Name Last Name Date of Birth USI Number * (Mobile or Home) Postcode Gender Male Female Postal Address Address: City: State: Current Residential Address Address: (if same as Postal leave blank) City: State: Do you consider yourself to have a No disability, impairment or long-term Yes / Please specify ____________________ condition? Are you of Aboriginal or Torres No Strait Islander origin? Yes - Aboriginal (If both, mark both boxes) Yes Torres Strait Islander “Yes” – Do you identify as a at risk? No (A young person between 15 24 Yes – years-of-age who is at risk of disengaging from education and employment) Have you been registered as not No employed, actively looking for Yes work or available to start work for at least 52 weeks? Do you currently hold a current or No valid version of any of the Yes Commonwealth Health Care Card – following prior to the Yes Pensioner Concession Card – commencement of this training? Yes Veteran’s Gold Card – OFFICE USE ONLY Qualification Certificate III in Hospitality Delivery Mode D (Blend of training by RTO)
Name Last Name Date of Birth USI Number * (Mobile or Home) Postcode Gender Male Female Postal Address Address: City: State: Current Residential Address (if same as Postal leave blank) Address: City: State: Do you consider yourself to have a disability, impairment or long-term condition? No Yes / Please specify ____________________ Are you of Aboriginal or Torres Strait Islander origin? (If both, mark both “Yes” boxes) No Yes - Aboriginal Yes – Torres Strait Islander Do you identify as a at risk? (A young person between 15 – 24 years-of-age who is at risk of disengaging from education and employment) No Yes Have you been registered as not employed, actively looking for work or available to start work for at least 52 weeks? No Yes Do you currently hold a current or valid version of any of the following prior to the commencement of this training? No Yes – Commonwealth Health Care Card Yes – Pensioner Concession Card Yes – Veteran’s Gold Card OFFICE USE ONLY Qualification Certificate III in Hospitality Delivery Mode D (Blend of training by RTO)
Skilled-Capital.docx