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Smart and Skilled Qualification Eligibility Form V1.8 January 2020
Smart and Skilled Qualification Application
OVERVIEW:
The SIT30616 Partial Certificate III in Hospitality is a fully funded NSW Government initiative under
Smart and Skilled. This eligibility form is for any prospective student wishing to apply for this funded
program.
ELIGIBILITY CRITERIA:
Are you:
15 years old or over?
no longer at school?
living or working in NSW?
an Australian citizen, Australian permanent resident, humanitarian visa holder or New Zealand
citizen?
If you answered ‘Yes' to all four questions, then you're eligible to enrol in a government-subsidised
course with an approved Smart and Skilled training provider.
NEXT STEPS:
After this application is complete:
Send your completed application with all required Evidences
(Please note: No applications can be processed without supporting evidence.)
CHP School of Hospitality will process the Smart and Skilled enrolment
CHP School of Hospitality will use Smart and Skilled eligibility criteria as a guide to determine the
applicant’s eligibility for the training program that has been applied for
An “Enrolment Confirmation Letter” will be issued to the successful applicant with the
descriptions, delivery modes and dates of training.
Options for applicants to provide proof of identity and eligibility evidences:
Option 1 – In person
Applicants can visit CHP School of Hospitality to the address below with original proof of identity
document and required eligibility evidences. The original proof of identity document and eligibility
evidences MUST be sighted by CHP School of Hospitality administration staff.
Option 2 – Email or post
Applicants can either email a copy of proof of identity document and required eligibility evidences to
[email protected] OR post a copy of proof of identity document and required eligibility evidences to
the address below:
Canterbury-Hurlstone Park RSL Club – attention to CHP School of Hospitality
20 – 26 Canterbury Road,
Hurlstone Park NSW 2193
mailto:[email protected]
Smart and Skilled Qualification Eligibility Form V1.8 January 2020
Smart and Skilled Qualification Eligibility Form The following information must be collected for all Smart and Skilled enrolments.
First Name:
Other name/s:
Last name:
Gender: Female Male Not Specified
Date of Birth:
Contact Information: Phone: Email:
What is your Unique Student Identifier? (USI) www.usi.gov.au to create (10 Characters)
Residential Address (at time of Training)
Unit No:
Street No:
Street Name:
Suburb:
State:
Postcode:
Are you living in NSW social housing; or are you or your household on the NSW housing register?
Yes ** See appendix No
Are you still at school? Yes No
What is your residency status?
Australian Permanent Resident
Humanitarian Visa
New Zealand Citizen
Other
Preferred Training Location: Course Start Date:
Australian Citizen
** See appendix
http://www.usi.gov.au/Social housing
Test Document to be attached
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citzenship
Test Document to be attached
Form userFile attachment on: 2020/01/31 14:54:28
Permanent resident
Test Document to be attached
Form userFile attachment on: 2020/01/31 14:54:31
refugee
Test Document to be attached
Form userFile attachment on: 2020/01/31 14:54:37
NEW ZEALAND TEST
Form userFile attachment on: 2020/01/31 14:55:48
Social housing
Test Document to be attached
Form userFile attachment on: 2020/01/31 15:08:44
citzenship
Test Document to be attached
Form userFile attachment on: 2020/01/31 15:08:50
Social housing
Test Document to be attached
Form userFile attachment on: 2020/01/31 17:01:31
citzenship
Test Document to be attached
Form userFile attachment on: 2020/01/31 17:01:57
Social housing
Test Document to be attached
Form userFile attachment on: 2020/02/06 17:15:32
refugee
Test Document to be attached
Form userFile attachment on: 2020/02/06 17:16:16
Social housing
Test Document to be attached
Form userFile attachment on: 2020/02/06 17:23:09
refugee
Test Document to be attached
Form userFile attachment on: 2020/02/06 17:23:21
Smart and Skilled Qualification Eligibility Form V1.8 January 2020
Have you achieved any qualifications since turning 17?
Yes, while still at school
Yes, after leaving school (post school qualifications)
No
What is the highest level of any post school qualification achieved?
(if applicable)
Certificate I
Certificate II
Certificate III (or Trade Certificate)
Certificate IV (or Advanced Certificate/Technician)
Certificates other than the above
Diploma (or Associate Diploma)
Advanced Diploma or Associate Degree
Bachelor Degree or Higher Degree
Are you Aboriginal or Torres Strait Islander?
Yes No
Has the student undertaken any other Smart and Skilled qualification this calendar year?
If Yes, please give details
No
Do you have a Disability? Yes No
If yes, please select disability assessment type
Please indicate your welfare status:
Do you require assistance for Language, Literacy and Numeracy (LLN)?
Yes No
** See appendix
Recipient of Disability Support Pension
** See appendix
I am a welfare recipient
I am a dependent child or spouse of a welfare recipient
** See appendix
I am not a welfare recipient
(Please give details or call 02 9559 0025 to discuss)
Assessed by a specialist support professional as a student with disability
** See appendix
** See appendix
https://smartandskilled.nsw.gov.au/aboutDisability pension
Test Document to be attached
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welfare
Test Document to be attached
Form userFile attachment on: 2020/02/06 17:17:15
welfare
Test Document to be attached
Form userFile attachment on: 2020/02/06 17:18:27
Disability pension
Test Document to be attached
Form userFile attachment on: 2020/02/06 17:23:56
welfare
Test Document to be attached
Form userFile attachment on: 2020/02/06 17:24:04
Smart and Skilled Qualification Eligibility Form V1.8 January 2020
If yes to being a welfare recipient please specify ** See appendix
Age Pension Special Benefit
Austudy Widow Allowance
Carer Payment Widow B Pension
Farm Household Allowance Wife Pension
Newstart Allowance Youth Allowance
Parenting Payment (Single) Veterans’ Affairs Pensions
Sickness Allowance
Family Tax Benefit Part A
(Maximum rate)
Veterans’ Children Education Scheme
Yes No
Job Service Provider Details:
Organisation ID: Client ID:
Have you been referred by a Employment Service Provider?
Yes No If yes, please indicate your Employment Service Provider referral ID
Are you registered or intending to be registered in an apprenticeship or traineeship for this qualification in NSW?
Yes, registered
Yes, intending to be registered
No
How did you hear about this program?
Website
Google Friend
Previous student Walking By
Job Network
Other
Client Declaration:
I, (name) understand that by signing below I agree that the details
listed above are true and correct.
Signed: Date:
PLEASE READ AND SIGN THE CONSENT FORM ON NEXT PAGE
Chevron Club Newsletter
Letter Box Mail CHPRSL Staff
Smart and Skilled Qualification Eligibility Form V1.8 January 2020
CONSENT TO USE AND DISCLOSURE OF PERSONAL INFORMATION TO THE DEPARTMENT OF
EDUCATION & COMMUNITIES AND OTHER GOVERNMENT AGENCIES
I (first, middle and last Name)
of (current residential address)
with date of birth
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 (USI), date of birth,
contact details, training outcomes and performance or sensitive personal information (including
my ethnicity or health information) (together Personal Information) collected by CHP School of
Hospitality 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 CHP School of Hospitality for the purposes of
evaluation and assessing my subsidised training.
PRINT FULL NAME OF STUDENT:
SIGNATURE OF STUDENT: DATE: Note: If under 18 years of age at the time of giving consent, then the consent of their guardian is required.
PRINT FULL NAME OF GUARDIAN:
SIGNATURE OF GUARDIAN: DATE:
Do you hold current RSA / RCG Interim Certificate or Competency Card?
YES NO
If yes, please scan and attach your current RSA / RCG Interim Certificate or Competency
Card with this application form.
** Appendix (next page)
citzenship
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Rsa test form attached
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Smart and Skilled Qualification Eligibility Form V1.8 January 2020
** APPENDIX - Additional Evidence Requirements
If you are currently a:
welfare recipient permanent resident humanitarian visa
holder disability assessed
social housing recipient
A copy of the following additional evidence is required:
Eligibility Requirement
Evidence Required
Citizenship One of the following must be sighted or collected:
Australian or New Zealand birth certificate or
Australian or New Zealand Passport or
Green Medicare Card or
Naturalisation Certificate
Permanent
resident
One of the following must be sighted or collected:
Passport & use the Department of Immigration and Border Protection’s Visa EntitlementVerification Online (VEVO) facility to confirm status as Australian permanent resident
Green Medicare Card
Humanitarian Visa holder
(Refugee or Asylum Seeker)
One of the following must be sighted or collected:
Relevant visa documentation/VEVO Report or
ImmiCard (where appropriate)
*Note: If a Bridging Visa holder, the student must provide a document form the Department of Immigration and Border
Protection acknowledging application for a humanitarian visa.
Welfare recipient
Any form of evidence that clearly shows your Centrelink reference Number (CRN) and the
benefit/allowance category you receive such as:
Current Concession Card or
Letter from Centrelink confirming receipt of the benefit or
Income Statement from Centrelink or
Approval letter from Centrelink that indicates the commencement date of your benefit (mustbe within two weeks of your enrolment)
Disability Support Pension:
Any form of evidence that clearly shows your Centrelink reference Number (CRN) and clearly states the student is receiving the Disability Support Pension:
Current Concession Card (with the letters DSP on the bottom of the card) or
Letter from Centrelink confirming receipt of the Disability Support Pension or
Income Statement from Centrelink
Disability Assessed
(If the Student is not receiving the disability support Pension please provide.)
A letter or statement supporting a clear additional need as a result of the student’s disability from:
A medical practitioner
An appropriate government agency (e.g. Veteran Affairs, TAFE NSW teacher consultant,School counsellor/special education coordinator, Centrelink, Disability Service Provider, JobCapacity Assessor, or
Specialist allied health professional (Including: a rehabilitation counsellor, psychologist,speech pathologist or occupational therapist).
Dependent of Welfare recipient
If the student is a dependent child, spouse or partner of a welfare recipient or DisabilitySupport Pension or Social Housing with Commonwealth Welfare Recipient Status you willneed to also provide evidence that Centrelink recognises the student as dependent.
Social Housing recipient Evidence of Commonwealth Recipient Status
Home Schooled Students Copy of current certificate of home-schooling registration, which clearly indicates the period
for which the student will be home schooled
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citzenship
Test Document to be attached
Form userFile attachment on: 2020/01/30 18:57:45
citzenship
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:06:46
Permanent resident
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:06:50
refugee
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:06:55
welfare
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:07:01
Disability pension
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:07:07
Disability letter
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:07:13
welfare
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:07:16
Dependent of welfare
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:07:20
Social housing
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:07:26
Home schooled
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:07:29
citzenship
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:24:21
Permanent resident
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:24:25
refugee
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:24:31
welfare
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:24:45
Disability pension
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:24:49
Disability letter
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:24:52
Dependent of welfare
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:24:55
Social housing
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:25:00
Home schooled
Test Document to be attached
Form userFile attachment on: 2020/01/30 19:25:09
Email: PRINT FULL NAME OF GUARDIAN: Preferred Training Location: Phone: USI: School: Offresidency status: OffOther Residency status: Quals: OffSocial-Housing1: OffQualAchieved1: OffQualAchieved2: OffQualAchieved3: OffQualAchieved4: OffQualAchieved5: OffQualAchieved6: OffQualAchieved7: OffQualAchieved8: OffAboriginal: OffSmart&Skilled: OffDisability: OffDisabilityType: OffWelfare: OffLLN: OffTraineeshipApprenticeship: OffFirst Name: Last name: Date8_af_date: Other names: Unit No: Street Name: Suburb: State: [(NSW) New South Wales]Street No: Date7_af_date: Date11_af_date: RSARCG: OffSubmit Enrolment Form to CHPSOH: Postcode: Date5_af_date: Check Box001: OffCheck Box002: OffCheck Box003: OffCheck Box004: OffCheck Box005: OffCheck Box006: OffCheck Box007: OffCheck Box008: OffCheck Box009: OffCheck Box0010: OffCheck Box0011: OffSmart and skilled: LLN2: Gender: OffAttach File5: Attach File1: Attach File2: Attach File3: Attach File4: Attach File6: Attach File7: Attach File8: Attach File9: Attach File10: Attach File11: Humanitarian: [Type of visa:]TCID-NO: TCID Number:welfare-additional: Other:Job Service Provider: Are you an Employment Service Provider Client?JASQuestion: OffJSA-ORG-ID: JSA-CLIENT-ID: JASQuestion2: OffJSA-REF-ID: Dropdown16: [.]Welfarestatus: Off