Enrolment Form - RTO Number 1982 Restricted Plumbing Permit Course This course is Restricted to Licensed Electricians and Gasfitters with a Non Plumbing Pathway About the course: Training in the Unit Exchange and Commission HWS must be completed and the candidate successful before applying to the Building Commission for the restricted plumbing permit. When the applicant has been successful in their training at MPA Skills, the application requirements below are to be fulfilled and submitted to the Building Commission with form 106 & fees payable. Who can obtain a restricted plumbing permit? Only licensed electrical workers and licensed gasfitters are eligible to obtain a restricted plumbing permit. Applicants for a restricted plumbing permit will be required to satisfy the Plumbers Licensing Board (the Board) that he or she is a fit and proper person to hold a restricted plumbing permit and have successfully completed the necessary training approved by the Board. The holder of a restricted plumbing permit is authorised to disconnect, remove, install and reconnect: a compression union; a temperature/pressure relief valve; an expansion control valve, in the course of removing or replacing a water heater. Duration of restricted plumbing permit The restricted plumbing permit is valid for three years. Application and permit fees Two fees are payable with this application: a non-refundable application fee of $22.50. a permit fee of $282.00. GST is not payable on the application or permit fee. If the Board does not grant your permit, the permit fee will be refunded. Permit requirements To be considered for a permit you must: provide a complete application including payment of application and permit fees; have the required qualifications; be a fit and proper person to hold a permit; and comply with any other requirements. Photographs Provide two identical passport size photographs of yourself. The photographs are used in the identity card issued with your permit. Video camera or photocopied images are not suitable. X:\Skill Centre\Website\Advanced Training\2018\2018 Restricted Plumbing Permit - Enrolment Form.docx 9/11/2017 11:01 AM 1 of 6
Complete your application Your application cannot be processed unless all sections are completed, photos and all other attachments provided and all fees paid. Incomplete applications The Building Commission cannot process incomplete applications. If your application is incomplete it may be returned and the application fee will not be refunded. Certified copies If you are providing a copy of a document with your application rather than the original it must be a certified copy. To have a copy certified you must show a copy of the document, together with the original document to a person who is a qualified witness. The witness must: certify the copy is a true copy of the original; place their signature, together with their full name and address and their qualification to be a witness, immediately adjacent to the words of certification. The following people, who must not be related to the applicant, are qualified to witness: Accountant Bank Manager Chemist Dentist Doctor Justice of the Peace Lawyer Local Government Councillor Minister of Religion Police Officer Post Office Manager Public Servant Real Estate Agent and other people listed in Schedule 2 of the Oaths, Affidavits and Statutory Declarations Act 2005. Lodging your application Complete and sign your application. Lodge it with your supporting documents: Lodge you application and pay by credit card using the payment slip on the form or pay by cheque or money order made payable to the Building Commission. Building Commission Locked Bag 14 Cloisters Square WA 6850 Lodge your application and pay by cash, cheque, or credit card at the Building Commission counter. Building Commission Level 1/ 303 Sevenoaks Street Cannington WA 6107 Office hours are: Mon Fri 8:30 am to 4:30 pm. Return of documents The Building Commission will not return documents including photographs submitted in permit applications. If you need a copy of the application or attached documents, please make a copy before you lodge your application. After your application is lodged If your application is complete it will be assessed by Building Commission officers. The officers will contact you if more information is required. X:\Skill Centre\Website\Advanced Training\2018\2018 Restricted Plumbing Permit - Enrolment Form.docx 9/11/2017 11:01 AM 2 of 6
Student Name: Date: Unique Student Identifier (USI) From 1 st January 2015 each student will need a Unique Student Identifier (USI) to obtain their Certificate or Statement of Attainment from their registered training origination, when studying nationally recognised training in Australia. What is a USI? The Unique Student Identifier or USI is a reference number made up of 10 numbers and letters that: creates a secure online record of your recognised training and qualifications gained in Australia, even from different training organisations will give you access to your training records and transcripts (available in late 2016) can be accessed online, anytime and anywhere is free and easy to create and stays with you for life Visit the website (www.usi.gov.au) to obtain a USI or for more information. Location of Course Maylands Campus (106 108 Caledonian Avenue, Maylands WA 6051) PRE REQUISITES *You must submit a copy of the below with your enrolment to be eligible to enrol on this course Gas Ticket or; Tick to show you have the below Electrical Contractors License TOOLS TO BE BROUGHT IN BY THE STUDENT 2 crescents (shifters) tape measure volt stick philips head screwdriver or battery drill with a philips head bit, multi grips pens, (black, red, blue) hammer STATIONARY TO BE PURCHASED BY STUDENT white out tape ruler Safety glasses & gloves steel capped boots Want More Information? For further information on training and assessment at MPA Skills please download the Student Handbook from our website. If you have any queries regarding enrolment and training please call training administration on 9471 6660 our team is happy to assist. Qualifications will be issued within 30 calendar days on condition that all fees have been paid and a USI number has been supplied X:\Skill Centre\Website\Advanced Training\2018\2018 Restricted Plumbing Permit - Enrolment Form.docx 9/11/2017 11:01 AM 3 of 6
COURSE FEES Course fees are subject to change. Your enrolment will not be processed until payment is received. Please complete the credit card section below. You will receive a confirmation text 3 weeks prior to the course start date and your card will be debited A cancellation fee may be charged where we are not given 10 working days notice prior to the start date Please choose which course date you would like to enrol in by ticking one of the boxes below. 2 Day Course (Monday to Tuesday) ** Please note the first day of the course commences at 4pm for registration** Part Time (4.30pm to 8.00pm) (Saturdays 8.00am to 4.00pm) 19 & 20 of March 2018 25 & 26 of June 2018 24 & 25 of September 2018 Course Units Restricted Plumbing Permit *CTF Subsidy: You may be eligible for the Construction Training Fund (CTF) subsidy if you are currently engaged in on-site work in WA s building and construction industry. This subsidy can only be claimed once. To find out more please contact the Construction Training Fund on Phone:1300 727 494 on inquiries@bcitf.org Please note the Full Non CTF Subsidy Course Fee must be paid. If you are eligible for the Construction Training Fund (CTF) subsidy you can apply to CTF who will reimburse you the difference between the full rate of the course and the CTF Subsidy Rate. For example for this course you would be reimbursed $619 * CTF Subsidy Course Fee Rate 3 & 4 of December 2018 Non CTF Subsidy Course Fee Rate Member Rate Non Member Rate *$265 $884 N/A N/A INVOICE Please note we will invoice the student one month prior the course commencing. If you would like the invoice addressed to a company instead of the enrolled student please complete the below. Invoices must be paid prior to commencing training. A cancellation fee may be charged where we are not given 10 working days notice prior to the start date. INVOICE THIS SECTION MUST CONTAIN COMPANY S DETAILS Name: (COMPANY) Billing Address Email Contact Person Suburb Phone Person responsible for accounts Purchase Order Number if required: I, am duly authorised officer of and hereby (company name) authorize MPA Skills to invoice with course registration fees relating (company name) (student name). Signed: Date: Our preferred payment method is online BSB: 066-114 Account Number: 10124842 Account Name: Reference: MPA Skills Displayed on your invoice (you must have an invoice number before you can make a payment) X:\Skill Centre\Website\Advanced Training\2018\2018 Restricted Plumbing Permit - Enrolment Form.docx 9/11/2017 11:01 AM 4 of 6
PERSONAL DETAILS Tradespersons licence No: Gas Permit No: Gas Permit Expiry: Surname: Given Name: Middle Name: Date of Birth: / / USI number: Gender: Male Female: City of Birth: Mobile: Home: Work: Email Address: Preferred Contact Method: email post Name of Emergency Contact Person: Emergency Contact Number: Relationship to you: Residential Address: Suburb: State: Postcode: Postal Address: if different to above Have you applied for a course at training with MPA Skills in the last 12 months? Yes No LANGUAGE AND CULTUAL DIVERSITY Are you of Aboriginal or Torres Strait Islander origin? No Yes, Aboriginal Yes, Torres Strait Islander Both Aboriginal & Torres Strait Islander In which country were you born? Australia Other please specify: Are you a permanent resident? Yes No If no: Visa number: Language spoken at home: How well do you speak English at home? Very Well Well Not very well Not at all EMPLOYMENT STATUS Of the following categories, which BEST describes your current employment status? (Tick ONE box only) Full-time employee Employed unpaid worker in a family business Part-time employee Unemployed seeking full time work Self-employed not employing others Unemployed seeking part-time work Employer Unemployed not seeking employment HOW DID YOU HEAR ABOUT MPA SKILLS Friend or Relative MPA Associations / Industry Event Newspaper Word of Mouth Master Plumbers / Masters Painters Journal Co-worker in the Trade Internet Search Employer / Work Experience Trade Representative or Trade store Other Please specify: MEDICAL HISTORY Do you consider yourself to have a disability, impairment or long-term condition? Yes No If you indicated the presence of a disability, impairment or long-term condition, please select the area(s) in the list: Hearing/deaf Learning Vision Physical Mental Illness Medical condition Intellectual Acquired brain impairment Other Do you need special assistance or equipment to work or complete your studies? Yes No If so what special assistance is required? PREVIOUS QUALIFICATIONS ACHIEVED X:\Skill Centre\Website\Advanced Training\2018\2018 Restricted Plumbing Permit - Enrolment Form.docx 9/11/2017 11:01 AM 5 of 6
Have you undertaken further studies? If yes, tick any applicable boxes Yes No Bachelor Degree or Higher Degree Certificate III (or Trade Certificate) Advanced Diploma or Associate Certificate II Degree Diploma or Associate Diploma Certificate I Certificate IV (or Advanced Certificate) Certificates other than listed I authorise MPA Skills to use all media and photographic images taken of me while attending MPA Skills for training. I am aware that media and photographs may be used for promotional material and on the website. Yes No Schooling Tick the level achieved: In which year did you complete that school level? Year 12 Year 11 Year 10 Year 9 Year 8 What is the main reason for undertaking this course? To get a job For interest or personal development To start a different career Extra skills/ requirement of my current job To start a different career To get into another course at TAFE or University To improve my career Other (please specify): Citizenship Status Are you an Australian Citizen: Yes If No, Visa Type: Visa No: Visa Expiry Passport Number: TERMS AND CONDITIONS Cancellations & Refunds All cancellations must be in writing to MPA Skills Head Office, preferably on the Course Cancellation form which is available from training reception or on our website. It is the responsibility of the participants to confirm that their written cancellation has been received. Cancellations received fourteen (14) or more days prior to course commencement will receive a full refund. Cancellations received between thirteen (13) and one (1) day prior to commencement of the course will receive a refund less the cancellation fee of $300.00. Participants who do not cancel their enrolment and fail to attend the course for which they are enrolled remain liable for the full course fees. Please note: Cancellation and postponement of course in this instance has the same meaning. FAX, MAIL, EMAIL OR PERSONALLY DELIVER THE ENROLMENT FORM TO THE MAYLANDS OFFICE 108 Caledonian Ave Maylands WA 6051 PO Box 126 Maylands WA 6931 Maylands Campus Telephone: (08) 9471 6660 Facsimile: (08) 9471 6601 advancedtraining@mpaskills.com.au www.mpaskills.com.au PRIVACY STATEMENT From 1 January 2015, MPA Skills 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/ You must declare that you have read the privacy information at http://www.usi.gov.au/training-organisations/documents/privacy-notice.pdf and that you have also read and consent to the collection, use and disclosure of your personal information pursuant to the information detailed at http://www.usi.gov.au/training-organisations/documents/privacy-notice.pdf Information collected by MPA Skills during a participant s enrolment and attendance will be used for the purposes of general student administration, identification, communication, State and Commonwealth agencies and research organisations. MPA Skills is bound by the Australian Privacy Principles via the Privacy Act, 1988 and is committed to safeguarding personal information it may hold at any time in respect of any individual, in accordance with the requirements of those principles. I have read and agree to the above conditions and I confirm that the information provided in this form is true and correct. If you are under 18 years of age, please ensure your parent/guardian signs this form. Participants Name: Signature: Date: / / Parent/Guardian Name: Signature: Date: / / NOTE: Enrolment may be subject to the receipt of relevant documentation and/or a successful interview (if applicable) X:\Skill Centre\Website\Advanced Training\2018\2018 Restricted Plumbing Permit - Enrolment Form.docx 9/11/2017 11:01 AM 6 of 6