Enrolment Application

Transcription

1 Enrolment Application Complete the Application Form and return to: Enrolment Officer The Training Collaborative 4 Cadagi St Meridan Plains, Qld, 4551 Or scan and to admin@trainingcollaborative.org.au Office Use Only Date Rec d / / Accpt d/decl Y N Receipt No. Student No. 1. Personal particulars Mr/Mrs/Miss/Rev/Dr etc.. Family Name:... Given Names:... Male: Female: What is the FULL address of your usual residence? Please provide the physical address (street address 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 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 Flat/unit details Street or lot number (e.g. 205 or Lot 118) Street name Suburb, locality or town State/territory Postcode What is your postal address (if different from above write as above if the same)? Postal delivery information (e.g. PO Box 254) Building/property name Flat/unit details Street or lot number (e.g. 205 or Lot 118) Street name Suburb, locality or town State/territory Postcode F.AD.001 TTC Enrolment Application Workshop.doc of 5

2 Phone Home... Work... Mobile: Date of Birth:... Person to contact in case of emergency: Phone:... Were you born in Australia? Yes No If no: In what country were you born?... What year did you arrive in Australia?... Are you an Australian citizen? Yes No What type of visa do you hold? Permanent Humanitarian Temporary Other... Are you of Aboriginal or Torres Strait Islander origin? No Aboriginal Torres Strait Islander Both Aboriginal and Torres Strait Islander 2. Student Status I am a current Carinity/Inside Out Chaplain or Carinity/Inside Out Chaplaincy Student I am not a current Carinity/Inside Out Chaplain or Carinity/Inside Out Chaplaincy Student. I heard about this workshop through I am currently enrolled with The Training Collaborative for the study of 3. Tick which workshop you are applying for: Accredited = assessment work and gaining of accredited unit, Non-accredited = no assessment work and statement of participation Title Coding Suicide Bereavement: Support those affected by suicide (accredited) CHCCCS018 Suicide Bereavement: Support those affected by suicide (non-accredited) No Coding Chronic Illness: Assisting those with chronic diseases (accredited) CHCCCS001 Chronic Illness: Assisting those with chronic diseases (non-accredited) No Coding DISCLOSURE Under certain circumstances The Training Collaborative is bound by law to disclose enrolment details for the purposes mentioned in the VETE Act 1991 and ESOS Act Agencies, such as Commonwealth and State Government departments, will be granted access to enrolment, attendance and study progress details. F.AD.001 TTC Enrolment Application Workshop.doc of 5

3 PLEASE COMPLETE ALL THE SECTIONS BELOW IF YOU ARE ENROLLING TO BE AN ACCREDITED PARTICIPANT AND ARE NOT AN ENROLLED STUDENT OF THE TRAINING COLLABORATIVE. IF ENROLLING TO BE A NON-ACCREDITED PARTICIPANT OR YOU ARE ALREADY AN ENROLLED STUDENT OF THE TRAINING COLLABORATIVE, PLEASE ONLY COMPLETE SECTIONS 7, 8, AND DECLARATION 4. Educational background 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 (go to question 3b) 3.1 In which year did you complete this school level? What suburb/town/locality were you living in if and when you completed Year 12? (ONLY if you completed Year 12 within the last 12 months)..postcode:. 3.2 Are you still attending secondary school? Yes No 3.3 Have you successfully completed any of the following qualifications? Yes No If yes, tick and name the qualification. YEAR COMPLETED Bachelor Degree or Higher Degree Advanced Diploma (or Associate Degree) Diploma (or Associate Diploma) Certificate IV (or Adv Certificate/ Technician) Certificate III (or Trade Certificate) Certificate II Certificate I Certificates other than the above Name of Qualification Recognition of Prior Learning (RPL): NOT APPLICABLE FOR THIS INTENSIVE. USI (Unique Student Identifier please click to obtain one):.. 5. Employment history: Of the following categories, which BEST describes your current employment status? (Tick 1) Full-time employee Employer Part-time employee Employed - unpaid worker in a family business Self-employed - not employing others Unemployed - seeking full-time work Unemployed - seeking part-time work Not employed - not seeking employment F.AD.001 TTC Enrolment Application Workshop.doc of 5

4 Please show details of the last five (5) years. Use extra pages if needed: Dates Nature of Employment Position Motivation for Change 6. Reasons for undertaking this study 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 7. Ministry vocational goals (please tick) Pastor Missionary Evangelist Youth Worker Member of a Ministry Team RE Teacher Chaplain Community Worker Voluntary worker Not applicable 8. Language Which language do you mainly speak at home? English (go to question 9) Other please specify How well do you speak and read English: Very well Well Not well Not at all 8.2 Will you require English language assistance as part of your study? Yes No 8.3 Do you have an IELTS score? (for international students) Yes: Grade No 9. Disabilities Answering these questions will not affect your enrolment. Do you have a disability, impairment or long term medical condition that may affect your studies? Yes No (go to question 9) If yes, please indicate your disability, impairment or long term medical condition by placing a tick in the box. You may tick more than one box. Hearing/Deaf Acquired Brain Impairment Physical Vision Intellectual Medical Condition Learning Other Mental Illness Would you like to receive advice on support services, equipment and facilities that may assist? Yes No 10. Your study will involve Field Training Please indicate where you will be undertaking your field placement. It is the student s own responsibility to arrange a field placement. TTC cannot offer any assistance in this area. If not known at this point write to be determined but by enrolling into this study you acknowledge that you understand that you MUST be able to demonstrate your learnt skills in a workplace or volunteer role. F.AD.001 TTC Enrolment Application Workshop.doc of 5

5 . 11. Working with Children Card. Are you the holder of a Working with Children Card (required as part of your field training if you undertake work with Minors in Qld) or equivalent? Yes No Please be prepared to provide image evidence of your card upon request Number Expiry date.. Address: P/Code... Ph Referees Pastor/Minister of the church you attend Name of Church:... Full name of Pastor:. Address: P/Code... Office Use Only Checked by: Date: Ph: Landline Mobile:. DECLARATION: I have read The Training Collaborative Student Handbook and I understand and agree with the conditions of enrolment (see and go to Enrolment Information) I declare that the information provided in the application is to the best of my knowledge accurate in all respect. I hereby authorise The Training Collaborative to use personal information to process and effect my application. Signature... Date: / / Sign or alternatively, return application from your own address. The Training Collaborative welcomes application for training from any Christian who is an active participant in a congregation of the Christian Church. However, we retain the right to decline an application from a person whose doctrinal beliefs or values are in conflict with those supported by our parent body, the Baptist Union of Queensland. The Training Collaborative Administrative Office: 4 Cadagi St, Meridan Plains, Qld, 4551 Ph: admin@trainingcollaborative.org.au Web: F.AD.001 TTC Enrolment Application Workshop.doc of 5