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"START EDUCATION"
Private College
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Enrolment - Domestic Students
 Personal Details
Title: *
First Name: *
Surname: *
Date of Birth: *
(format dd-mm-ccyy)
Gender: * Male Female

Course Details
USI (If known):
Name of Qualification: *
Mode of Training: *
Type of Training: *

 Contact Details
Residential Address: *
State: Postcode:
Postal Address: *
 Same as Residential Address
State: Postcode:
Contact Number: *
Mobile: Home:
Email Address: *

 Country of Birth & Citizenship
In which country were you born? Ausralia Other, please specify:
What is your residency status in Australia? *
Other, please specify:
Expiry Date (format dd-mm-ccyy):
Are you of Aboriginal or Torres Strait Islander origin?

 Language Proficiency
How well do you speak English?
Do you need help with English?
Do you speak a language other than English at home? No Yes, please specify:
Speaking and Listening: *
Reading: *
Writing: *

 Disability
Do you consider that you have a disability, impairment or long-term condition that might affect your training ? (You may indicate more than one area) No
Yes (Please select)
Hearing/deafness
Intellectual
Learning disability
Medical condition
Mental illness
Physical disability
Visual disability
Other, please specify:

Please specify any particular requirements you might have:

 Education Details
What is your highest completed school level qualification?: *
In what year did you complete that school level? (eg 2007) *
Are you still attending secondary school? No Yes
Since leaving school have you successfully COMPLETED any of the following qualifications? (You may indicate more than one area): No
Yes, (please select)
Advanced Diploma or Associate Degree
Bachelor Degree or Higher Degree
Certificate II
Certificate III
Certificate III or Trade Certifiate
Certificate IV or Advanced Certificate/Technician
Diploma or Associated Diploma
Other, please specify:

 Career Objectives
Of the following categories which best describes your main reason for undertaking this course / traineeship? *
Other, please specify:

 Employment Status
Which of the categories BEST describes your current employment status? *
Number of hours employed per week:
Date commenced with current employer:
(format dd-mm-ccyy)
Employer Name:

 Recognition (Credit Transfer/RPL/RCC)
If you have an appropriate certificate or statement of attainment (SOA) relating to the above qualification or specific units within the qualification you may apply for credit transfer. If you have life experience, knowledge, past training and/or testimonials in any of the units you may wish to apply for Recognition of Prior Learning (RPL) or Recognition of Current Competencies (RCC)
Do you have an appropriate certificate
or SOA as evidence of credit transfer?		 No Yes
Do you wish to apply for RPL or RCC?
(fee is applicable)		 No Yes

 Student Declaration
By submitting this form I am agreeing to the Start Education enrolment standard terms and conditions. Prior to enrolment I was informed about training, assessment and support services and about my rights and obligations.I have been provided with further information through Start Education's website www.starteducation.com.au. I understand information provided (including personal details, identification, and training outcomes) may be used by the Department of Education for audit, verification, research, statistical analysis, program evaluation, post-completion surveys and internal management purposes. I declare the information provided in this form is accurate and I consent to the use of my information for these purposes.

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