New Smart and Skilled Eligibility Form

Smart & Skilled Eligibility Form

First Name*
Last Name*
Mobile Phone Number*
Do you live in NSW?*
Do you work in NSW?*
Do you intend to apply for Recognition of Prior Learning (RPL)?*
Recognition of prior learning (RPL), is a process for giving candidates credit for skills, knowledge and experience gained through working and learning. It can be gained at any stage of their lives, through formal and informal learning, in Australia or overseas, through work or other activities such as volunteering.
Are you currently employed?*
Company Name*
Work Suburb*
Work Postcode*
Do you have any disabilities?*
How long have you been employed for with this company?*
Approximate employment start date with this company (i.e. 14/01/2018)*
Employment Status*
Number of hours that you currently work (per week)*
Are you expected to become unemployed?
(e.g. companies in declining industries, people whose employment is conditional on immediately undertaking work relevant training, workers who have been stood down or furloughed)
Have you experienced (current or past) domestic or family violence?*
Are you currently a recipient of any Commonwealth government welfare benefits or allowances?*
An individual who is seeking a concession as a dependent child, spouse or partner of someone who is receiving a specified Commonwealth benefit or allowance must provide documentary evidence that Centrelink recognises the individual as dependent. The evidence should clearly show the Centrelink Reference Number (CRN) of the benefit or welfare recipient.

Specified Commonwealth benefits and allowances
- Age Pension
- Carer Payment
- Exceptional circumstances relief pay
- Family Tax Benefit Part A
- Newstart Allowance
- Sickness Allowance
- Veterans' Affairs Pension
- Widows Allowance
- Wife Pension
- Austudy
- Disability Support Pension
- Farm Household Allowance
- Parenting Payment (Single)
- Special Benefit
- Veterans' Choldren Education Scheme
- Widow B Pension
- Youth Allowance
At this current point in time, have you been UNEMPLOYED for 52 or more consecutive weeks?*
Are you an Employment Service Provider client?*
Employment Service Provider Organisation/ID
Employment Service Provider Client ID
Have you been referred to this training by your Employment Service Provider client?*
Employment Service Provider Referral ID
Have you completed any formal qualifications since turning 17 (i.e. Certificate I, II, III, IV, Diploma, Bachelor etc)?*
What is the LEVEL, NAME and YEAR you completed qualification/s? (i.e. Certificate IV in Fitness - 2019)*
Have you commenced, completed or are currently undertaking any other Smart and Skilled qualifications this calendar year?*
Are you currently undertaking any other study?*
What is the name of the qualification you are studying?*
Have you commenced a NSW Traineeship or Apprenticeship before?*
What was the name of the qualification that you commenced?*
Did you successfully complete the Traineeship that you commenced?*
What year did you successfully complete this Traineeship/Apprenticeship?*
I understand and agree that 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, or sensitive personal information (including my ethnicity or health information) (together Personal Information) collected by the Australian College of Professionals may be disclosed to the Department of Education and Communities (Department). 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 consent to the collection, use and disclosure of my Personal Information in the manner outlined above. 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 the Australian College of Professionals for the purposes of evaluating and assessing my subsidised training. Note: If under 18 years of age at the time of giving consent, then the consent of their guardian is required.
Confirmation*
- I confirm that the information contained in this eligibilty Survey, is true and accurate.
Date of Declaration*
DD slash MM slash YYYY