Peer Veet > Training > Upskill Training > Upskilling Expression of Interest Form

Have you attended PEER VEET before?
YesNo

Personal Details

Surname*

Given Names*

Date of Birth*

Gender
MaleFemale

Street Address & Suburb*

Postcode*

Postal Address & Suburb

Postcode

Work Phone

Mobile Phone

Contact Phone Number*

Email Address

Enrolment Information [If CITB funded: you must complete ALL of the information in this section]

Area
Pre-ApprenticeshipApprenticeshipTraineeshipUpskillingOther

Course*

Commencing*

CITB Number

Currently an apprentice?
YesNo

If yes, what year?
1234

Employer/School

ABN/ACN

Employer Phone

Employer Fax

Contact Name

Employer Mobile Phone

Employer Street Address

Postcode

Trade Union / Association

Membership Number

If you provide relevant trade union / association details, you may be eligible for further subsidy on selected Upskilling courses.

Emergency Contact Information

Name

Phone

Other Information

Indigenous Status
AboriginalTorres Strait IslanderBothNeither

Are you at School?

Level Completed

Year Completed

State/Country Completed

Language spoken at home
EnglishOther

If other, please specify

If not English, proficiency in English
Not goodGoodVery good

Labour force status
Full-timePart-time
EmployerSelf-employed
Unpaid employmentUnemployed (seeking full-time work)
Unemployed (not seeking work)Unemployed (seeking part-time work)

Disability
YesNo

If yes:
Acquired Brain DisorderHearing/DeafIntellectual
LearningMedical ConditionMental Illness
PhysicalVisionOther

Prior Education
YesNo

If yes:
Bachelor Degree or Higher Degree LevelDiploma
Advanced Diploma & Associal Degree LevelCertificate I
Certificiate IICertificate III
Certificate IV

Miscellaneous Education

FOR UPSKILLING STUDENTS:
I do understand that payment must be received at least 7 days prior to the commencement of a course to confirm my place.

I do solemnly and sincerely declare that the above information is a true and correct record. I am aware that the information in this Expression of Interest form may be provided to the Department of Further Education, Employment, Science and Technology and the Commonwealth Department of Education, Employment and Workplace Relations for statistical purposes.*
YesNo

*Required

Expression of Interest to Attend Upskilling Course

Personal Details

Enrolment Information [If CITB funded: you must complete ALL of the information in this section]

Emergency Contact Information

Other Information