Experienced Entrant Form

Experienced Entrant Form - Standard 11

Standard 11 Coal Mining Surface Generic Induction

Overview:

To be eligible to attend the 1-day experienced entrant course, you must be able to show you have worked on a resources industry site, anywhere across Australia, for at least 3 months within the last 5 years.

The resources industry covers coal and metalliferous mining (including associated refineries), oil & gas and quarrying.

For any questions or assistance, please contact info@worksafeconnect.com, Townsville: 07 4728 9866; Brisbane: 07 3277 3282

Pathways and Outcomes:

If you have sufficient evidence, you are eligible to attend the 1-day experienced entrant course.

If you have insufficient evidence, you will attend the 2-day new entrant course.

Providing you successfully complete all assessment items in either course, a Statement of Attainment will be issued for six (6) units of competency (RIISS00034 Surface Coal Mine Safety Skill Set).

1. Student Information

Full Name:*

Email:*

Phone Number:*

2. Role Description

Please summarise the work you have performed in the resources industry, anywhere across Australia, within the last five (5) years.

Provide ONE of the following:*

Select or enter value

Short Summary of Role (if CV not uploaded below):

For example, dump truck operator at XYZ mine from Jan'22 to Sep'23.

3. Evidence

You must select at least ONE item of evidence below that proves your experience within the resources industry.

The evidence must clearly identify:

you
the site name
dates on industry resources site within the last five (5) years

Evidence:*

Evidence to be uploaded at the end of this form in Section 6.

Select or enter value

4. Risk Management

A key part of the course is risk assessment.

Risk Assessment*

Please select all statements that apply based on your work experience:

I have regularly completed Take 5s, SLAMs, or Personal Risk Assessments.

I have participated in documented risk assessments (e.g., JSEA, JSA, SWMS, or similar procedures).

I have not been involved in documented risk assessments (including identifying hazards, assessing risks, and implementing control measures).

5. English Skills

Is a language other than English spoken in your home?*

Select

If “Yes,” please choose the option below that best describes your English skills:*

I can read, write, and speak English fluently.

I can speak in English fluently but may need help with reading or writing.

I can understand English but may struggle with reading, writing or fast conversations.

6. Third Party Verification

Please provide details below of a third-party person who can verify the evidence provided if required.

Full Name:*

Company:*

Phone:*

Email:*

7. Student Declaration

I confirm I have worked for at least 3 months in the last 5 years on a resources industry site.*

I confirm the authenticity of the evidence provided.*

8. File Upload

Please upload evidence mentioned above.*

This includes your CV / Resume (if applicable) and evidence that proves your experience within the resources industry.

Drag and drop files here or

Send me a copy of my responses

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