ONLINE ENROLMENT FORM - CHC33021 CERTIFICATE III IN INDIVIDUAL SUPPORTPlease enable JavaScript in your browser to complete this form.1Personal Details2Unique Student Identifier (USI)3AVETMISS Data Collection4Privacy Notice5Submit 1 – Personal Details Title: *MrMrsMsMissotherName *FirstMiddleLastDate of Birth: *Gender *MaleFemalePrefer not to specifyHome Address *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryMobile/Telephone: *Email *Emergency Contact Contact Name *FirstLastRelationship:Contact NumberHow did you hear about us? EmployerFacebookGoogle SearchInstagramLinkedInWord of MouthOtherContinue2 – Unique Student Identifier (USI) Do you have a USI? *YesNoIf Yes, Please Enter your unique student identifier USIInformation From January 2015 it is compulsory for all students enrolling in nationally recognised training at any College or University to obtain a Unique Student Identifier (USI). This number will be your own personal student number which can be used across all educational institutions. If you do not already have a USI, you will need to create one prior to enrolment at Brighten Institute Australia. Please create a USI by clicking on the link below where you will be directed to the USI government website, then return here to continue your enrolment. CREATE A USI Recognition of Prior Learning Do you wish to apply for Recognition of Prior Learning? Yes, I doNo, I don'tPreviousContinue3 – AVETMISS Data Collection Q1. Of the following categories, which best describes your main reason for undertaking this course? *To get a job (01)To develop my existing business (02)To start my own business (03)To try for a different careers (04)To get a better job or promotion (05)It was a requirement of my job (06)I wanted extra skills for my job (07)To get into another course of study (08)For personal interest or self-development (12)To get skills for community/voluntary work (13)other reasons (11)Q2. Of the following categories, which best describes your current employment status? *Full-time employeePart-time employeeSelf-employed - Not employing othersSelf-employed - Employing othersEmployed - Unpaid worker in a family businessUnemployed - Seeking full-time workUnemployed - Seeking part-time workNot Employed - Not seeking employmentQ3. Are you still enrolled in secondary schooling? *YesNoQ4. What is your HIGHEST completed school level?Did not go to schoolYear 8 or 9 belowYear 9 or equivalentCompleted Year 10 or equivalentCompleted Year 11 or equivalentCompleted Year 12 or equivalentQ5. In which year did you complete that school level? *Prior Education (Post-Secondary) Q6. Have you successfully completed any post-secondary education? *YesNoPrior Education - Have you completed any of the following qualifications? (Select all that apply) *Certificate I (524)Certificate II or Advanced Certificate/Technician (521)Certificate III or Trade Certificate (514)Certificate IV or Advanced Certificate/Technician (511)Certificates other than the above (990)Diploma or Associated Diploma (420)Advanced Diploma or Associated Degree (410)Bachelor or higher degree (008)Language Q7. In what country were you born? *Australia (1101)Other Country(Please Specify)Q8. Do you speak a language other than English at home (If more than one, please specify the language you speak most often) *No, English onlyYes, I speakPlease SpecifyQ9: How well do you speak English? *Very WellWellNot WellNot at allDisability Q10: Do you consider yourself to have a disability, impairment, or long-term condition?Hearing/Deaf (11)Physical (12)Intellectual (13)Learning (14)Mental Illness (15)Acquired brain impairment (16)Vision (17)Medical Condition (18)Other (please specify) (19)Please Specify *Indigenous Status Q11. Are you of Aboriginal or Torres Strait Islander origin? *Yes, Aboriginal.Yes, Torres Strait IslanderYes, Aborigial and Torres Strait IslanderNo, neither Aboriginal nor Torres Strait IslanderSmart & Skilled Funding Q1. If offered, do you wish to apply for Smart & Skilled Funding? *YesNoPersonal Eligibility a) Please select the living/working location that best describes you. *Live or work in NSW (determined by postcode of the usual place of residence or place of work); ORLive in a defined NSW border area as identified by a postcodeb) What is your citizenship status: *Australian CitizenAustralian Permanent ResidentHumanitarian visa holderItemNew Zealand CitizenNone of the above(please sepecify)c) Are you over 15 years old? *YesNod) Are you either... *No longer in secondary school; ORa Year 12 school leaver in 2021Fee Free Scholarship Eligibility e) Are you a recipient of a Commonwealth Government welfare benefit? *YesNoif you answered yes, please select the welfare benefit you receive below: Select the welfare benefit *AustudyAge PensionCarer PaymentFamily Tax Benefit (Part A)JobseekerParenting Payment (single)Sickness AllowanceSpecial BenefitVeterans' Affair PensionVeterans' Children Education SchemeYouth AllowanceOtherPlease specifyf) Are you: *Aged between 17 to 25 at the time of enrolmentAged between 17 to 25 at the start date for trainingNone of the aboveEmployment Status g) Are you: *UnemployedEmployed, but need to undertake work relevant trainingExpected to become unemployedStood down or furloughedh) Have you attached evidence of this? *YesNoPlease specifyHousing i) Do you live in a NSW housing department household? *YesNoPrevious Study j) Have you undertaken any government subsidised fee free training/qualification in Year 2023? *YesNoDate / TimePreviousContinue4 – Privacy Notice Please read carefully Why we collect your personal information As a registered training organisation (RTO), we collect your personal information so we can process and manage your enrolment in a vocational education and training (VET) course with us. How we use your personal information We use your personal information to enable us to deliver VET courses to you, and otherwise, as needed, to comply with our obligations as an RTO. How we disclose your personal information We are required by law (under the National Vocational Education and Training Regulator Act 2011 (Cth) (NVETR Act)) to disclose the personal information we collect about you to the National VET Data Collection kept by the National Centre for Vocational Education Research Ltd (NCVER). The NCVER is responsible for collecting, managing, analysing and communicating research and statistics about the Australian VET sector. We are also authorised by law (under the NVETR Act) to disclose your personal information to the relevant state or territory training authority. How NCVER and other bodies handle your personal information NCVER will collect, hold, use and disclose your personal information in accordance with the law, including the Privacy Act 1988 (Cth) (Privacy Act) and the NVETR Act. Your personal information may be used and disclosed by NCVER for purposes that include populating authenticated VET transcripts; administration of VET; facilitation of statistics and research relating to education, including surveys and data linkage; and understanding the VET market. NCVER is authorised to disclose information to the Australian Government Department of Education, Skills and Employment (DESE), Commonwealth authorities, state and territory authorities (other than registered training organisations) that deal with matters relating to VET and VET regulators for the purposes of those bodies, including to enable: administration of VET, including program administration, regulation, monitoring and evaluation facilitation of statistics and research relating to education, including surveys and data linkage understanding how the VET market operates, for policy, workforce planning and consumer information. NCVER may also disclose personal information to persons engaged by NCVER to conduct research on NCVER’s behalf. NCVER does not intend to disclose your personal information to any overseas recipients. For more information about how NCVER will handle your personal information please refer to the NCVER’s Privacy Policy at www.ncver.edu.au/privacy. If you would like to seek access to or correct your information, in the first instance, please contact your RTO using the contact details listed below. DESE is authorised by law, including the Privacy Act and the NVETR Act, to collect, use and disclose your personal information to fulfil specified functions and activities. For more information about how the DESE will handle your personal information, please refer to the DESE VET Privacy Notice at https://www.dese.gov.au/national-vet-data/vet-privacy-notice. Surveys You may receive a student survey which may be run by a government department or an NCVER employee, agent, third-party contractor or another authorised agency. Please note you may opt out of the survey at the time of being contacted. Contact information At any time, you may contact Brighten Institute Australia to: request access to your personal information correct your personal information make a complaint about how your personal information has been handled ask a question about this Privacy Notice Please tick and agree below to state that you have read, understood and agree to the Privacy Notice outlined above: Privacy Notice – Please read carefully *YES, I understood and agree to the Privacy Notice outlined above:PreviousContinue5 – Submit Course Name: CHC33021 CERTIFICATE III IN INDIVIDUAL SUPPORTPrice: $7,500.00Full Couse $7,500.00, The 1st instalment as $1,500Select your course commencement date *Which mode of delivery would you like to conduct the course in? *Face to faceOnlineBlendedConsent * CONSENT *I have read and understand BIA’s Privacy Notice and agree to the Disclosure of Personal Information to the Department of Education and Other Government Agencies.CONSENT 2 *I authorise Brighten Institute Australia and the Department of Education to have appropriate access to my USI records.Student Declaration The information I have provided is true, accurate, complete, and not misleading in any way. I am a NSW resident or worker including where specified in an approved border area (Aboriginal and Torres Strait Islander only). I have completed and signed this Enrolment Form. Under the Data Provision Requirements 2012, Brighten Institute Australia is required to collect personal information about you and to disclose that personal information to the National Centre for Vocational Education Research Ltd (NCVER). More information regarding this is found on page 6 of the Enrolment Application form, and in our Privacy Policy (https://www.brighten.edu.au/archive/downloadable/policies/privacy) I have read and understood the Student Handbook Student Name *Signature *Clear SignatureTotal$0.00Credit Card *
