Application Form

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Course

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CSEIPS01075 - Prepare to work safely in the construction industry [White Card] (FFS)
01 Jan 2019 - 31 Dec 2022 IPS Institute
Available
CSEIPS01189 - Control traffic with stop-slow bat (FORMAL)
30 Jan 2021 - 31 Dec 2024 IPS Institute
Available
CSEIPS01190 - Control traffic with stop-slow bat (REFRESHER)
30 Jan 2021 - 31 Dec 2024 IPS Institute
Available
CSEIPS01191 - Implement traffic management plans (FORMAL)
30 Jan 2021 - 31 Dec 2024 IPS Institute
Available
CSEIPS01192 - Implement traffic management plans (REFRESHER)
30 Jan 2021 - 31 Dec 2024 IPS Institute
Available

Student Details 

Details provided in the Application form will compile your student profile, please ensure all details are correct.
Title
Entity Data - Profile - Title
First Name
Entity Data - Profile - First Name
Middle Name
Entity Data - Profile - Middle Name
Surname
Entity Data - Profile - Surname
Known By
Entity Data - Profile - Known By
Birth Date (dd/mm/yyyy)
Entity Data - Profile - Birth Date
Gender
Entity Data - Profile - Gender
Citizenship Status
Entity Data - Profile - Citizenship Status
Nationality
Entity Data - Profile - Nationality
Country of Passport
Entity Data - Profile - Country of Passport
Country of Birth
Entity Data - Profile - Country of Birth
Town/City of Birth
Entity Data - Profile - Town/City of Birth
Profile Picture
Entity Data - Profile - Profile Picture
Unique Student Identifier (USI)
Entity Data - AVETMISS - Unique Student Identifier (USI)
If you cannot remember or locate your Unique Student Identifier (USI) number, IPS Institute can search for your USI number of you behalf.
Basic - Checkboxes

Contact Details

Details provided in the Application form will compile your student profile, please ensure all details are correct.
Mobile Number
Entity Data - Contact - Home - Mobile Number
E-mail Address
Entity Data - Contact - Home - E-mail Address
[Home] Address -
Entity Data - Address
Home Address (lookup)
(Manually entered addresses will not be registered, please select your address from the automatic drop down menu)
Entity Data - Address - Lookup
[Home] Address - Street Address 1
Entity Data - Address - Street Address 1
[Home] Address - Street Address 2
Entity Data - Address - Street Address 2
[Home] Address - Unit/Flat Number
Entity Data - Address - Unit/Flat Number
[Home] Address - Street/Lot number
Entity Data - Address - Street/Lot number
[Home] Address - Street Name
Entity Data - Address - Street Name
[Home] Address - Suburb
Entity Data - Address - Suburb
[Home] Address - Overseas State/Province
Entity Data - Address - Overseas State/Province
[Home] Address - State
Entity Data - Address - State
[Home] Address - Post Code
Entity Data - Address - Post Code
[Home] Address - Country
Entity Data - Address - Country
Postal Address (if different to home address)
(Manually entered addresses will not be registered, please select your address from the automatic drop down menu)
Entity Data - Address - Postal - Lookup
Address - Postal - Unit/Flat Number
Entity Data - Address - Postal - Unit/Flat Number
Address - Postal - Street/Lot number
Entity Data - Address - Postal - Street/Lot number
Address - Postal - Street Name
Entity Data - Address - Postal - Street Name
Address - Postal - Suburb
Entity Data - Address - Postal - Suburb
Address - Postal - Post Code
Entity Data - Address - Postal - Post Code
Address - Postal - State
Entity Data - Address - Postal - State
Address - Postal - Country
Entity Data - Address - Postal - Country
Emergency Contact
Entity Data - Contacts - Type
Relationship
Entity Data - Contacts - Relationship
First Name
Entity Data - Contacts - First Name
Surname
Entity Data - Contacts - Surname
Phone Number
Entity Data - Phone - Home - Phone Number

Identification

Details provided in the Application form will compile your student profile; please ensure all details are correct.
You MUST provide at least one (1) form of Photographic Identification, and a copy of your Construction Induction Card (White Card).
 
Photo Identification:
Basic - File

Student Background (AVETMISS)

Disability Flag
Entity Data - AVETMISS - Disability Flag
Disability Type
Entity Data - AVETMISS - Disability Type
Indigenous Status
Entity Data - AVETMISS - Indigenous Status
At School
Entity Data - AVETMISS - At School
Highest School Level Completed (e.g. Year 12)
Entity Data - AVETMISS - Highest School Level
Year Completed Highest School Level (e.g. 2020)
Entity Data - AVETMISS - Year Completed (Highest School)
Main Language Spoken
Entity Data - AVETMISS - Main Language
Proficiency in spoken English
Entity Data - AVETMISS - Proficiency in spoken English
Reason for Study
Entity Data - AVETMISS - Study Reason
Language Literacy and Numeracy (LLN) assessment

As a requirement of the student entry procedure, students may have to undertake a Language Literacy and Numeracy (LLN) assessment. Please tick the box which best relates to you.
Basic - Checkboxes
Have you completed any Prior Education?
Entity Data - AVETMISS - Prior Education Flag
Prior Education Type
Entity Data - AVETMISS - Prior Education Type

Employment Details

Current Employment status
Basic - Checkboxes
Current Business Name
Basic - Text
Workplace Address
Basic - Text
Employer Contact
Entity Data - Contacts - Type
First Name
Entity Data - Contacts - First Name
Surname
Entity Data - Contacts - Surname
Phone Number
Entity Data - Phone - Home - Phone Number
E-mail Address
Entity Data - Phone - Home - E-mail Address

Previous Training and Studies

Credit Transfers

To ensure all Credit Transfers can be applied, please provide copies of your completed qualifications or statement of attainments. We will require all pages, front and back of the certificate(s). Further clarification or documentation may be requested under certain circumstances as evidence of Credit Transfer


Qualification / Units
Basic - Text
File
Basic - File
Qualification / Units
Basic - Text
File
Basic - File
Qualification / Units
Basic - Text
File
Basic - File

Declaration 

Please complete all required fields
Basic - Checkboxes
Digital Signature
Basic - Digital Signature
Date
Basic - Date