Application for Enrolment Form

Applicant 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 and want [name of RTO] to apply for a USI on your behalf, you must write your name, including any middle names, exactly as written in the identity document you choose to use for this purpose. See section on the USI at the end of this form for a detailed explanation. Note: Course Fees on the website are the maximum and may be reduced at time of enrolment depending on Seasonal Specials run by the Institute.

Gender* - MaleFemale

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.

Privacy Statement & Student Declaration

I declare that the information I have provided to the best of my knowledge is true and correct.

I understand that my RTO, International Institute Australia is required to submit data sourced from this enrolment form to the national VET administrative collection as a regulatory reporting requirement. The information contained on my enrolment form may be used by my RTO or the following third parties for administrative, regulatory and/or research purposes:

  • School - if I am a secondary student undertaking VET, including a school based apprenticeship or traineeship.
  • Employer - if I am enrolled in training paid by my employer.
  • Government departments and authorised agencies.
  • Researchers.

Application for Unique Student Identifier
If you would like us [International Institute Australia] to apply for a USI on your behalf you must authorise us to do so and declare that you have read the privacy information at http://www.usi.gov.au/Training-Organisations/Pages/Privacy-Notice.aspx. You must also provide some additional information as noted at the end of this form so that we can apply for a USI on your behalf.

I authorize International Institute Australia to apply pursuant to sub-section 9(2) of the Student Identifiers Act 2014, for a USI on my behalf.

I have read and I consent to the collection, use and disclosure of my personal information pursuant to the information detailed at <a href=http://www.usi.gov.au/Training-Organisations/Pages/Privacy-Notice.aspx>http://www.usi.gov.au/Training-Organisations/Pages/Privacy-Notice.aspx</a>

I understand that I may receive a National Centre for Vocational Education Research (NCVER) student survey.

Note: parental consent required if student is under the age of 18.

Course Preferences

International and Local Students - Please Select


BSB40215 Certificate IV in Business (totaling 26 weeks)
BSB51915 Diploma of Leadership and Management (totaling 52 weeks)
BSB61015 Advanced Diploma of Leadership and Management (totaling 46 weeks)

Other Details (International Students)


Visa Status StudentTouristWorking HolidayOther
If you will be applying for a Student Visa, at which DIBP office will you apply? OffshoreOnshoreAlready have a Visa
Do you have Overseas Student Health Cover (OSHC)? YesNo
If YES - OSHC provider name:

If NO
Please arrange OSHC for meI will arrange my own OSHC
Details of OSHC SingleCoupleFamily
Dependants One dependant (Spouse or Child)More than one dependant

Employment Status

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

Full time Employee Not employed - not seeking employment
Part time Employee Employed - unpaid worker in a family business
Employer Unemployed - seeking full time work
Unemployed - seeking part time work Self-employed (not employing others)

Your Background

Are you of Aboriginal or Torres Strait Islander Origin?NoYes - AboriginalYes - Torres Strait IslanderYes - Both

Were you born in Australia? YesNo - my Country of Birth is:
Do you speak a language OTHER THAN English at home? If more than one language, indicate the one spoken most often.NoYes - we mainly speak:

How well do you speak English? Very WellWellNot WellNot at All

Do you require any language, literacy or numeracy assistance?YesNo

Do you have any disabilities?YesNo - If YES, please specify:

Hearing/Deaf Physical Intellectual Learning
Mental Illness Vision Medical Condition Acquired brain impairment
Other;
Do you have any special needs which may affect your learning? YesNo - If YES, please specify:

Prior Education

What is your highest COMPLETED school level?

Year 12 or equivalent Year 11 or equivalent
Year 10 or equivalent Year 9 or equivalent
Year 8 or below Never attended school

Where and in which YEAR did you complete that school level? AustraliaOverseas -

Are you still attending secondary school? YesNo

Since leaving school, have you COMPLETED any of the following qualifications? (select all that apply)

Bachelor degree or higher Advanced diploma or associate degree
Diploma (or assoc. Diploma) Certificate IV (or Advanced/Technician Cert)
Certificate III (or Trade Cert) Certificate II
Certificate I Certificates other than the above
If YES, what was the name of the qualification(s)?

Study Reason

Of the following categories, which BEST describes you 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
Requirement of my job To get a better job or promotion
Extra skills for my job To get into another course of study
Personal interest or self-development Other

English Level

English Language Level of Proficiency Achieved? BeginnerIntermediateAdvanced

Proficiency Score Test (IELTS, TOEFL, etc)

Recognition of Prior Learning

Are you seeking Recognition of Prior Learning? YesNo

Unique Student Identifier

From 1 January 2015, we International Institute Australia 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.

Enter your Unique Student identifier (if you already have one):

Additional Information for USI Application – Only required if you do not already have a USI

Town/City of Birth (please write the name of the Australian or overseas town or city where you were born)

We will also need to verify your identity to create your USI. 100 points ID requires photo or scan of Passport and Drivers Licence.

Please provide details for one of the forms of identity below.

Please ensure that the name written in ‘Personal Details’ section is exactly the same as written in the document you provide below.

Australian Driver Licence

State: Licence Number:

Medicare Card

Medicare card number: Individual reference number (next to your name on Medicare card):
Card colour: (select which applies) GreenYellowBlue Expiry date:

Australian Birth Certificate

State/Territory:

Australian Passport

Passport Number:

Non-Australian Passport (with Australian Visa

Passport Number: Country of issue:

Immicard

Immicard Number:

Citizenship Certificate

Stock Number: Acquisition date:

In accordance with section 11 of the Student Identifiers Act 2014, International Institute (Aust) Pty Ltd will securely destroy personal information which we collect from individuals solely for the purpose of applying for a USI on their behalf as soon as practicable after we have made the application or the information is no longer needed for that purpose, unless we are required by or under any law to retain it.

Attachments
Please attach the following to this application (a PDF or Photo):

Copy of Passport/ID -
Copy of Evidence of English language test/proficiency -
Evidence of completion of Year 12 or its equivalent -
Certified copies of Academic Transcripts -
Note: You must attach a completed Pre-Training Review Form which can be downloaded from here.
Pre-Training Review and LLN - -
Other, please specify? - -