APPLICATION FORM LICENSED TRADES ISSUE OF QUALIFICATION POST GAP TRAINING. SECTION A Applicant Details & Document Checklist

Transcription

1 APPLICATION FORM LICENSED TRADES ISSUE OF QUALIFICATION POST GAP TRAINING SECTION A Applicant Details & Dcument Checklist INSTRUCTIONS FOR APPLICANTS This Applicatin Frm is a request fr the issue f a qualificatin, pst gap training. Yu must prvide scanned cpies f the fllwing: Statement f Attainment frm gap training undertaken Evidence f emplyment / emplyer reference (up t 12 mnths) Prvisinal Licence (Electrician) / Registratin (Plumber) E-Prfiling Reprt (Electrician) clur riginal, signed by emplyer and applicant Passprt Bi Page Surname First Name Secnd Name Hme Address Street Name, Twn/City Cunty/Prvince Pstcde, Cuntry Pstal Address (if different frm abve) Hme Phne N. Internatinal cuntry and area cde prefix. Alternative Cntact N. Mbile N. Date f Birth (dd/mm/yyyy) Street Name Twn/City Pstcde Street Name Twn/City Pstcde Cunty/Prvince Cuntry Cunty/Prvince Cuntry Age Gender Male Female E- Prfiling N. (Electrician nly) Electrical Licence N. (Electrician) & State Plumbing Registratin N. (Plumber) Unique Student Identifier (USI) Current Passprt Number Cuntry f Passprt Cuntry f Residence

2 What is yur Citizenship and Residence status? Australian Citizen New Zealand citizen living in Australia Permanent Resident Date granted: DD / MM / YYYY Expiry date: DD / MM / YYYY Other Temp Prtectin Visa Hlder Australian Student Visa Hlder Temp Visa Hlder Sub class: Date granted: DD / MM / YYYY Expiry date: DD / MM / YYYY Humanitarian Visa Hlder Date granted: DD / MM / YYYY Expiry date: DD / MM / YYYY SECTION B Statistical Enrlment Data Upn cmpletin f yur successful skills assessment, Victria University will enrl yu int the qualificatin and unit/s f study in rder t issue the assciated Australian Qualificatin. This sectin will refer t yur skills assessment as studies. This sectin MUST be cmpleted. D yu cnsider yurself t have a disability, impairment r lng-term medical cnditin? (please tick) N Yes Please cmplete belw: I wuld like infrmatin abut available services. Acquired Brain Impairment Hearing/Deaf Intellectual Learning Medical Mental Illness Mbility Physical Visin Other D yu speak a language ther than English at hme? N Yes, Language: Hw well d yu speak English? Very well Well Nt Well Nt at all In what cuntry were yu brn? Year f arrival in Australia Are yu f Abriginal r Trres Strait Islander rigin? Yes N, I am neither Abriginal nr Trres Strait Islander If yu have Permanent Residence status, which statement best describes yur circumstances? Permanent Residence des nt apply t me I am residing in Australia during the semester I am residing utside Australia fr the semester I have had permanent residence fr mre than 12 mnths In which year did yu leave Secndary Schl? In which year did yu cmplete highest secndary level? Where was yur permanent hme address during year 12? Pstcde: Suburb/Twn: What was the highest secndary schl level cmpleted?

3 Did nt g t schl Year 8 r belw Year 7 r belw Year 9 r belw Cmpleted Year 10 Cmpleted Year 11 Cmpleted Year 12 Have yu dne any training with a VET registered RTO r an ACE prvider since 2011? Yes - list up t 3 training rganisatins belw N Which f the fllwing qualificatins have yu successfully cmpleted? Enter ne r mre f the fllwing cdes in the clumns belw: A = Australian E = Australian Equivalent I = Internatinal A E I Bachelr Degree r Higher Degree Level Advanced Diplma r Assciate Degree Level Diplma Level Certificate I Certificate II Certificate III Certificate IV Miscellaneus Educatin What was the highest level f educatin cmpleted by yur parents/guardians? Father Mther Pstgraduate Qualificatins (e.g. Masters, PhD) Bachelr Level Qualificatins Other Pst Schl Qualificatins (e.g. VET/TAFE Certificate, Assciate Degree r Diplma) Cmpleted Year 12 Schling r Equivalent Did nt cmplete Year 12 Schling r Equivalent Cmpleted Year 10 Schling r Equivalent Did nt cmplete Year 10 Schling r Equivalent

4 Dn t knw Nt applicable Which f the fllwing classificatins BEST describes yur current r recent ccupatin? If unemplyed g t next questin. Manager Prfessinals Technicians and Trade Wrkers Cmmunity and Persnal Service Wrkers Sales Wrkers Machinery Operatrs and Drivers Laburers Other Clerical and Administrative Wrkers What is yur current emplyment status? Full Time Emplyed Self-emplyed Nt emplying thers Emplyed Unpaid wrker in family business Unemplyed Seeking Part Time wrk Part Time Emplyed Emplyer Unemplyed Seeking Full Time wrk Nt emplyed Nt seeking emplyment What is yur main reasn fr undertaking this skills assessment? T get a jb T try fr a different career T develp my existing business T get int anther curse f study It was a requirement f my jb T get a better jb r prmtin I wanted extra skills fr my jb Fr persnal interest r self-develpment T start my wn business Other reasns

5 SECTION C Applicant s Declaratin Please attach tw (2) passprt sized phts f yurself. Phts are t be certified in the space prvided belw, indicating This is a true pht f (applicant full name) and must include stamp, date, certifier signature and details. Please d nt staple. This is a true pht f (Applicant s full name) Certifier stamp, signature and details Please affix passprt sized pht #1 here Please affix passprt sized pht #2 here Curse: Certificate III in Electrtechnlgy (Electrician) / Certificate III in Plumbing I (Applicant name) declare that: The infrmatin cntained in this applicatin is true and crrect and that all dcuments are genuine. All evidence I have prvided relates t me and my wrk and can be verified. I have read and understand the infrmatin supplied t me in this applicatin. I will infrm Victria University f any changes t my details cntained in this applicatin while my applicatin is being prcessed. I authrise my appinted agent r representative t act in all matters cncerned with this applicatin. I authrise Victria University t make any enquiries necessary t assist in the assessment f my skills including cntacting training institutins, emplyers r ther authrities, and t use any infrmatin supplied fr that purpse. I understand that Victria University may verify infrmatin relating t this applicatin with any Australian state r territry licensing r training authrity. I authrise Victria University t enrl me int the Curse indicated abve and the nminated Units f Study. I authrise fr Victria University t act as my prxy and prvide such persnal details n my behalf in rder t cmplete my enrlment. I declare that t the best f my knwledge the infrmatin supplied n this frm is crrect and cmplete. Applicant s Signature Date (dd/mm/yyyy)

6 SECTION D Payment Frm Applicant s Full Name Nminated Occupatin Cntact Phne N. Date (dd/mm/yyyy) TOTAL AMOUNT PAYABLE: $ Please cmplete the fllwing CREDIT CARD authrisatin: I, authrise Victria University t debit my credit card fr the ttal amunt f $ as payment fr the issuing f my Full Qualificatin having cmpleted the required gap training. I understand that the fee is nn-refundable. Credit Card Type MasterCard VISA Credit Card N Expiry Date M M - Y Y CVV N Name n Card Signature f Cardhlder PAYMENT INFORMATION FOR APPLICANTS Fees will be deducted in Australian dllars in the frm f Credit Card ONLY

7 SECTION E Submitting yur applicatin INSTRUCTIONS FOR APPLICANTS Electrnic applicatins Victria University prefers applicatins sent electrnically t the apprpriate address (as listed belw). Applicatins by pst Send t the address listed belw. D nt send riginal dcuments; please ensure dcuments are cpied and certified accrdingly. Yu can send yur cmpleted Applicatin in ne f the fllwing ways t Victria University: BY (preferred) trs@vu.edu.au BY REGULAR POST Trades Recgnitin Services Victria University-Sunshine Campus PO Bx Melburne VIC 8001 Australia BY COURIER / IN PERSON Trades Recgnitin Services Victria University-Sunshine Campus 460 Ballarat Rad Sunshine VIC 3020 OFFICE HOURS Mnday t Friday, 9.00am 5.00pm Eastern Standard Time ENQUIRIES Fr all enquiries relating t this applicatin, please cntact Skilled Trades Recgnitin Services n: WEBSITE