AEI Australia

    Enrolment Application Form

    This confidential enrolment form collects personal information about you to primarily support administrative, regulatory, and research purposes, as well as to ensure the course aligns with your needs. All staff at Academy of Education and Innovation Australia are legally obligated to safeguard the information you provide on this form. Additional details about privacy can be found in the notice at the end of the form. Fields marked * are required.

    Application for Enrolment

    Which course would you like to enrol into? *

    Qualification

    General English (Starter - Upper Intermediate)

    Preferred start date: *

    Have you ever studied with Academy of Education and Innovation Australia before? *

    Do you wish to apply for Credit? *If YES, certified copies of transcripts from previous qualifications must be provided with this form (upload them below), along with a Credit Application Form.

    Do you wish to apply for Recognition of Prior Learning? *If you indicate YES, you will be contacted to discuss this further.

    Personal Details

    1. Enter your full name*

    *Please write the name that you used when you applied for your Unique Student Identifier (USI), including any middle names. If you do not yet have a USI and want Academy of Education and Innovation Australia to apply for a USI on your behalf, you must write your name, including any middle names, exactly as written in the identity document you choose to use for this purpose. See the section on the USI further down this form for a detailed explanation.

    3.   Gender(Tick ONE box only)*

    4. Enter your contact details

    5. What is the address of your usual residence?Please provide the physical address (street number and name, 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 to your home. If you are from a rural area use the address from your state’s or territory’s ‘rural property addressing’ or ‘numbering’ system as your residential street address. Building/property name is the official place name or common usage name for an address site, including the name of a building, Aboriginal community, homestead, building complex, agricultural property, park or unbounded address site.

    6. What is your postal address (if different from above)?

    Language and cultural diversity

    7.   In which country were you born?*

    8.   Do you speak a language other than English at home?*If more than one language, indicate the one that is spoken most often.

    9.   Are you of Aboriginal or Torres Strait Islander origin?*For persons of both Aboriginal and Torres Strait Islander origin, mark both ‘Yes’ boxes.

    Disability

    10.  Do you consider yourself to have a disability, impairment or long-term condition?*

    11. If you indicated the presence of a disability, impairment or long-term condition, please select the area(s) in the following list:You may indicate more than one area. Please refer to the Disability supplement below for an explanation of the following disabilities.

    Disability supplement – explanation of each area (click to open)

    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 vision managed by wearing glasses or lenses.

    11 — Hearing/deaf

    Hearing impairment is used to refer to a person who has an acquired mild, moderate, severe or profound hearing loss after learning to speak, communicates orally and maximises residual hearing with the assistance of amplification. A person who is deaf has a severe or profound hearing loss from, at, or near birth and mainly relies upon vision to communicate, whether through lip reading, gestures, cued speech, finger spelling and/or sign language.

    12 — Physical

    A physical disability affects the mobility or dexterity of a person and may include a total or partial loss of a part of the body. A physical disability may have existed since birth or may be the result of an accident, illness, or injury suffered later in life; for example, amputation, arthritis, cerebral palsy, multiple sclerosis, muscular dystrophy, paraplegia, quadriplegia or post-polio syndrome.

    13 — Intellectual

    In general, the term ‘intellectual disability’ is used to refer to low general intellectual functioning and difficulties in adaptive behaviour, both of which conditions were manifested before the person reached the age of 18. It may result from infection before or after birth, trauma during birth, or illness.

    14 — Learning

    A general term that refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical abilities. These disorders are intrinsic to the individual, presumed to be due to central nervous system dysfunction, and may occur across the life span. Problems in self-regulatory behaviours, social perception, and social interaction may exist with learning disabilities but do not by themselves constitute a learning disability.

    15 — Mental illness

    Mental illness refers to a cluster of psychological and physiological symptoms that cause a person suffering or distress and which represent a departure from a person’s usual pattern and level of functioning.

    16 — Acquired brain impairment

    Acquired brain impairment is injury to the brain that results in deterioration in cognitive, physical, emotional or independent functioning. Acquired brain impairment can occur as a result of trauma, hypoxia, infection, tumour, accidents, violence, substance abuse, degenerative neurological diseases or stroke. These impairments may be either temporary or permanent and cause partial or total disability or psychosocial maladjustment.

    17 — Vision

    This covers a partial loss of sight causing difficulties in seeing, up to and including blindness. This may be present from birth or acquired as a result of disease, illness or injury.

    18 — Medical condition

    Medical condition is a temporary or permanent condition that may be hereditary, genetically acquired or of unknown origin. The condition may not be obvious or readily identifiable yet may be mildly or severely debilitating and result in fluctuating levels of wellness and sickness, and/or periods of hospitalisation; for example, HIV/AIDS, cancer, chronic fatigue syndrome, Crohn’s disease, cystic fibrosis, asthma or diabetes.

    19 — Other

    A disability, impairment or long-term condition which is not suitably described by one or several disability types in combination. Autism spectrum disorders are reported under this category.

    Schooling

    12. What is your highest COMPLETED school level (tick one box only)*If you are currently enrolled in secondary education, the Highest school level completed refers to the highest school level you have actually completed and not the level you are currently undertaking. For example, if you are currently in Year 10 the Highest school level completed is Year 9.

    13.  Are you still enrolled in secondary or senior secondary education?

    Previous qualifications achieved

    14.  Have you SUCCESSFULLY completed any of the qualifications listed in question 15?*

    15. If yes, tick ANY applicable boxes

    Employment

    16. Of the following categories, which BEST describes your current employment status? (Tick one box only)*For casual, seasonal, contract and shift work, use the current number of hours worked per week to determine whether full time (35 hours or more per week) or part-time employed (less than 35 hours per week).

    Study reason

    17. Of the following categories, select the one which BEST describes your main reason for undertaking this course/traineeship/apprenticeship? (Tick one box only)*

    Unique Student Identifier (USI)

    From 1 January 2015, Academy of Education and Innovation Australia 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 www.usi.gov.au on a computer or mobile device.

    19.  If you do not have a USI, would you like us to apply for a USI on your behalf?

    APPLYING ON YOUR BEHALF
    If you would like Academy of Education and Innovation Australia to apply for a USI on your behalf you must authorise us to do so and declare that you have read the privacy information at https://www.usi.gov.au/documents/privacy-notice-when-rto-applies-their-behalf
    You must also provide some additional information so that we can apply for a USI on your behalf. Please provide your town/city of birth and ensure that the name written in ‘Personal Details’ section is exactly the same as written in the document you provide below.
    In accordance with section 11 of the Student Identifiers Act 2014, Academy of Education and Innovation Australia will securely destroy personal information which we collect from individuals solely for the purpose of applying for a USI on their behalf as soon as practicable after we have made the application or the information is no longer needed for that purpose, unless we are required by or under any law to retain it.

    21. We will also need to verify your identity to create your USI. Please provide details for one of the forms of identity below.

    1. Australian Driver’s Licence

    State:Licence Number:Card Number:

    4. Non-Australian Passport (with Australian Visa)

    Passport number:Country of issue:

    2. Medicare Card

    Medicare card number:Individual reference number (next to your name on card):Card colour:

    Expiry date:

    5. ImmiCard

    ImmiCard Number:

    6. Citizenship Certificate

    Stock number:Acquisition date:

    3. Australian Passport

    Passport number:

    7. Certificate of Registration by Descent

    Acquisition date:

    USI APPLICATION DECLARATION

    The following questions are not mandatory (emergency contact and employment details), they are recommended to include for best practice only.

    Next of kin/emergency contact

    These are people that Academy of Education and Innovation Australia may need to contact in an emergency during your participation in training. Please ensure that the people named are aware that they have been nominated as emergency contacts and agree to their details being provided to Academy of Education and Innovation Australia.

    Employment Details Not applicable for class based students or Academy of Education and Innovation Australia employees – skip section

    Supporting Documents (PDF, JPG, PNG, DOC or DOCX – max 5 MB each)

    PRIVACY NOTICE

    Under the Data Provision Requirements 2012, Academy of Education and Innovation Australia is required to collect personal information about you and to disclose that personal information to the National Centre for Vocational Education Research Ltd (NCVER).
    Your personal information (including the personal information contained on this enrolment form and your training activity data) may be used or disclosed by Academy of Education and Innovation Australia for statistical, regulatory and research purposes. Academy of Education and Innovation Australia may disclose your personal information for these purposes to third parties, including:

    • Commonwealth and State or Territory government departments and authorised agencies;

    • NCVER;

    • Organisations conducting student surveys; and

    • Researchers.

    Personal information disclosed to NCVER may be used or disclosed for the following purposes:

    • Issuing statements of attainment or qualification, and populating authenticated VET transcripts;

    • facilitating statistics and research relating to education, including surveys;

    • understanding how the VET market operates, for policy, workforce planning and consumer information; and

    • administering VET, including programme administration, regulation, monitoring and evaluation.

    NCVER will collect, hold, use and disclose your personal information in accordance with the Privacy Act 1988 (Cth), the VET Data Policy and all NCVER policies and protocols (including those published on NCVER’s website at www.ncver.edu.au).
    You may receive an NCVER student survey which may be administered by an NCVER employee, agent or third party contractor. You may opt out of the survey at the time of being contacted.

    Student Declaration and Consent (please tick all)

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