Enrolment Form

Which of the below are you enrolling into? *

Start date if known?

Select the item below which best describes the main reason you are undertaking this course? *

Personal Details

Preferred pronoun?

SheHeTheyOther

Given Names *

Family Name *

Gender *

MaleFemaleNon-binaryDifferent identity

Date of Birth *

Street address *

Town/Suburb *

State *

Post Code *

Contact Information

Email Address *

Alternative email address

Mobile number *

Home phone

Work phone

Emergency contact's name and relation to you

Emergency contact's number

How did you find out about this course? *

Anything you would like us to know?

Statistical Information

The AVETMISS Data is sent to NCVER (National Centre for Vocational Education Research) and helps Registered Training Organisations like ourselves deliver courses which would better suit our students.

NCVER will collect, hold, use and disclose your personal information in accordance with the law, including the Privacy Act1988(Cth) (Privacy Act) and the NVETR Act. For more information about how NCVER will handle your personal information please refer to the NCVER’s Privacy Policy at www.ncver.edu.au/privacy.

In which country were you born? *

AustraliaOther

If you where born outside of Australia; which country where you born? *

What is your citizenship status *

What town/city where you born? *

I am of aboriginal or Torres Strait Islander descent? *

NoAboriginalTorres Strait IslanderBoth

Do you have a disability? *

YesNo

What is your disability?

Do you require assistance?

YesNo

What is your highest completed school level? *

Are you still enrolled in high school? *

YesNo

Have you successfully completed any of the qualifications listed below? *

Which best describes your current employment status? *

Unique student identifier (USI)

From 1 January 2015, Kiama Community College can be prevented from issuing you with a nationally recognised VET qualification or statementof attainment when you complete your course if you do not have a Unique Student Identifier (USI). In addition, we are required to include yourUSI in the data we submit to NCVER. If you have not yet obtained a USI you can apply for it directly at https://www.usi.gov.au/your-usi/create-usi on your computer or mobile device.

Do you have a USI number? *

YesYes, but I will need Kiama Community College to look it up for meNo

What is your USI number? *

If you would like Kiama Community College to apply for a USI or search for your existing USI on your behalf you must authorise us to do so and declare that you have read the privacy information.

You will also need to upload some identification, preferably your licence or medicare card.

I have read and I consent to the collection, use and disclosure of my personal information (which may include sensitive information) pursuant to the information detailed at https://www.usi.gov.au/documents/privacy-notice-when-rto-applies-their-behalf

I authorise Kiama Community College to apply pursuant to sub-section 9(2) of the Student Identifiers Act 2014, for a USI on my behalf

ACE Funding Eligibility

I would like to apply for a fee-free position in the course

Payment Options

Make full payment nowInvoice my employer/organisation (payment must be made prior to course starting)

Employer/Organisation contact name and number

ACE Funding Eligibility

To access ACE funding, you need to be experiencing a disadvantage that is impacting your ability to study or gain/maintain employment.

If you are eligible you will not need to pay any fees.

To be deemed eligible for funding and receive a fee-free place in the course you must:

An Australian citizen, New Zealand citizen, permanent resident, humanitarian visa holder, or an eligible asylum seeker, and
Be aged 15 years or older, and
Live or work in NSW, and
No longer enrolled in secondary school

And fall into at least one of the below categories:

Please identify which payment type you are on? *

Centrelink Confirmation eservices

I authorise the below: *

YesNo

Kiama Community College Ltd T/A Kiama & Shoalhaven Community Colleges to use Centrelink Confirmation eServices to perform a Centrelink/DVA enquiry of my Centrelink or Department of Veterans’ Affairs customer details and concession card status to enable the business to determine if I qualify for an educational course concession.
Services Australia (the agency) to provide the results of that enquiry to Kiama & Shoalhaven Community Colleges.

I understand the below: *

YesNo

the agency will disclose personal information to Kiama & Shoalhaven Community Colleges including my name, address, payment type, payment status and concession card type and status to confirm my eligibility for relevant educational course concession.
that Kiama & Shoalhaven Community Colleges may disclose information contained in the Centrelink statement of information to Training Services NSW for the purpose of obtaining the educational course concession rate.
this consent, once signed, remains valid while I am a customer of Kiama & Shoalhaven Community Colleges unless I withdraw it by contacting the Kiama & Shoalhaven Community Colleges or the agency. I can get proof of my circumstances/details from the agency and provide it to Kiama & Shoalhaven Community Colleges so my eligibility for relevant educational course concession can be determined.
if I withdraw my consent or do not alternatively provide proof of my circumstances/details, I may not be eligible for the educational course concession provided by Kiama & Shoalhaven Community Colleges.

Please provide your Centrelink Reference Number *

Please provide a written statement in relation to the eligibility boxes you have ticked *

Please provide a statement confirming the business meets the definition of a small business **A small business is an enterprise with less than 20 full-time employees; or, less than 200 full-time employees if the enterprise's primary operations are in a regional or remote location

Please upload a letter from your employer confirming employment and that the employer meets the definition of a small business or is a not-for-profit *

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*A small business is an enterprise with less than 20 full-time employees; or, less than 200 full-time employees if the enterprise's primary operations are in a regional or remote location

If relevant, Please upload a document that confirms you are eligible for funding; this could be:

Your current Commonwealth benefits card
A letter, or income statement from Services Australia
Referral letter from a supporting agency
Evidence from a government agency
A letter from a Medical professional
A letter from a relevant support agency or community organisation

Upload your document here

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Credit Card Details *

Pay

Student Declaration and Consent

Would you like to receive course marketing emails *

I confirm I have read and agree to the Terms and Conditions

I confirm I have been provided with and have read this linked Privacy Notice

https://kcc.nsw.edu.au/doc/Enrolment_Privacy_Notice_v2.pdf

I declare I have been provided with the student information (student handbook linked below)
http://kcc.nsw.edu.au/doc/KSCC_Student_Handbook_2024-WEB.pdf

I declare the information I have provided regarding eligibility to be true, accurate, complete and not misleading in any way. *

I consent to the collection, use and disclosure of my Personal Information in the manner outlined in this link.
Consent to Use & Disclosure of Personal Information *

I have read and agree with the linked photo/image consent statement

Please upload your drivers license or another document confirming your identity

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Please upload either your Medicare Card, Passport, Birth Certificate, immicard or other Visa document

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If you are unable to upload evidence and/or documents:

I will text evidence to the community college mobile number 0401 981 799I will email the evidence to admin@kcc.nsw.edu.au

You will not be enrolled until the required documentation and Identification has been received by our enrolment team

Signature: *

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Date: *

*Parent/Guardian consent is required for all students under the age of 18

Parent/Guardian full name

Parent/Guardian signature

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Enrolment Form

Personal Details

Contact Information

Statistical Information

Unique student identifier (USI)

Centrelink Confirmation eservices

Student Declaration and Consent

Enrolment Terms and Conditions