NSW Smart and Skilled Enrolment Information

"*" indicates required fields

Full Name*

Email*

Date of birth*

DD slash MM slash YYYY

Address*

Consent to use and disclose personal information*

I consent to the collection, use and disclosure of my Personal Information in accordance with the Privacy Notice below.

I understand and agree that, under the Data Provision Requirements 2012, Comtech Training is required to collect personal
information (information or an opinion about me), collected from me, my parent of guardian, such as my name, Unique Student
Identifier, date of birth, contact details, training outcome and performance, sensitive personal information (including my ethnicity
or health information) and other enrolment and training activity-related information (together Personal Information) and disclose
that Personal Information to the National Centre for Vocational Education Research Ltd (NCVER).

My Personal Information (including the personal information contained on this enrolment form and my training activity data) may
be used or disclosed by Comtech Training for statistical, regulatory and research purposes. Comtech Training may disclose my
personal information for these purposes to third parties, including:

- School if I am a secondary student undertaking VET, including a school-based apprenticeship or traineeship;
- Employer if I am enrolled in training paid by your employer;
- Commonwealth and State or Territory government departments and authorised agencies, including the NSW Department of Industry (Department);
- NCVER; Organisations conducting student surveys; and
- Researchers.

Personal information disclosed to NCVER may be used or disclosed for the following purposes:

- issuing a VET Statement of Attainment or VET Qualification, and populating Authenticated VET Transcripts;
- facilitating statistics and research relating to education, including surveys;
- understanding how the VET market operates, for policy, workforce planning and consumer information; and
- administering VET, including program administration, regulation, monitoring and evaluation.

I may receive an NCVER student survey which may be administered by an NCVER employee, agent or third party contractor. I may
opt out of the survey at the time of being contacted.

NCVER will collect, hold, use and disclose my Personal Information in accordance with the Privacy Act 1988 (Cth), the VET Data
Policy and all NCVER policies and protocols (including those published on NCEVER's website at www.ncever.edu.au)

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

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

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 Comtech Training for the purposes of evaluating and assessing my subsidised training.

I declare that the information I have provided to the best of my knowledge is true and correct.

Section A : Smart & Skilled Fee Free Apprenticeship Initiative

You may be eligible for fee free apprenticeship training.

1. Have you participated in telecommunications training as part of an Australian Apprenticeship prior to July 1st 2018*

Yes (go to question 2)

No (you may be eligible for a fee free apprenticeship)

2. Was the apprenticeship with your current employer?*

Yes (go to question 3)

No (you may be eligible for a fee free apprenticeship)

3. Have you completed, cancelled or deferred your apprenticeship?*

Yes (go to question 4)

No ((you may be eligible for a fee free apprenticeship)

4. What date did you complete, cancel or defer your apprenticeship?

DD slash MM slash YYYY

Section B: Smart & Skilled Enrolment Information

5. Have you undertaken any other Smart and Skilled qualification this calendar year?*

Yes

6. Have you achieved any qualifications since turning 17?*

Yes, while still at school

Yes, post school qualification

7. Are you registered or intending to be registered in an apprenticeship or traineeship for this qualification in NSW?*

Yes, intending to be registered

Yes

8. Would you like to apply for RPL (Recognition of Prior Learning) or CT (Credit Transfer) for this qualification?*

Yes, I will apply for RPL or CT and can provide evidence of prior learning*

*Evidence of units completed must be provided at enrolment or prior to commencement

9. Are you living in Social Housing or are you or your household on the NSW Housing Register?*

Yes

10. Are you an Employment Service Provider client?*

Yes

If yes, my ESP provider is:

If yes, my referral number ID is:

11. Do you have a long-term unemployment status of more than 52 weeks (as at today)?*

Yes, if yes, you will need to provide a letter from your JSA

12. Have you been receiving support services from Domestic and Family Violence Support Organisations?

Yes, (evidence may be requested from the provider)

13. Are you a refugee or asylum seeker?*

Yes (a copy of relevant visa will be required)

14. Commonwealth Government Benefits*

I am a recipient

I am not a recipient

I am a dependent child or spouse of a recipient

Please identify your benefit type:

Austudy

Sickness Allowance

Family Tax Benefit A-Max. Rate

Carer Payment

Farm Household Allowance

Veteran’s Affairs Pensions

Special Benefit

Widow B Pension

Veteran Children Education Scheme

Wife Pension

Youth Allowance

Parenting Payment (Single)

Widow Allowance

Newstart Allowance Exceptional Circumstances Relief

Age Pension Payment

15. Disability If you are in receipt of a payment for Disabilities*

Yes, I am in receipt of a Disability Support Pension

Yes, I am a dependent child/spouse of a person in receipt of a Disability Support Pension

I do not have a disability

I have supplied one of the following:

My concession card, showing CRN

A Current Centrelink Income Statement

A letter from my GP

Letter from the Dept of Human Services

A Letter from an allied health professional

File

Max. file size: 128 MB.

Consent*

By signing and completing this form, I declare all information to be true and correct.

I give permission for Comtech Training to use the following information to calculate my eligibility using the Smart and Skilled Calculator Online.

Student Signature*

NSW Smart and Skilled Enrolment Information

Section A : Smart & Skilled Fee Free Apprenticeship Initiative

Section B: Smart & Skilled Enrolment Information

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