation.

In the context of the qualification and the job role and the level of language, literacy and numeracy that the vocation and

industry requires, consider the following questions:

• What does the student have to listen to and understand?

• What does the student have to say?

• What does the student have to read?

• What does the student have to write?

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• Does the student need to understand and interpret diagrams, pictures or symbols?

• What maths calculations does the student need to do?

Additional Language, Literacy, and Numeracy assistance required to achieve workplace competency?

Yes No

Review deems proposed assessment instruments, learning material and strategies as appropriate.

Yes No

Review deems proposed assessment instruments, learning material and strategies require adjustment.

Yes No

Additional language, literacy or numeracy support will be required. Yes No

Review identified current competence (list below) (if Mutual Recognition, attach Statement of Results)

Yes No

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

Date of Pre Training Review _______/_______/_____

Employer Name: (if applicable)

Supervisor/Employer Name: (if applicable)

Signature of Smart Connection representative

conducting Pre Training Review

Print name of Smart Connection representative

conducting Pre Training Review

LLN (SIS)

© Commonwealth of Australia, 2013 P a g e | 8 Version 16 Dec 2014 Admit a resident & Making numbers work 1 downloaded from www.precisionconsultancy.com.au/acs_framework

LLN for SIS

Student Name : ____________________________________________________________

Course Code & Name : ________________________________________________________

Directions to the student

This test must be completed by you, and completed on your own.

Once you have completed the LLN test, it will be assessed by an authorised Smart Connection

Training (SCT) representative. If your results are not to the satisfactory requirement to gain entry to

the course, your SCT representative will speak to you about assistance that you may be able to

access or required.

Please answer each question.

Please read each question thoroughly before answering.

If you are unsure about any question, you may seek advice from your SCT representative.

Admit a resident

Part A

Mr Andrew John Stephens moved into Carlton Manor two days ago. He is 82 years old – born on

New Year’s Day – and describes himself as being in ‘tiptop’ condition. He likes to be called ‘AJ’. His

walking is limited and is characterised by a pronounced limp, the result of a number of (right) knee

operations over the last 15 or so years. His left ankle is also significantly dSCTged from contact sport

in his earlier years, and this causes him pain. He is very reluctant though to take any pain killers and

says he needs to be encouraged to do gentle exercise to avoid further dSCTge. He is on medication

for cholesterol and takes aspirin as a precautionary measure. Three years ago he received ongoing

treatment for an enlarged prostate and is under observation for that condition, which causes him

some discomfort and inconvenience when urinating.

Mr Stephens had a successful career in government ranks and indicated in the interview that he

would be keen to be on any resident committees at Carlton Manor. He is alert with a good command

of English, his first language. He also speaks and understands a little French. He reads the newspaper

(normal print size) each day and enjoys discussing current affairs, and watching current affairs and

documentaries on TV. He says he sometimes forgets names and dates and can become confused if

there is a lot of change. Mr Stephens does not have any particular hobbies, nor does he like physical

exercise. He says he played enough football in his youth to last him a lifetime. It was interesting that,

on invitation, he joined the regular ladies’ card group both afternoons that he was there and seemed

to enjoy the experience.

Mr Stephens describes himself as having a very healthy appetite and likes a broad range of foods. He

enjoys a glass of sweet white wine with dinner.

LLN (SIS)


1. What do you think Carlton Manor is? (1 point)

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2. Who do you think is the audience for this bio of Mr Stephens? (1 point)

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3. Explain in your own words what you think the following phrases mean:

a) tiptop condition (1 point) __________________________________________________

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b) contact sport (1 point) ____________________________________________________

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c) pronounced limp (1 point) _________________________________________________

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d) precautionary measure (1 point) ____________________________________________

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LLN (SIS)


4. The table below shows how many boxes of apples, bananas, grapes and oranges were sold by

Greens Fruit Shop in December 2013.

60

50

40

30

20

10

Apples Bananas Grapes Oranges

a) What was the most popular fruit sold by Greens during December 2013? (1 point)

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b) What was the least popular fruit sold by greens during December 2013? (1 point)

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c) Did Greens sell more apples or oranges in December 2013? (1 point)

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5. Circle the correct answer. Greens sold half as many grapes as: (1 point) Apples Bananas Oranges

6. Each box of oranges holds 50 oranges. How many oranges did Greens sell in December 2013? (1 point)

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7. In November 2013 Greens sold 10% fewer apples than in December. How many boxes of apples

did they sell in November? Can you mark this on the table in question 13? (1 point)

LLN (SIS)


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8. The following table shows the normal price and the closing down sale price for a range of goods

at Top Shelf Office Supplies.

TOP SHELF OFFICE

Item Normal Price $

Closing Down Sale Price $

Lap Top Computers 1500.00 1000.00

Top Quality Paper (Box) 26.00 13.00

Desk Chairs 155.00 100.00

Filing Cabinets 80.00 60.00

Blank CDs (box of 20) 40.00 32.00

Use the information from the table to answer the following questions. Show how you worked out your answers without using a calculator.

a) What is the difference in dollars between the normal price and the sale price for the desk

chairs? (2 points) b) You buy one computer and two boxes of paper at the sale price. What is the total that you

will pay? (2 points) c) How much would two filing cabinets cost at the normal price? (2 points)

LLN (SIS)


d) You purchase two computers at the sale price. How much have you saved on the normal

price? (2 points)

9. What is the percentage (%) saving of the filing cabinets in the sale? Show your working out. (2 points)

10. How much change would you get from $500.00 if you purchase the following items? Show

your working out.

a) Two boxes of paper (2 points)

b) 40 blank CDs (2 points)

c) One desk chair (2 points)

Declaration of Authenticity

LLN (SIS)


I declare that I (name)_______________________________have completed the SCT Language,

Literacy and Numeracy pre-training test.

Signed __________________________________________________________________

Print name ________________________________________________________________

Smart Connection Training (SCT) representative officer to complete

Score: _______/ 28 points (22 – 28 points = 80-100%)

(Below 80%, alternate assistance may be required)

Remarks by the SCT representative Officer (if applicable)

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

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SCT representative officer name _____________________________________________

Date___________________________________

Documents

STANDARD ENROLMENT QUESTIONS - Tennis Australia · Smart Connection Company Pty Ltd t/a ... and currently filling this enrolment form, ... birth certificate, driver licence, Australian