Small Business Foundations Enrolment Form

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Please select from the list below, all the courses that you wish to be enrolled into:

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Personal Information

Please complete all the fields below

Title
Entity Data - Profile - Title
First Name
Entity Data - Profile - First Name
Middle Name
Entity Data - Profile - Middle Name
Surname
Entity Data - Profile - Surname
Date of Birth
Entity Data - Profile - Birth Date
Gender
Entity Data - Profile - Gender
Please select your preferred pronouns from the options below:

Entity Data - Profile - Properties
E-mail Address
Entity Data - Contact - Home - E-mail Address
Mobile Number
Entity Data - Contact - Home - Mobile Number
Please provide us with the details of an Emergency Contact

First Name
Entity Data - Contacts - First Name
Surname
Entity Data - Contacts - Surname
Relationship with Emergency Contact (Who are they to you)
Entity Data - Contacts - Relationship
Phone or Mobile Number
Entity Data - Phone - Home - Mobile Number
[Home] Address -
Entity Data - Address
Address - Lookup
Entity Data - Address - Lookup
[Home] Address - Overseas State/Province
Entity Data - Address - Overseas State/Province
[Home] Address - State
Entity Data - Address - State
[Home] Address - Post Code
Entity Data - Address - Post Code
[Home] Address - Country
Entity Data - Address - Country
[Home] Address - Street Address 1
Entity Data - Address - Street Address 1
[Home] Address - Street Address 2
Entity Data - Address - Street Address 2
[Home] Address - Unit/Flat Number
Entity Data - Address - Unit/Flat Number
[Home] Address - Street/Lot number
Entity Data - Address - Street/Lot number
[Home] Address - Street Name
Entity Data - Address - Street Name
[Home] Address - Suburb
Entity Data - Address - Suburb
Do you have a different postal address?
Basic - Radio buttons
What is your postal address?
Entity Data - Address - Postal - Lookup
Address - Postal - Unit/Flat Number
Entity Data - Address - Postal - Unit/Flat Number
Address - Postal - Street/Lot number
Entity Data - Address - Postal - Street/Lot number
Address - Postal - Street Name
Entity Data - Address - Postal - Street Name
Address - Postal - Suburb
Entity Data - Address - Postal - Suburb
Address - Postal - Post Code
Entity Data - Address - Postal - Post Code
Address - Postal - State
Entity Data - Address - Postal - State
Address - Postal - Country
Entity Data - Address - Postal - Country

Language and Cultural Diversity

In which Country were you born in?
Entity Data - Profile - Country of Birth
What is the name of the Town/City you were born in?
Entity Data - Profile - Town/City of Birth
What is the main language you speak at home?
Entity Data - AVETMISS - Main Language
What is your Citizenship status?
Entity Data - Profile - Citizenship Status
What is your Nationality?
Entity Data - Profile - Nationality
Are you of Aboriginal or Torres Strait Islander origin?
Entity Data - AVETMISS - Indigenous Status

Disability

Do you have a disability, impairment or long-term condition?
Entity Data - AVETMISS - Disability Flag
If you indicated the presence of a disability, impairment or long-term condition, please select the area(s) in the following list:
Entity Data - AVETMISS - Disability Type
Other - Please Specify
Basic - Text

Education

Are you still enrolled in public or private primary or high school education? (Kindergarten to year 12)
Entity Data - AVETMISS - At School
Have you SUCCESSFULLY completed any other qualification?
Entity Data - AVETMISS - Prior Education Flag
What level was the qualification?
Entity Data - AVETMISS - Prior Education Type
Of the following categories, select the one which BEST describes the main reason you are undertaking this course
Entity Data - AVETMISS - Study Reason
Of the following categories, which BEST describes your current employment status?
Entity Data - AVETMISS - Labour Force Status

Attendance Options for Hybrid Session: In-Person or Online via Microsoft Teams

This course will be conducted as a hybrid session. Please indicate your attendance preference by selecting either in-person or online via Microsoft Teams.

In-Person Attendance
The location for this course is Business Growth Centre, Gateshead NSW. A follow-up email will be sent with more information. If you have any questions, contact the College on (02) 4348 4300.

Online Via Microsoft Teams
To complete the course, you will need to have access to a laptop – with Internet connectivity for Microsoft Teams. A follow-up email will be sent with login information for each session. If you have any questions, contact the College on (02) 4348 4300.
Basic - Dropdown

Proof Of Identification 

In order to be eligible for this funded training, you will be required to provide evidence of proof of address and proof of citizenship.

You will be required to provide a total of two (2) documents.

You will need to bring the selected documents with you to the first day of your course.

In the spaces below please select which card/document you will provide and the number on that card

Document 1

Please select which card/document you will provide the number for
Basic - Dropdown
Please provide your Drivers Licence number
Entity Data - Identification - Drivers Licence
Please provide your Proof of Age Card number
Entity Data - Identification - Proof of Age Card
Please provide your Centrelink Benefit Card number
Entity Data - Identification - Centrelink Benefit Card
Document 2

Please select which card/document you will provide the number for
Basic - Dropdown
Please provide your Medicare number
Entity Data - Identification - Medicare
Please provide your Birth Certificate number
Entity Data - Identification - Birth Certificate
Please provide your Passport number
Entity Data - Identification - Passport
Unique Student Identifier

What is your Unique Student Identifier (USI)
Entity Data - AVETMISS - Unique Student Identifier (USI)

Targeted Skills for Small Business - Eligibility


The Targeted Skills for Small Business Program will deliver targeted short workshops for small business owners and employees, and employees of not-for-profit businesses.

A small business is an enterprise with: less than 20 full time equivalent (FTE) employees; or,

Less than 200 FTE employees if the enterprise’s primary operations is in a Regional or Remote Location

As this course is funded by the NSW Government, please select from the following option which best applies to you- disability
Basic - Dropdown
Business Name
Basic - Text
I confirm that my business meets the definition of a small business
Basic - Radio buttons
Digital Signature
Basic - Digital Signature
Evidence is required from your employer to confirm you work for a small business.

Please supply your employer or supervisor's name and email address for us to contact them for the evidence.

Full Name
Basic - Text
Email Address
Basic - Text

Consent to Use and Disclosure of Personal Information

I, (First, middle and last Name)
Basic - Text
of, (current residential address)
Basic - Text
with date of birth
Basic - Date
Understand and agree that, under the National Vocational Education and Training Regulator (Data Provision Requirements) Instrument 2020, Central Coast Community College is required to collect personal information (information or an opinion about me), collected from me, my parent or guardian, such as my name, Unique Student Identifier, date of birth, contact details, training outcomes 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 my enrolment form and my training activity data) may be used or disclosed by Central Coast Community College for statistical, regulatory and research purposes. Central Coast Community College may disclose my personal information for these purposes to third parties, including:

• Employer – if I am enrolled in training paid by my employer;

• Commonwealth and State or Territory government departments and authorised agencies, including the NSW Department of Education (Department);

• NCVER; • Organisations (including the Department) 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 publised on NCVER’s website at www.ncver.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 exercise 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 Central Coast Community College 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.

I consent to the collection, use and disclosure of my Personal Information in the manner outlined above.
Basic - Checkboxes
Digital Signature
Basic - Digital Signature
Date
Basic - Date

Student Declaration

Student Declaration:

I confirm that I have read, understood and consent to the Terms and Conditions of Central Coast Community College found in the Student Handbook and on Central Coast Community College website

I understand that my rights and responsibilities as a student are outlined in the Student Handbook and I should refer to this handbook for further information on USI, LLN Assessment, complaints, and appeals, WHS, support services and other legislative and regulatory policies and procedures. I agree to follow the policies and procedures outlined in the Student Handbook and to ask questions on any matters I don’t understand.

I declare that all information provided by myself to Central Coast Community College in relation to this enrolment form is true, accurate, complete and not misleading in any way. I understand that the NSW Department of Education may request evidence regarding my eligibility at any time and I am responsible to provide this evidence.

Basic - Radio buttons
I declare that:
Basic - Radio buttons
Please select who helped you to complete this enrolment form
Basic - Radio buttons
Student Signature
Basic - Digital Signature
Date
Basic - Date