Notification of Enrolment Policy and Procedure

Consent to Use and Disclose Personal Information

CONSENT TO USE AND DISCLOSURE OF PERSONAL INFORMATION TO THE DEPARTMENT OF EDUCATION & COMMUNITIES AND OTHER GOVERNMENT AGENCIES

(First, Middle, and Last Name)

(Current residential address)

(dd/mm/yyyy)

Understand and agree that personal information (information or an opinion about me), collected from me, my parent or guardian, such as my name, Unique Learner Identifier, date of birth, contact details, training outcomes and performance, or sensitive personal information (including my ethnicity or health information) (together Personal Information) collected by AD1 College, may be disclosed to the Department of Education & Communities (Department).

The Department may disclose my personal information to other Australian government agencies, including those located in States and Territories outside of New South Wales.

The above government agencies may use my Personal Information for any purpose relating to the exercise of their government functions, including but not limited to the evaluation and assessment of my training, the determination of my eligibility to receive subsided training or for any Fee Exemption or Concessions. My Personal Information may also be disclosed to other third parties if required by law.

I consent to the collection, use and disclosure of my Personal Information in the manner outlined above.

I also acknowledge and agree that the Department may contact me by telephone, email or post during or after I have ceased subsidised training with the College of Transformation, Education and Training for the purposes of evaluating and assessing my subsided training.

I confirm that I have been understood the contents of the Learner Handbook.

NOTE: IF UNDER 18 YEARS OF AGE AT THE TIME OF GIVING CONSENT, THEN THE CONSENT OF THEIR GUARDIAN IS REQUIRED

Open this document in Adobe Acrobat Reader to add your digital signature.

LEARNER INFORMATION

Title
Given Name(s)
Middle Name
Surname
Preferred name if different
Date of birth (dd/mm/yyyy)
Mobile phone number (01)
Home phone number (02)
Home Email
Work Email
Address
Post Code
Gender
Country of Birth If not Australia:
City of Birth
Native Language If not English:
Aboriginal or Torres Strait Islander origin
Proficiency in Spoken English
English assistance needed

If yes, you will be directed towards a Learning Centre. Please contact AD1 College Administration on (02) 9594 0655.

Qualification Name and Code
Qualification Start Date
Attending Other School/s
Highest COMPLETED school level
Year Completed
Disabilities
Dependent child or partner of a person in receipt of a disability support pensions
Unique Student Identifier
Australian Citizenship
Permanent resident or Humanitarian Visa holder
A Certificate of Evidence of Residence Status (CERS)
Humanitarian visa
I am registered as a NSW apprentice or new entrant trainee
Last Qualification completed since leaving school
Currently enrolled in a Qualification Course(s) other than the one this form applies to.

If Yes, name of course(s):

Do you wish to apply for Recognition of Prior Learning?
Do you have any special needs?
Do you require support with any of the following
Speaking Difficulties
Listening Difficulties
Reading Difficulties
Writing Difficulties
Flexibility with delivery due to work, family, or other commitments

Prospective Learner Declaration

I,

(First, Middle, and Last Name)

Of

(Current residential address)

With date of birth:

(dd/mm/yyyy)

Declare that all information provided by myself to AD1 College in connection with the Notification of Enrolment Process is true, accurate, complete and not misleading in any way.

I have been informed of (delete as relevant)

  • There is not a subcontracting arrangement in place
  • The fees chargeable
  • The Learner Information as follows:
    • Recognition of Prior Learning and Credit Transfer
    • Consumer protection information
    • Subcontractor information if relevant
    • What a learner should do if they wish to defer or discontinue training
    • How learners can access support during training
    • Contact details for any support services provided
    • Learner Handbook
Today’s Date
EMERGENCY CONTACT DETAILS
Emergency Contact Name
Relationship with Contact
Emergency Contact’s Phone Number
English Proficiency of Emergency Contact
Other languages spoken by your Emergency Contact Person, if English is not spoken