Enrolment Form – Momentum Collective Staff Step 1 of 5 0% This enrolment form is for Momentum Collective staff undertaking training with an accredited component.Course Name*Please select your course from the drop downWorking with clients with complex needsBSB50420 – Diploma of Leadership and ManagementPersonal DetailsName* SelectMr. Mrs.MissMsOther Title First Last Date of Birth* DD slash MM slash YYYY Gender*SelectMaleFemaleOtherPhone Number*Email* Enter Email Confirm Email Residential Address*Please enter the address at which you usually reside. 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. Street Address Address Line 2 City State / Province / Region Postal Code Is your postal address different from your residential address?* Yes No Postal Address* Street or PO box Address Line 2 City State / Province / Region Postal Code Language, Culture & DiversityCountry of birth* Australia New Zealand Citizenship Status Australian citizen New Zealand citizen Australian permanent resident Australian temporary resident Visa subclass Visa number Do you speak a language other than English fluently?* Yes No Please specify* Do you identify as* Aboriginal Torres Strait Islander Neither Do you consider yourself to have a disability, impairment or long-term condition?*Disability in this context does not include short-term disabling health conditions such as a fractured leg, influenza, or corrected physical conditions such as impaired visions managed by wearing glasses or lenses. Yes No Please select, from the list below, areas that apply to you*If you indicated the presence of a disability, impairment or long-term condition, please click here for guidelines to help classify which area applies. Hearing/deaf Physical Intellectual Learning Mental Illness Acquired brain impairment Vision Medical Condition Other Please provide details* Education, Employment & Study DetailsHiddenEmployment StatusWhich best describes your current employment status? SelectEmployed- Full TimeEmployed- Part TimeEmployed- CasualUnemployed- Seeking Full Time WorkUnemployed- Seeking Part Time WorkUnemployed- Not Seeking WorkSelf-EmployedAre you still enrolled in Senior or Senior-secondary Education?* Yes No What is your highest completed school level?*SelectYear 12Year 11Year 10Year 9Year 8Never AttendedOtherHave you successfully completed any of the following qualification levels?* Certificate I Certificate II Certificate III Certificate IV Diploma Advanced Diploma Bachelor Degree or Higher Other Education (including certificates or overseas qualifications not listed above) None Are you seeking Credit from a previous course or Recognition of Prior Learning as part of this course enrolment?* Yes No If yes, please describe*Briefly describe previous study or experience that you will be seeking Credit or RPL for. Credit Transfers require evidence in the form of certification, statements of attainment or USI transcript and are subject to verification with the issuing body. Students undertaking RPL pathway will complete a self assessment of skills before being issued a RPL kit designed to gather evidence and assessment of current skills and competency.Employment Status*Which best describes your current employment status? SelectFull-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 employmentReason for study*Of the following categories, select the one which BEST describes the main reason you are undertaking this course.SelectTo get a jobTo develop my existing businessTo start my own businessTo try for a different careerTo get a better job or promotionIt was a requirement of my jobI wanted extra skills for my jobTo get into another course of studyFor personal interest or self-developmentTo get skills for community/voluntary workOther reasonsOther reason for studyPlease briefly outline why you are undertaking the course Unique Student Identifier (USI) & IdentificationDo you have a USI?* Yes What is a USI? USI* A USI is…*If you are a new or continuing student undertaking nationally recognised training, you will need a USI in order to receive your qualification or statement of attainment. Your USI will give you access to an online record of the training you have done since 1 January 2015. For more information visit usi.gov.au. If you don’t have a USI, Grow Training Group can create a USI on your behalf. Please ensure you read the USI Priviacy Notice here before confirming your permission below. I would like ‘Grow Training Group’ to create my USI and have read the Privacy Statement Oops I already have one Town/City of Birth* USI* Photo IDAll students are required to provide proof of identity in the form of colour copies (front & back) of government issued photo ID. This identification documentation will also be used to create your USI, if requested. Documents MUST be current at time of enrolment. If you have a copy of your ID, please upload using the Select Files option below or take a clear photograph and text to Student Services on 0437 702 456. Drop files here or Select files Max. file size: 128 MB. Password*As part of our commitment to ensuring the privacy of your personal and academic details, please provide us with a password. This password will allow you to access your own student information. Access by any third party will require your written consent in each instance. Privacy Notice & Student DeclarationWhy 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 the NCVER and other bodies handle your personal information The 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. The 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. The NCVER may also disclose personal information to persons engaged by NCVER to conduct research on NCVER’s behalf. The NCVER does not intend to disclose your personal information to any overseas recipients. For more information about how the 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 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 Grow Training Group 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 NoticeStudent Declaration & ConsentI declare that the information I have provided to the best of my knowledge is true and correct. I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above. I have read, understand and agree to the Terms & Conditions Student Signature* Reset signature Signature locked. Reset to sign again
