Preferred delivery style: Blended RPL GAP Training
Employment: Of the following categories, which best describes your Employment Status?
Study Reason: What is your reason for wanting to complete this Course?
Schooling: What is your highest completed School Level: Year 12 Year 11 Year 10 Year 9 Year 8 or below
Previous Educational Achievements: Since leaving school have you successfully completed any other qualifications? Yes No If Yes, what is your highest completed achievement:
Cultural Diversity: Were you born in Australia? Yes No If No, in which country were you born?
Do you identify yourself as any of the following: Aboriginal Torres Strait Islander South Sea Islander
Language: Do you speak a language other than English at home? Yes No (English Only) If yes, please specify the main language spoken at home? How well do you speak English? Very Well Well Not Well Not at all Is English language assistance required (including reading and/or writing)? Yes No
Medical Conditions/Disability: Do you consider yourself to have a disability, impairment or long term condition? Yes No If Yes, please tick ANY applicable boxes:
Licences: Please list any Licences you currently hold e.g. Car, HR, Forklift, Traffic Controller, the Class of licence and expiry date.
Emergency Contact: Name: Address: Phone: Relationship:
By checking this box you are agreeing to the Terms & Agreement and state the details entered are true and correct.
Signature: Date: