Intended Course of Study

Personal Details

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 please write your name exactly as written in the identity document you choose to use.

Enter your Contact Information

Home phone, including area code

Enter contact information in case of emergency

Residential Address *

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 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.

Enter Postal Address if different from Residential Address

Language & Cultural Diversity

(If more than one language, indicate the one that is spoken most often)
(For persons of both Aboriginal and Torres Strait Islander origin, mark both ‘Yes’ boxes)

Disability

If you answered YES to the above question do you require any assistance to participate in this course?
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)

Schooling

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. (Tick ONE box only)
Please select the highest level of education attained
Of the following categories, which BEST describes your current employment status? 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 – Of the following categories, which BEST describes your main reason for undertaking this course / traineeship /apprenticeship?

Unique Student Identifier

From 1 January 2015, Active Training 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 computer or mobile device. Please note that if you would like to specify your gender as ‘other’ you will need to contact the USI Office for assistance.

A 10 digit code which may take this form: AA11BBCCD2
Unique Student Identifier (USI)

In providing my USI, I confirm Active Training is authorised to collect, use and disclose my student identifier for the purposes required under the Student Identifiers Act 2014.

I understand that I will receive a notice regarding Active Training’s use of this information to confirm my USI.

I understand that Active Training’s name included in the notice may be different to the name they are familiar with – the name of the organisation verifying my USI is Active Training.

Privacy Information

Please view the following for applicant privacy information. Privacy Notice & Applicant Declaration

Signatures

Application Signature

*Parental/guardian consent is required for all students under the age of 18.
Parent Guardian Signature

Payment details

If an invoice is to be sent to your employer, please note Employer Name below
Last updated: 8 Feb 2023, 9:22:01 am
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