Government Funded Enrolment Form

Personal Details

Title

First Name

Middle Name

Last Name

Gender

Date of Birth

USI (Unique Student Identifier)

Contact Details

Email

Phone

Mobile

Address

Street Address

Street Address 2

City / Suburb

State

Postcode

Country

Emergency Contact

Contact Name

Relationship

Phone

Course Selection

Qualification / Course

Education and Employment

Highest School Level Completed

Prior Qualifications

Employment Status

Reason for Study

Language and Diversity

Language Spoken at Home

English Proficiency

Aboriginal / Torres Strait Islander

Disability

Eligibility

To be eligible for Smart and Skilled you must be an Australian citizen, permanent resident, humanitarian visa holder or NZ citizen, aged 15+, no longer at school, and living or working in NSW.

Citizenship / Residency

Are you currently at school?

Country of Birth

I give permission for AMBI to look up my USI

Residential Postcode (NSW)

Program Stream

Fee Concession / Exemption

Concessions and exemptions may reduce your student fee. You must provide evidence at enrolment.

Fee Category

Concession Evidence Type

Recognition of Prior Learning / Credit Transfer

Do you wish to apply for RPL or Credit Transfer?

Apprenticeship / Traineeship

Complete this section only if you are enrolling as an apprentice or trainee.

Type

Training Contract ID

Employer Name

Employer ABN

Student Declaration

I declare that all information provided by me in this form is true, accurate, complete and not misleading in any way.

I consent to the collection, use and disclosure of my personal information by AMBI Education and the NSW Department of Education for the purposes of administering Smart and Skilled, including determining eligibility, calculating fees and subsidies, and reporting to government agencies and NCVER.

I understand that a student fee may apply and I will be informed of the applicable fee before training commences. I have been advised of the refund policy for withdrawal or deferment.

I understand that a Notification of Enrolment will be completed on my behalf and I have not concurrently enrolled in the same qualification at another provider under Smart and Skilled.