registered secondary teachers enrolment application pack ... lln online - single...registered...

ONLINE: TAELLN411A Single Unit Enrolment Application Pack

Registered Secondary teachers

Enrolment Application Pack - Online Course

FOR PARTICIPANTS COMPLETING SINGLE UNIT TAELLN411A

ONLINE ONLY

Name of applicant:

Postal address:

Phone:

Declaration

I declare that the information contained in this application is true and correct and that all documents are genuine. This also confirms that I have already completed a TAE or TAA qualification, and that I belong or have access to an organisation that delivers VET programs.

Candidate Signature: (please handwrite) _____________________________ Date:

Once completed you will need to either scan to [email protected] OR post the application and the evidence requirements to: Worklinks Training, PO Box 98, Caboolture 4510

Please type responses before printing

Fax: Email:

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mailto:[email protected]

MAIL TO:

PO BOX 98

CABOOLTURE QLD 4510

e: [email protected] | w: www.worklinks.com.au | p: (07) 5498 9601 | f: (07) 5498 9376


ABN: 28 316 834 043

FOR BILLING PURPOSES

Please complete this section if

you are not paying for this course

personally

Organisation/School:

Contact Name:

Contact Phone:

Contact Email:

Mailing Address:

PARTICIPANT DETAILS - PAGE 1 (COMPLETE ON YOUR COMPUTER BEFORE PRINTING)

Surname: Date Of Birth*:

Given Names: Gender: Male Female

Residential Address:

(Please indicate address for certification) City: Postcode:

Home Phone: Work Phone:

Mobile Phone: Email:

* Information required for AVETMISS (National VET Statistics only)

A separate enrolment form is required for each participant. Please complete all fields.

Please invoice: Me The organisation listed below

Section 1: ENROLMENT FORMONLINE: TAELLN411A - Single Unit Enrolment

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MAIL TO:

PO BOX 98

CABOOLTURE QLD 4510



ABN: 28 316 834 043

PARTICIPANT DETAILS - PAGE 2 (COMPLETE ON YOUR COMPUTER BEFORE PRINTING)

I am a: SecondaryTeacher Trainer with BSZ

Country of Birth*: Language Spoken at Home*:

Proficiency in English: Very Well Well Not Well Not at All

Indigenous Status* (select one): Aboriginal Torres Strait Islander

Both Aboriginal and Torres Strait Islander Neither

Do you consider yourself to have a disability, impairment or long-term condition? Yes No

If yes, please indicate (select all relevant fields):

Hearing/Deaf Physical Intellectual Learning

Mental Illness Vision Medical Condition

Acquired Brain Impairment Other (Please State): __________________________________

Highest School Level*: Never attended school Year 8 or below Year 9 or equivalent

Year 10 or equivalent Year 11 or equivalent Year 12 or equivalent

Year of Highest School Level*:

Currently Attending School: Yes No

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MAIL TO:

PO BOX 98

CABOOLTURE QLD 4510



ABN: 28 316 834 043

PARTICIPANT DETAILS - PAGE 3

Qualifications Completed* (please indicate below):

Bachelor Degree or Higher Advanced Diploma or Associate Degree Diploma or Associate Dip

Certificate IV Certificate III Certificate II Certificate I

Employment Status (please indicate below):

Please select the main reason that you are undertaking this study:

Are you computer literate and have a basic knowledge of computer software? Yes No

Do you require any literacy/numeracy assistance? Yes No

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MAIL TO:

PO BOX 98

CABOOLTURE QLD 4510



ABN: 28 316 834 043

PARTICIPANT DECLARATION

Applicant’s certification: I hereby certify that the information provided and attached is true, correct and authentic.

(Please print this completed form, sign and date it, and post the original to the PO Box listed at the top of the page)

Please indicate where you heard about this course:

Candidate Signature: (please handwrite) _____________________________ Date:

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MAIL TO:

PO BOX 98

CABOOLTURE QLD 4510



Section 1: ENROLMENT FORM

Certificate IV in Training and Assessment (TAE40110)

ABN: 28 316 834 043

Participant Acknowledgment - Part 1

I hereby acknowledge that I have been given a copy of the Worklinks Participant Information Handbook

(available on the website).

In signing this statement, I also give Worklinks permission to show copies of any of my assessment work to

the Australian Skills Quality Authority, if Worklinks is audited as a Registered Training Organisation.

I also understand that I can access the full Worklinks AQTF Policies and Procedures Manual, on request

from the Worklinks office.

If on completion of this course/training program, I am deemed competent against any unit/s of

competency, I acknowledge that competency has been determined at that particular time and that it is my

own responsibility to maintain this level of competency on an ongoing basis eg through workplace

experience, professional development activities, further training, etc.

Training course enrolled in:

Full Name of participant:

Candidate Signature: (please handwrite) _________________________ Date:

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MAIL TO:

PO BOX 98

CABOOLTURE QLD 4510



ABN: 28 316 834 043

Participant Acknowledgment - Part 2

I hereby acknowledge that:

a) All course work that I submit towards this qualification must be my own

b) I understand that I have 12 months from the date that I receive my unique username and password

for online study, to submit all necessary assessment items

c) I understand that participation in this course requires access to the following IT resources, and

acknowledge my capacity to gain adequate access to these resources:

A personal computer using either:

Internet Explorer 8 or 9;

Firefox 3.X or later; or

Safari 4 or later

Adobe Reader 9 or later (this can be downloaded for free from http://get.adobe.com/reader/)

Flash Player 9 or later for Windows and Mac (this can be downloaded for free from http://

get.adobe.com/flashplayer/)

Full name of participant:

Candidate Signature: (please handwrite) _________________________ Date:

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http://get.adobe.com/reader/

http://get.adobe.com/flashplayer/

http://get.adobe.com/flashplayer/

MAIL TO:

PO BOX 98

CABOOLTURE QLD 4510



ABN: 28 316 834 043

When you have completed this enrolment form, please submit it to Worklinks via:

Scan and Email - [email protected]

Or

Post - Worklinks Inc, PO Box 98, Caboolture QLD 4510

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From 1 January, 2015, all training participants require a Unique Student Identifier (USI) when enrolling or re-enrolling in nationally recognised training. If you do not already have a USI, you are required to create one at www.usi.gov.au/create-your-USI/Pages/default.aspx - this does not cost anything.

Please insert your USI below:

Section 2 – Statutory declaration

Please complete the STATUTORY DECLARATION on the next page.

All course work I submit for the Certificate IV in Training and Assessment will be my own work and will not be written for me by any other person.

The work submitted will contain no plagiarised material and will not be obtained from any other source, except where due acknowledgement has been made.

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Commonwealth of Australia

STATUTORY DECLARATION

Statutory Declarations Act 1959

1 Insert the name, address and

occupation of person making the declaration

I,1

make the following declaration under the Statutory Declarations Act 1959:

2 Set out

matter declared to in numbered paragraphs

2 All course work I submit for the Certificate IV in Training and

Assessment will be my own work and will not be written for me by any other person.

The work submitted will contain no plagiarised material and will not be obtained from any other source, except where due acknowledgement has been made.

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I understand that a person who intentionally makes a false statement in a statutory declaration is guilty of an offence under section 11 of the Statutory Declarations Act 1959, and I believe that the statements in this declaration are true in every particular.

3 Signature of person making the declaratio

n

3

4 Place

5 Day

6 Month and year

Declared at 4

on 5

of 6

Before me,

7 Signature of person before whom the declaration is made (see over)

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8 Full name, qualification and address of person before whom the declaration is made (in printed letters)

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Note 1 A person who intentionally makes a false statement in a statutory declaration is guilty of an offence,

the punishment for which is imprisonment for a term of 4 years — see section 11 of the Statutory

Declarations Act 1959.

Note 2 Chapter 2 of the Criminal Code applies to all offences against the Statutory Declarations Act

1959 — see section 5A of the Statutory Declarations Act 1959.

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A statutory declaration under the Statutory Declarations Act 1959 may be made before–

(1) a person who is currently licensed or registered under a law to practise in one of the following occupations:

Chiropractor Dentist Legal practitioner

Medical practitioner Nurse Optometrist

Patent attorney Pharmacist Physiotherapist

Psychologist Trade marks attorney Veterinary surgeon

(2) a person who is enrolled on the roll of the Supreme Court of a State or Territory, or the High Court of Australia, as a legal practitioner (however described); or

(3) a person who is in the following list:

Agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public

Australian Consular Officer or Australian Diplomatic Officer (within the meaning of the Consular Fees Act 1955)

Bailiff

Bank officer with 5 or more continuous years of service

Building society officer with 5 or more years of continuous service

Chief executive officer of a Commonwealth court

Clerk of a court

Commissioner for Affidavits

Commissioner for Declarations

Credit union officer with 5 or more years of continuous service

Employee of the Australian Trade Commission who is:

(a) in a country or place outside Australia; and

(b) authorised under paragraph 3 (d) of the Consular Fees Act 1955; and

(c) exercising his or her function in that place

Employee of the Commonwealth who is:

(a) in a country or place outside Australia; and

(b) authorised under paragraph 3 (c) of the Consular Fees Act 1955; and

(c) exercising his or her function in that place

Fellow of the National Tax Accountants’ Association

Finance company officer with 5 or more years of continuous service

Holder of a statutory office not specified in another item in this list

Judge of a court

Justice of the Peace

Magistrate

Marriage celebrant registered under Subdivision C of Division 1 of Part IV of the Marriage Act 1961

Master of a court

Member of Chartered Secretaries Australia

Member of Engineers Australia, other than at the grade of student

Member of the Association of Taxation and Management Accountants

Member of the Australasian Institute of Mining and Metallurgy

Member of the Australian Defence Force who is:

(a) an officer; or

(b) a non-commissioned officer within the meaning of the Defence Force Discipline Act 1982 with 5 or more years of continuous service; or

(c) a warrant officer within the meaning of that Act

Member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the National Institute of Accountants

Member of:

(a) the Parliament of the Commonwealth; or

(b) the Parliament of a State; or

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(c) a Territory legislature; or

(d) a local government authority of a State or Territory

Minister of religion registered under Subdivision A of Division 1 of Part IV of the Marriage Act 1961

Notary public

Permanent employee of the Australian Postal Corporation with 5 or more years of continuous service who is employed in an office supplying postal services to the public

Permanent employee of:

(a) the Commonwealth or a Commonwealth authority; or

(b) a State or Territory or a State or Territory authority; or

(c) a local government authority;

with 5 or more years of continuous service who is not specified in another item in this list

Person before whom a statutory declaration may be made under the law of the State or Territory in which the declaration is made

Police officer

Registrar, or Deputy Registrar, of a court

Senior Executive Service employee of:

(a) the Commonwealth or a Commonwealth authority; or

(b) a State or Territory or a State or Territory authority

Sheriff

Sheriff’s officer

Teacher employed on a full-time basis at a school or tertiary education institution

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