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APPLICATION FORM
This application form consists of:

1) Student information questions

2) Suitability for the industry questions

3) Training preferences questions

4) A language and literacy test

5) A numeracy test

The combination of these two tests will be used to determine whether or not a student is eligible for enrolment.

Students who are assessed as not having the required level of language, literacy and numeracy skills may be denied enrolment and referred to external support services. Students
denied enrolment can apply for enrolment again once they have developed skills in that area.

Apex Training institute will comply with the national privacy principles in the handling of personal information of students.

Completion of the test should be supervised by an Apex Training institute member of staff.

APPLICANT DETAILS

NAME

____________________________________________________________

MAILING ADDRESS
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_____________________________________________________________________________________________

_____________________________________________________________________________________________

PHONE NUMBER

____________________________________________________________

EMAIL ADDRESS

____________________________________________________________

COURSE APPLYING FOR

____________________________________________________________

STUDENT INFORMATION

1. Do you have a Unique Student Identifier (USI)?(Circle one)

Yes No

2. What is your USI (if you have one)?

____________________________________________________________

3. What visa classification do you have (e.g. Citizen, Vocational Education and Training Sector visa (subclass 572), Partner (Provisional) visa (subclass 309) etc etc) ?
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_________________________________________________________________________________________

_________________________________________________________________________________________

4. Have you completed a Certificate III course or above within Australia (e.g. Certificate III in Childrens Services, Bachelor of Business, Diploma of Business etc) ? (Circle
one)

Yes No

5. If you have completed a Certificate III qualification, was it completed while at secondary school?

Yes No

6. Are you under the Single and Teenage Parent Program?

Yes No

7. Have you completed a Certificate III course or above outside of Australia (e.g. Certificate III in Childrens Services, Bachelor of Business, Diploma of Business etc)?

Yes No

8. Have you reviewed the course fact sheet in full?

Yes No (If No, you must review the course fact sheet before proceeding with the enrolment process? Link: http://www.apextraining.edu.au/course-
fact-sheets )
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SUITABILITY FOR INDUSTRY

This is the type of work you will be undertaking in this Industry.

A day in the life of a an aged care worker

An aged care worker provides personal, physical and emotional support to older people who require assistance with daily living. They
provide assistance with daily tasks such as showering, dressing, and eating, and often assist with outings and social activities. The level
of assistance provided will depend on the ability and health of the client.
An Aged care worker provides care either in a clients home, or in a residential care setting. They carry out their duties under direct or
regular supervision within clearly defined care plans or organisational guidelines. They may be required to work evenings, weekends
and rostered shifts. Their work may include carrying out some supervised medical tasks, such as changing dressings or administering
medications. An aged care worker also needs to be aware of any changes in their clients physical or mental health such as increased
discomfort, loss of mobility, hearing or sight loss, signs of depression or anxiety, and report these to their supervisor. They need to also
be on the lookout for any safety hazards that may pose risks to themselves, staff and their clients.

An Aged care worker must know how to use equipment such as hoists to lift the client in and out of bed, or swivel cushions to ease
getting into and out of cars. They may also utilise special communication technologies, such as software that produces spoken output
for people with hearing difficulties, and magnifies or presents information as Braille for those with sight disabilities. An aged care
worker may also need to be familiar with vehicle modifications such as wheelchair hoists, modified driving controls and specially-
modified wheelchair-accessible vehicles.
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1. Is this the type of work environment you are expecting to work in after successful completion of this qualification?

Yes No

2. Do you have any previous qualifications relevant to this course?

____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
3. What work experience or existing knowledge do you have of the industry you want to apply to study in (e.g. : worked in an aged care facility)?

____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
4. Why does this course appeal to you?

____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
5. If already working in the Industry, do you enjoy working in this industry (and why)?

____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________

6. What do you hope to achieve from gaining this qualification (e.g: skills and knowledge to get a job in the field/pathway to higher education.)?
____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
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____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
___________

7. What is the benefit of pursuing more than one specialisation (e.g. ageing and disability combination) of Certificate III in Individual Support?
____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________

8. Do you have any pre-existing injuries that might influence your suitability for attending work placement? If so, please list. (Work placement MUST be
completed as part of this course)

__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________

9. Are you aware the course you want to study contains work placement? Are you aware that you will need to adjust your schedule at work and at home in
order to attend work placement over 120 hours (about 3 to 4 weeks working full time) ?
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________

TRAINING PREFERENCE QUESTIONS

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Apex provides the following delivery modes: face to face; online; blended and self-paced. Please circle how you prefer to learn, this will enable our staff to
evaluate which delivery mode will be suitable for you.

1. How do you prefer to learn (please circle one)?

A. Being shown how to do something, and then trying it yourself with some supervision
B. Researching and reading , theorising and discussing
C. A mix of being shown how to do something, trying it out, and talking to someone who has done it
D. Working with others on the same problem-I do not like doing it alone
E. Finding information on the internet at a time and place that suits me, so learning can fit in with my lifestyle

2. Where do you prefer to learn (please circle one)?

A. Outside, doing practical things with an end result that I can see
B. In libraries, lecture theatres and places where I can discuss, read and research ideas
C. In a relaxed environment with lots of discussions, where I can ask the teacher when I need help or guidance
D. In a family friendly environment where I learn from others life experience
E. At my laptop or home computer, in an environment and at a time that suits me.

Rate your skills in the following areas (Poor, Need Improvement, Good and Excellent)

Reading Excellent Good Needs Improvement Poor

Writing Excellent Good Needs Improvement Poor

Numeracy Excellent Good Needs Improvement Poor

Computer Skills Excellent Good Needs Improvement Poor

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READING

Read the following information about Lings study and travel aspirations and then answer the questions below.
Ling completed school at the age of seventeen and wanted a job that would allow her to work anywhere in Australia. Ling is now nineteen years old and is considering a
career in aged carer. She has always loved taking care of people and often visits and takes care of her grandmother who suffers from dementia. Ling wants to complete
an aged course so she can take care of others, just like she feels her parents have done for her all her life. She found Apex Training institute via Google and enrolled to
complete the CHC33015 Certificate III in Individual Support.

a) How old is Ling?

b) What condition does Lings grandmother suffer from?

c) What course did she enrol in?

d) Why does she want to study aged care?

e) How old was Ling when she left school?

f) How did Ling discover Apex Training institute?

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NUMERACY

You have $5. You buy two apples and a mango. Apples cost 60 cents each and mangoes cost 2 dollars each. How much change should
you receive?
$1 $1.40 $1.80 $3.20

What is 10% of 120?

What is 5 multiplied by 10 ?
.............................................................................................................................

Student Declaration
I agree that I have completed this form to the best of my ability and have been honest in all my responses

Student Signature:

Date: / /
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FOR OFFICE ADMIN USE

Application (Pre-Training) Review Outcomes

Discussion Comments / Notes by vocational advisor/ student support team member:

*Students are not encouraged to undertake training where there is not a reasonable prospect of their completion.

Recommended Course of Study

Course Code Course Name certificate

CHC33015 Certificate III in Individual Support

Ageing Home & Community Comments:

Disability

Reasons why this course is the most suitable and appropriate for this individual student:

(career consultant to fill this section)

Meets their career pathway

Already working in the industry

Upskilling to further career

Passion for working with children

Other
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Declaration 1-Appropriate and Suitable

I confirm according to my assessment that this course is suitable and appropriate for this student due to the reasons noted above and that the course mode of delivery is also suitable to
the students needs.

Apex Staff Signature:

Date:

Declaration 2-NOT appropriate and Suitable

I confirm according to my assessment that this course is NOT suitable and appropriate for this student due to the reasons noted above and that the course mode of delivery is also suitable
to the students needs.

My recommendations are:

Apex Staff Signature:

Date:

Manager comments and decision

Signature:

Date