Application Form

Course Application

This is a Course Application form for prospective students who wish to enrol in the:

CHC43215 Certificate IV in Alcohol and Other Drugs - Blended Delivery intake.

Notes:

a) This delivery intake may require you to participate in weekly classes via Zoom or face to face. The blended delivery intake is designed for those who are not employed in an AOD agency providing services to clients with AOD issues. If you are employed in a role working with clients with AOD issues and prefer a workplace-based and online method of study please indicate in your application.

b) Please ensure you have your Unique Student Identifier available at the time of applying.

c) To assist with recognition of prior learning and to ascertain eligibility for government-supported training, please upload certified copies of identification (passport/birth certificate/medicare card, other) as well as certified copies of competencies/modules of learning already achieved in the spaces allocated.

d) When making this application you must provide us with personal information that we are required to provide for government vocational education and training (VET) data collection requirements.

e) This form enables you to enter your name in sections and that this is considered to be your digital signature.

f) If you are applying for RPL or Credit Transfers then uploading your existing qualifications at the time of application will save time later on.

g) If you are applying to have your training covered by government funding then it is preferable that you upload evidence of identity and for concession at the time of applying. This will save valuable time for our administration team and enable your enrolment to be processed efficiently. However, if you do not have this evidence available now, you can email it directly to studentadmin@odyssey.org.au after you complete this application. OUr administration team will contact you once your application is received.

PLEASE NOTE: All fields marked with an asterisk (*) must be completed

.

Your Personal Information

Please enter your contact details - ensure you enter your name details exactly as when you applied for a Unique Student Identifier.

Preferred Title

First Name

Surname

Middle Name

Known by

Date of Birth

Please tell us of a person to contact in case of an emergency

Full Name

Relationship to you

Telephone number

Please tell us about your study preferences including your availability to participate in face to face Zoom or classroom-based learning and assessment.

Participation in face to face sessions may be restricted to those who are unemployed dependent upon numbers enrolling. Zoom sessions are usually conducted during business hours and recordings of these sessions will be available for a limited time following each session. Odyssey has been providing training via Zoom during Covid restrictions.

I am available to attend face to face classroom workshops

I am available to attend sessions for observational assessment of competencies

I can participate in training via webconferencing

Your contact details

In this section we ask you to provide us with your contact details - phone, email, residential address and (postal address if different)

E-mail Address Personal

E-mail Address Work

Mobile Number *

Work Phone

Home Phone *

Residential Address Details

House/Building/Unit Number *

Street Name *

State *

Suburb/Town/Locality *

Post Code *

Country

Address - Postal - Street Address 1 - House/Building/Post Box (Complete only if different to your residential address)

Address - Postal - Street Address 2

Address - Postal - Suburb

Address - Postal - State

Address - Postal - Post Code

Gender and Citizenship

On this page we are seeking information about your gender and citizenship

Gender *

Female

Male

Indeterminate/Intersex/Unspecified

Country of Birth*

Town/City of Birth*

What is your country of Citizenship *

Australian Citizenship Status *

Please let us know about your citizenship status (select one of the following)

Do you identify as being of Aboriginal and or Torres Strait Islander origin?

Aboriginal and or Torres Strait Islander Status *

Employment

In this section we are asking you to provide us with information about your current employment. We are required to collect this information for national data reporting.

Which of the following BEST describes your current employment status (select one from the drop down menu) Labour Force Status *

Which of the following CLASSIFICATIONS best describes your current or recent occupation? *

Which of the following classifications BEST describes the industry of your current or previous employer? *

LANGUAGE AND CULTURAL DIVERSITY

In this section we are seeking information about the main language you use to communicate, and about other languages you may speak and to advise us about any disability you may experience.

Is English the main language you speak at home and work? *

Yes

No

English Language Proficiency

How well do you speak English? *

Very well

Well

Not well

Not at all

If English is not your first language, have you undertaken an accredited TOEFL or IELTS test in the last 18 months? * (if you answer yes to this question, then please upload the certificate you received below)

Yes

No

File

Do you consider yourself to have a disability, impairment or long term condition? *

Not Stated

No

Yes

If so please tick the relevant boxes

If other please specify here

If the main language you speak is not English, then please tell us the main language you speak (select one from the drop down menu) *

EDUCATION HISTORY & PREVIOUS QUALIFICATIONS

Please tell us about your prior education and other details. This information is required for national data reporting.

What is the Highest School Level you have completed? *

In what year did you complete that study? *

Unique Student Identifier (USI) Please provide your USI in the space provided below.*

The Australian Government requires all students undertaking a nationally-recognised qualification to obtain a Unique Student Identifier (USI).

For more information about the USI, or to create your own, please follow this link https://www.usi.gov.au/students

If you already have a USI, please enter it in the field below. Please note that if you cannot provide us with your USI then we may not be able to process your enrolment fully.

Enter your USI here

Student Acknowledgement regarding USI usage by Odyssey House/trading as Odyssey Institute

You must select all points and make sign with your name in confirmation below.

I agree to comply with all relevant policies and procedures of Odyssey Institute

I understand that I will receive notice regarding Odyssey Institute's use of this information to confirm my USI

I understand that Odyssey House Victoria (trading as Odyssey Institute) my check my USI details via usi.gov.au, and that the name of the organisation verifying my USI is Odyssey Institute.

Victorian Student Number (VSN)

All students who are aged 24 or younger will require a Victorian Student Number (VSN). If you already have a VSN please enter it in the number field below.

If you have one, enter your VSN here:

If you don't yet have a number and are aged 24 or younger please tick the checkbox below and leave the number field above empty.

If you've been allocated a VSN but no longer recall the number please tick the final checkbox and leave the others blank. If you didn't enter a VSN please tick one of the following:

I am new to the Victorian Education System. I have never attended a Victorian school, TAFE or other training provider.

I have been allocated a VSN in the past but no longer recall the number and have no record of it.

Please tell us about the type of qualification/s you have previously achieved. *

In regards to the qualification/s you have already achieved, please select one of the following Prior Education Achievement Recognition Identifiers to indicate whether they are Australian, Australian Equivalent or International qualifications. *

Australian

Australian equivalent

International

Please enter your name in the section below as confirmation that you understand and acknowledge the information provided above. Entering your name in the section is considered the same as our signature. Please enter your name in the cell below as confirmation of your understanding of Odyssey Institute's role in checking your USI details.

RECOGNITION OF PRIOR LEARNING AND CREDIT TRANSFERS

On this page we are seeking information about whether you wish to apply for Recognition of Prior Learning (RPL) and or Credit Transfers for units of competency and or modules achieved in prior study.

I wish to apply for RPL

Yes

No

National Recognition / Credit Transfers

If you have completed some of the study units before enrolling with us you may be eligible to have these units recognised. To gain credits your Academic transcripts including statements of attainment or results showing unit.module codes and names MUST be attached below at the time of application.

Upload notarised copies of your Qualifications. Please ensure you include statements of results or attainment which list the modules/units completed. If uploading multiple files please add to one 'Zip' file to upload.

Are you currently employed in role or organisation that involves working with clients with alcohol and other drugs issues? *

Yes

No

Please provide a brief overview of your work history *

List any short courses or conferences attended

If you are a volunteer please specify how long you have been a volunteer in an organisation that supports people with AOD issues (eg how many hours per week for how long?)

PAYMENT OF FEES

On this page we are asking you to provide us with information about how you intend to pay the fees for the training program. Payment plans are available only to full fee paying students. Please note that, under the Standards of the national VET Regulator (Australian Skills Quality Authority) an RTO may hold no more than $1500 of student fees paid in advance. If you are a full fee paying student this will affect the amount you nominate to pay on a payment plan.

Please tell us who is paying the fees due for this training program?

I am paying the fees myself

My employer is paying

If your employer is paying the fees, please tell us your manager's or the company finance officer's email for receiving invoices.

I will be paying the fees by (choose one of the following):

Direct debit - Full payment upfront (only if paying government subsidised rate)

Paypal - Full payment upfront (only if paying government subsidised rate)

I require a payment plan - (Only for full fee paying students)

Payment plan options - for full fee paying students only

10 payments of approximately $471.50 per month

10 fortnightly payments of $471.50 per fortnight

Other - please contact studentadmin@odyssey.org.au

ADDITIONAL INFORMATION TO HELP US WITH YOUR APPLICATION

On this page we are seeking additional and supplementary information, some of which is required for national VET data reporting and other to assist us with our market research. As well all students who apply to study with Odyssey Institute will be contacted to discuss the suitability of the program for their needs as part of a Pre-Training Review (PTR).Some of the information collected on this page assists with the PTR.

Supplementary Information *

The information we are asking for below is required to provide for national Vocational Education and Training (VET) data collection.

Of the following categories which best describes your main reason for undertaking this course *

Additional Assistance

Please tell us if there are areas where you believe you may need assistance when undertaking training. *

Do you need assistance with literacy or numeracy skills? *

Yes

No

May need assistance

Please outline what type of assistance you would like with literacy and numeracy skills.

How did you first hear about this course? *

What is your reason for choosing Odyssey Institute for this training? *

Flexible delivery

Reputation

Previous experience

All of the above

Eligibility for government supported training

On this page you are to provide us with information to assist us to determine if you are eligible for government supported funding under the Skills First program for the Certificate IV in Alcohol and Other Drugs. A senior Odyssey Institute officer will also assess your eligibility for Skills First Funding before granting approval based upon the information you provide us. This form and the evidence you provide will be checked by a senior Odyssey Officer to confirm your eligibility and will be retained on our student records system.

PLEASE DO NOT LEAVE ANY SECTION BLANK - CONTACT studentadmin@odyssey.org.au IF YOU DO NOT UNDERSTAND ANY QUESTION OR SECTION OF THIS FORM.

Are you applying for a government supported training place? If you answer 'No' then please do not complete any other questions on this page.

Yes - I believe I am eligible for government supported training because I have not completed any other courses at the Certificate IV level or higher.

Yes - I believe I am eligible for a government supported training because I am a jobseeker and eligible for the JobTrainer initiative

No I am not seeking government supported training (SKIP THE REST OF THESE QUESTIONS & GO TO THE NEXT PAGE)

Q 1. What is the highest qualification, not including secondary or high school) that you have COMPLETED or EXPECT TO COMPLETE at the time the training you are applying for is scheduled to start? (please include the code and full title of qualification if possible, eg. Certificate III in Aged Care. If you have no completed any qualifications, write not applicable)

Evidence of Citizenship/Residency and Age

In order to be approved for government-subsidised training you must provide us with evidence of citizenship, residency and age. Please attach a certified copy of ONE the following

Please attach a certified copy of the evidence item above to this application.

Q 2. How many other government funded courses have you enrolled in that will start in the same calendar year as the course/s you re applying for now? (DON'T include the courses you are applying for now. DO include other course/s at this and other training providers you've enrolled in, but haven't started yet).*

Q 3. In your lifetime, how many government subsidised courses have you started (commenced) that are at the same course level (e.g. Certificate IV, Diploma) as the one you are applying for now? * If you are applying for a course on the Foundation Skills list, tick not applicable

Q 4. Not including the course/s you are seeking to enrol in now, how many other government subsidised courses are you undertaking training in at the moment? *

Q 5. Are you seeking to enrol in a qualification under the JobTrainer initiative? Note: You can only enrol in one qualification under the JobTrainer initiative. NOTE YOU CAN ONLY ENROL IN ONE QUALIFICATION UNDER THE JOBTRAINER INITIATIVE IF YOU CHECK NO THEN PLEASE UPLOAD YOUR EVIDENCE OF IDENTIFICATION, SIGN THIS FORM AND GO TO THE NEXT PAGE

YES

NO

Q 6. If you answered YES to question 5, have you previously started a qualification under the JobTrainer Initiative?

YES

NO

Q 7. If you answered YES to question 6 above, are you applying to recommence in the same qualification that you already commenced under the JobTrainer Initiative?

YES

NO

Q 8. Are you 17 - 24 years of age?

YES

NO

Q 9. Are you a JobSeeker?

YES

NO

Q 10. If you answered 'YES' to question 9, tick any of the following boxes if they apply to you. Please upload or email a verified copy of this to studentadmin@odyssey.org.au

I have a current and valid Health Care Card, Pensioner Concession Card or Veteran’s Gold Card

I have a separation certificate from my employer

I have a letter from my employer or a company receiver on company letterhead that says I have been, or will be, made redundant or retrenched

Q 11. If you did not check any boxes at Question 10 above, you can make a declaration here that you are unemployed by ticking the box beside the statement

I declare that I am currently unemployed.

STUDENT DECLARATION & SIGNATURE

I, (print your full name in the space below)

Declare the following to be true and accurate statements (select only one or two and then three or four):

1) I AM enrolled in a school, including government, non-government, independent, Catholic or home school
OR

2) I AM NOT enrolled in a school, including government, non government, independent, Catholic or home school

3) I understand that my enrolment in the above qualification/s may be subsidised by the Victorian and Commonwealth Government under the Skills First Program. I understand how enrolling in the above qualification/s will affect my future training options and eligibility for further government subsidised training under the Skills First program.

4) I acknowledge and understand that I may be contacted by the Department of Education and Training or an agent to participate in a survey, interview or other questionnaire.

.... in seeking to enrol in the CHC43215 Certificate IV in Alcohol and Other Drugs, I declare and confirm that the information I have provided is true, accurate and current, and am entering my name here as a signature. (Odyssey Institute considers entering your name as a signature and will not process your application unless you sign this section)

Date

Privacy Statement and Student Declaration

Privacy Notice

Please read this section carefully – you will be required to acknowledge your understanding of this information at the end of the document.

Under the Data Provision Requirements 2012, Odyssey House Victoria is required to collect personal information about you and to disclose that personal information to the National Centre for Vocational Education Research Ltd (NCVER).

Your personal information (including the personal information contained on this enrolment form and your training activity data) may be used or disclosed by Odyssey House Victoria for statistical, regulatory and research purposes. Odyssey House Victoria may disclose your personal information for these purposes to third parties, including:

· Employer - if you are enrolled in training paid by your employer;

· Commonwealth and State or Territory government departments and authorised agencies;

· NCVER;

· Organisations 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

· Pre-populating RTO student enrolment forms;

· Understanding how the VET market operates, for policy, workforce planning and consumer information; and

· Administering VET, including program administration, regulation, monitoring and evaluation.

You may receive an NCVER student survey which may be administered by a government department or NCVER employee, agent or third party contractor or other authorised agencies. Please note that you may opt out of the survey at the time of being contacted.

NCVER will collect, hold, use and disclose your personal information in accordance with the Privacy Act 1988 (Cth), the VET Data Policy and all NCVER policies and protocols (including those published on NCVER’s website at www.ncver.edu.au).

The Victorian Government through the Department of Education and Training (the Department), develops, monitors and funds vocational education and training (VET) in Victoria. The Victorian Government is committed to ensuring that Victorians have access to appropriate and relevant VET services. Any personal information collected by the Department for VET purposes is protected in accordance with the Privacy and Data Protection Act 2014 (Vic) and the Health Records Act 2001 (Vic).

Collection of your data – Odyssey House Victoria is required to provide the Department with Student and training activity data. This includes personal information collected in the Odyssey Institute enrolment form and unique identifiers such as the Victorian Student Number (VSN) and the Commonwealth’s Unique Student Identifier (USI).

Odyssey Institute provides data to the Department in accordance with the Victorian VET Student Statistical Collection Guidelines, available at http://www.education.vic.gov.au/providers/rto/Pages/datacollection.aspx

Use of your data – The Department uses student and training data, including personal information, for a range of VET purposes including administration, monitoring and planning, including interaction between the Department and Student where appropriate.

The data may be subjected to data analytics, which seek to determine the likelihood of certain events occurring (such as program or subject completion), which may be relevant to the services provided to the student.

Disclosure of your data – As necessary and where lawful, the Department may disclose VET data, including personal information, to its contractors, other government agencies, professional bodies and or other organisations for VET-related purposes. In particular, this includes disclosure of VET student and training data to the Commonwealth and the National Centre for Vocational Education Research (NCVER).

Legal and Regulatory – The Department’s collection and handling of enrolment data and VSNs is authorised under the Education and Training Reform Act 2006 (Vic_). The Department is also authorised to collect and handle USIs in accordance with the Student Identifiers Act 2014 (Cth) and the Student Identifiers Regulation 2014 (Cth).

Survey participation – You may be contacted to participate in a survey conducted by NCVER or a Department-endorsed project, audit or review relating to your training. This provides valuable feedback on the delivery of VET programs in Victoria. You may receive a student survey which may be administered by a government department or NCVER employee, agent, third party contractor or other authorised agencies. Please note you may opt out of the NCVER survey at the time of being contacted.

NCVER will collect, hold use and disclose your personal information in accordance with the Privacy Act 1988 (Cth), the National VET Data Policy and NCVER policies and protocols (including those published on NCVER’s website at www.ncver.edu.au).

Consequences of not providing your information – Failure to provide your personal information may mean that it is not possible for you to enrol in a training program and / or to obtain a Victorian Government subsidised training place.

Access, correction and complaints – You have a right to seek access to or correction of your own personal information. You may also complain if you believe your privacy has been breached.

For further information please contact Odyssey Institute’s Compliance Manager in the first instance by phone 03 8537 7111 or email cwilliams@odyssy.org.au.

Further information – For further information about the way the Department collects and handles personal information, including access, correction and complaints, go to http://www.education.vic.gov.au/Pages/privacy policy.aspx.

For further information about Unique Student Identifiers, including access, correction and complaints, go to http://www.usi.gov.au/Students/Pages/student-privacy.aspx

USI Privacy Notice

Consent for collection, use or disclosure of personal information

You are advised and agree that you understand and consent that the personal information you provide in connection with your application for a Unique Student Identifier (USI):

· Is collected by the Registrar as authorised by the Student Identifiers Act 2014

· Is collected by the Registrar for the purposes of:

o Applying for, verifying and giving a USI;

o Resolving problems with a USI; and

o Creating authenticated vocational education and training (VET) transcripts.

May be disclosed to:

· Commonwealth and State/Territory government departments and agencies and statutory bodies performing functions relating to VET for:

o The purposes of administering and auditing VET, VET providers and VET programs.

o Education and related policy and research purposes; and

o To assist in determining eligibility for training subsidies.

· VET regulators top enable them to perform their VET regulatory functions;

· VET Admission Bodies for the purposes of administering VET and VET programs

· Current and former Registered Training Organisations to enable them to delivery VET courses to the individual, meet their reporting obligations under the VET standards and government contracts and assist in determining eligibility for training subsidies;

· Schools for the purposes of delivering VET courses to the individual and reporting on these courses;

· The National Centre for Vocational Education Research for the purpose of creating authenticated VET transcripts, resolving problems with USIs and for the collection, preparation and auditing of national VET statistics;

· Researchers for education and training related research purposes;

· Any other person or agency that may be authorised or required by law to aces the information;

· Any entity contractually engaged by the Student Identifiers Registrar to assist in the performance of his or her functions in the administration of the USI system; and

Will not otherwise be disclosed without your consent unless authorised or required by or under law.

The consequences of not providing the Registrar with some or all of your personal information are that the Registrar will not be able to issue you with a USI.

Privacy Policies and Complaints

You can find further information on how the Registrar collects, uses and discloses personal information about you in the Registrar’s Privacy Policy or by contacting the Registrar on usi@education.gov.au or telephone 1300 857 536 international enquiries +61 2 6240 8740. The Registrar’s privacy Policy contains information about how you may access and seek correction of the personal information held about you and how you may make a complaint about a breach of privacy by the Registrar in connection with the USI and how such complaints will be dealt with.

You may also make a complaint to the Information Commissioner about any interference with privacy pursuant to the Privacy Act 1988., including in relation to the misuse or interference of our unauthorised collection, use, access, modification or disclosure of USIs.

In accordance with Section 11 of the Student Identifiers Act 2014, Odyssey Institute will securely destroy personal information which we collect from individuals solely for the purpose of applying for a USI on their behalf as soon as practicably after we have made the application or the information is no longer needed for that purpose, unless we are required by or under any other law to retain it.

Privacy Statement & Student Declaration*

I acknowledge and agree to the terms described in the Privacy Statement & Student Declaration and Consent.

I agree to the comply with all Odyssey Institute policies and procedures related to engagement in learning

Parent/Guardian Statement

(consent is required for all students under the age of 18) If you are under 18 years of age then a senior Odyssey Institute Officer will contact you about parent of guardian consent.