READY FOR WORK ENROLMENT FORM Name * First Name Last Name Other Given Name First Name Last Name Male/Female/Other * Male Female Other Date of Birth MM DD YYYY Unique Student Identifier (USI if you have one) Email * Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Mobile Number Country (###) ### #### Were you born in Australia? Yes No Are you of Aboriginal or Torres Strait Islander Origin? Yes No Do you speak a language other than English at home? Yes No If yes, please specify the main language spoken at home Do you consider yourself to have a disability, impairment or long-term condition? Yes No If yes, please select from the following: Hearing/deaf Physical Intellectual Learning Mental Acquired brain impairment Vision Medical condition Other Do you require assistance with language, literacy and numeracy? No Yes If yes, What assistance do you need? Tutorial Support Interpreter Adaptive equipment Other Do you have a current/valid Blue Card and/or Yellow Card? (Not required to complete this course) No Yes Do you have a current/valid police check? (Not required to complete this course) No Yes I declare that I give permission for HST to disclose contact details to ASQA and/or DESBT if required for Quality Assurance purposes Yes No, I dont give permission Date MM DD YYYY Workforce Australia status Not of benefit JobSeeker payment Youth allowance Age pension Carer allowance Parenting payment Disability support pension Austudy Employment status Less than 25 hours per week More than 25 hours per week Not employed Not in labour force Volunteer work Period Unemployed Less than 12 months Between 12 and 24 months Greater than 24 months Employed N/A Thank you! We will be in contact very soon. If you have any questions, please email us at hello@wotindustry.au
