First Name
Surname
Date of Birth
Gender	Select One MaleFemale
Address
Address Cont.
Suburb
Postcode
Phone
Mobile
Email
Which Country were you born?
Do you mainly speak English at home?
Do you speak a language other than English at home?
Nationality
Are you of Aboriginal or Torres Strait Islander origin?
Select One NoYes, Aboriginal Yes, Torres Strait Islander Yes, both Aboriginal & Torres Strait Islander
Do you consider yourself to have a disability, impairment or long term condition?
Select One YesNo
If YES, please indicate the areas of disability, impairment or long term condition
Select One Hearing/DeafPhysical Intellectual LearningMental Illness Acquired Brain Impairment Vision Medical Other       I also suffer from Select One Hearing/DeafPhysical Intellectual LearningMental Illness Acquired Brain Impairment Vision Medical Other
What is your highest completed school year?
Select One Completed Year 12Completed Year 11 Completed Year 10 Completed Year 9Completed Year 8 or lower Did not go to school
In which year did you complete that school level?
Are you still attending secondary school
Select One Yes - I amNo - I am not
Have you successfully completed any of the following qualifications?
Select One Bachelor Degree or higherAdvanced Diploma or Associate Degree Diploma or Associate Diploma Certificate IV or Advanced Certificate/TechnicianCertificate III or Trade Certificate Certificate II Certificate I Certificates other that the above
Of the following categories, which best describes your current employment status?
Select One Full-Time employeePart-Time employee Self Employed - not employing others EmployerEmployed - Unpaid worker in a family business Unemployed - seeking full-time work Unemployed - seeking part-time work Not Unemployed - not seeking employment
What is your main reason for undertaking this course / traineeship / apprenticeship
Select One To get a jobTo develop my existing business To start my own business To try for a different careerTo get a better job or promotion It was a requirement of my job I wanted extra skills for my job To get into another course of study For personal interest For self-development Other reasons