- PLEASE NOTE: you must already hold a CHC30121 Certificate III in Early Childhood Education and Care or CHC30113 Certificate III in Early Childhood Education and Care
Student's Personal Details
*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 Educare College 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 section on the USI at the end of this form for a detailed explanation.
If yes, please provide that name.
e.g.Maiden Name, Name change
DD slash MM slash YYYY
*Please enter the details of your Parent/Guardian
Please provide the physical address (street number and name, not a 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.
Language & Cultural Diversity
Please refer to the Disability supplement for an explanation of the following disabilities (You may indicate more than one area).
Education & Training Information
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.
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).
Credit Transfer/s: for previously completed study.
Unique Student Identifier (USI)
If your answer is "No", you can apply for a USI by visiting here
or fill out the USI creation authorisation form below for Educare College to apply on your behalf
- If you would like Educare College 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 here. You must also provide some additional information as noted at the end of this form so that we can apply for a USI on your behalf.
I authorise Educare College to apply pursuant to sub-section 9(2) of the Student Identifiers Act 2014, for a USI on my behalf.
(please write the name of the Australian or overseas town or city where you were born)
We will also need to verify your identity to create your USI.
Please provide a colour copy
By accepting these Terms and Conditions, I agree that:
An Educare College Representative will be in contact with you to conduct an Enrolment Interview.
During the Enrolment Interview you will be required to complete and review a Language, Literacy and Numeracy Indicator (LLN).
Once the Enrolment Interview has been completed, you will be asked to sign to acknowledge the interview has been conducted and documented accurately. If further evidence is requested for eligibility the Educare College Representative will advise of what is required.
A review of funding eligibility will be conducted and a decision will be made on your eligibility for the funding applicable to the course you are enrolling into. An email or letter will be sent to confirm your enrolment or advise you are ineligible for funding. If you are ineligible for funding we can discuss alternate paths to enrolment and funding options for your chosen course.
If at any time you have any questions regarding the enrolment please contact Educare College on 07-3726-5399 or email email@example.com
Annexure 1 - Disability Supplement
The purpose of the Disability supplement is to provide additional information to assist with answering the
If you indicated the presence of a disability, impairment or long-term condition, please select the
area(s) in the following list:
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
'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.
Under the Data Provision Requirements 2012, Educare College is required to collect personal information
about you and to disclose that personal information to the National Centre for Vocational Education Research Ltd
Your personal information (including the personal information contained on this enrolment form), may be used, or
disclosed by Educare College for statistical, administrative, regulatory and research purposes. Educare College
may disclose your personal information for these purposes to:
- Commonwealth and State or Territory government departments and authorised agencies; and
Personal information that has been disclosed to NCVER may be used or disclosed by NCVER for the following
- populating authenticated VET transcripts;
- facilitating statistics and research relating to education, including surveys and data linkage;
- pre-populating RTO student enrolment forms;
- understanding how the VET market operates, for policy, workforce planning and consumer information;
- administering VET, including program administration, regulation, monitoring and evaluation.
You may receive a student survey which may be administered by a government department or NCVER employee, agent or
third-party contractor or other authorised agencies. Please note you may opt out of the survey at the time of
NCVER will collect, hold, use, and disclose your personal information in accordance with the Privacy Act 1988
(Cth), the National VET Data Policy and all NCVER policies and protocols (including those published on NCVER’s
website here .