Minimum Qualification Standards Program

Certificate IV in Child, Youth and Family Intervention (Residential and Out of Home Care) (CHC40313)

Personal Details

First Name*

Please enter your legal first name (in full)

Middle Name/s

Please enter your legal middle name if applicable

Last Name*

Please enter your legal surname

Home Phone

Mobile*

Email*

Date of Birth*

Street Address*

City/Suburb*

State*

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Postcode*

Country*

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Gender*

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Place of Birth (Country)*

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Place of Birth (City)*

Cultural Diversity and Citizenship

Please select your Citizenship status*

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Citizenship Status Other

If not included on the above list

Do you identify with any of the following?*

Aboriginal

Torres Strait Islander

Both Aboriginal/ Torres Strait Islander

None of These

Do you have a culturally and/or linguistically diverse (CALD) background that may impact on your studies?

Yes

Language

Do you speak any other languages at home apart from ENGLISH?*

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What is the main language you speak at home?*

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Where English is NOT the main language spoken at home, please confirm how well you speak English

Very well

Well

Not well

Not at all

Is English language assistance required?

If yes, please contact EnquiriesCIV.CYFI@tafe.qld.edu to discuss alternative arrangements.

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Disability Support

Do you have a disability, impairment or long term condition?

Please provide details of the condition

(you may choose to disclose or not)

Do you require disability support assistance?

If yes, a representative will be in touch with you shortly to discuss support

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Eligibility Documents

To determine your eligibility to access this funded program, TAFE Queensland requires you to provide documentation to verify your; 1. Identity and date of birth (DOB) 2. Queensland residency 3. Eligible citizenship or visa status 4. Employment as a current residential care worker The documentation that you provide must also be equal to 100 points. Different types of identity documents are worth different points. You can use different combinations of documents to make up your 100 points, but you must include at least 1 primary document as part of your 100 points. Primary Documents Points:  Birth certificate 50 points (Identity, DOB, Citizenship)  Driver licence 60 points (Identity, DOB, Queensland residency)  Passport 50 points (Identity, DOB, Citizenship, Queensland residency) Secondary Documents Points:  Certificate of Australian citizenship 40 points (Citizenship)  Change of name certificate 40 points (Identity)  Australian visa 40 points (Visa status)  Marriage certificate 40 points (Identity)  Medicare card 40 points (Identity, DOB, Queensland residency) As proof of current employment in the residential care workforce please provide a letter of support from your current employer;  Letter must be on letter-headed paper and include employer's full name and address  Letter must include your full name, job title and a description of what your role entails

Documents Upload*

Please attach copies of your identification and eligibility documents in the field below.

Drag and drop files here or

I confirm that I have attached proof of age*

I confirm that I have attached proof of QLD residency*

I confirm that I have attached proof of citizenship/eligible visa*

I confirm that I have attached a minimum of 100 points ID*

I confirm that I have attached proof of current employment*

Employment Details

Are you a current residential care worker?*

Select

If yes, please provide the name and address of your current employer

Employer Name*

Employer Address*

Fees & Payment

The total cost of completing the Certificate IV in Child Youth and Family Intervention (Residential and Out of Home Care)(CHC40313) with TAFE Queensland is $100 for eligible workers. This fee may be less if you are eligible for credit transfer. A statement will be forwarded upon enrolment into the Certificate IV in Child, Youth and Family Intervention (Residential and Out of Home Care) (CHC40313) with details of how payment can be made.

If you are successful in your application, who will be covering the co-contribution fee for training?*

Select

Prospective Student Details

Do you have an existing student ID number with TAFE Queensland?

If yes, please state below

Do you have a Unique Student Identifier (USI) number?

If yes, please state below

I confirm that I have supplied my USI*

If NO, then I give permission for TAFE Queensland to apply for a USI on my behalf and confirm I have provided the relevant ID documents above to support this requirement. (Either Australian Passport, Non-Australian Passport with Australian Visa, Australian Birth Certificate, Australian Driver's Licence, Medicare Card, Citzenship Certificate).

Yes

No, I give permission for TAFE to create on my behalf

Emergency Contact

(Person you want us to contact in an emergency)

Emergency Contact First Name*

Emergency Contact Last Name*

Emergency Contact Relationship*

Emergency Contact Mobile*

Emergency Contact Email*

Additional Information

Any additional comments you would like to include for our information.

Student Declaration*

I agree to abide by TAFE Queensland rules, regulations and policies and acknowledge that facilities made available for my use will be used only in accordance with the principles of proper use and relevant rules. I confirm the accuracy of the information contained within this form and where necessary identification documents provided.

TAFE Queensland Disclosure Statement*

Educational authorities - such as TAFE Queensland, research organisations contracted by TAFE Queensland, and the National Centre for Vocational Education Research - conduct surveys of past and existing students for customer satisfaction, improvement and marketing purposes. Please indicate your agreement below.

Consent to Obtain/Release Information Disclaimer*

The information you provide on this form will be used by the Queensland Government and TAFE Queensland for the purposes of assessing your eligibility, as well as administering and monitoring the Regional Skills Adjustment Strategy (RSAS). By completing this online form you are providing your consent for Queensland Government and TAFE Queensland to conduct an educational history check, and to disclose your information to your employer under RSAS. You are also providing your consent for representatives of the Queensland Government and TAFE Queensland to contact you regarding your possible involvement in public relations, marketing, promotion, advertising and media in connection with RSAS. All personal information will be managed in accordance with the Information Privacy Act 2009. Individuals accessing funding for the Minimum Qualification Standards Program under RSAS, must agree to the above if they wish to proceed.

Consent to Store Data Offshore Disclaimer*

This registration form is being provided using Smartsheet which is based in the USA. Information you provide on this form will be transferred to Smartsheet’s server in the USA. By volunteering to complete this registration with TAFE Queensland, you agree to this transfer.

If you do not consent, please contact RSAS@tafeqld.edu to discuss your options.

Please note that the first intake (May 2019) has now closed for TAFE Queensland's Residential Care MQS Program. Delivery dates for the second intake are now being finalised, and eligible applicants will be notified of training dates in due course.

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