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Courses
BSB40120 Certificate IV in Business
CHC32015 Certificate III in Community Services
CHC33021 Certificate III in Individual Support
CHC42021 Certificate IV in Community Services
CHC52021 Diploma of Community Services
HLT33021 Certificate III in Allied Health Assistance
MSM30116 Certificate III in Process Manufacturing
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Select your course location
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Course Location
Perth WA
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Student Details
Surname
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First Name
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Preferred Name
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Gender
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Male
Female
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Date of birth
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Citizenship
Were you born in Australia
No
Yes
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If no, what country were you born?
Do you Identify as
Aboriginal
South Sea Islander
Torres Strait Islander
Do you consider yourself to have a disability, impairment or long term condition?
No
Yes
If yes, please indicate the areas of disability, impairment or long term condition:
Hearing/Deaf
Physical
Intellectual
Learning
Acquired Brain Impairment
Vision
Medical Condition
Mental Illness
Language
Do you speak a language other than English at home?
No, English only
Yes
If yes, please specify?
How well do you speak English?
Well
Very well
Not well
Not at all
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Is English language assistance required?
No
Yes
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(Please contact AEATS to seek assistance)
Mobile Phone
Home Phone
Work Phone
Email
Street Address
City
Postal code
Is your postal address the same as your street address?
No
Yes
Are you living in NSW Social Housing?
No
Yes
N/A
Employment (if applicable)
Occupation
Employer
Contact
Address
City/Suburb
State
Postcode
Phone
Fax
Email
Of the following categories, which best describes your current employment status?
Unemployed - looking for full time work
Unemployed - looking for part time work
Employed full time by someone else
Employed part time by someone else or school based apprentice
Self employed - not employing other people
Employer - someone who employs other people
Employed unpaid family worker
Not employed - not looking for employment
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Please provide details of any supplementary welfare (if applicable)
Have you been unemployed for longer than 6 months?
No
Yes
Employment Service Provider name (if you have one)
Employment Service Provider Client ID (if you have one)
Schooling
What is your highest completed school level?
Year 12
Year 11
Year 10
Year 9 or equivalent
Year 8 or lower
Did not go to school
In which year did you complete that level?
Are you still attending secondary school?
Yes
No
If yes, please provide the following:
Year Level
School
Contact
Address
City/Suburb
State
Postcode
Previous Qualifications Achieved
Have you undertaken any other Smart & Skilled training this year?
Yes
No
If yes, what Smart & Skilled training have you completed?
Have you successfully completed any of the following qualifications?
Yes
No
Tick any applicable
Bachelor Degree or Higher Degree
Advanced Diploma or Associate Degree
Certificate IV
Certificate III (or Trade Certificate)
Certificate II
Certificate I
Certificates other than above