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Fee for Service Enrolments

Thanks for your interest in enrolling!

Please be aware we have moved our enrolment forms to a brand-new enrolment system. To continue your enrolment, please navigate to your preferred course option below and click “enrol now” on the new page or follow the prompts to proceed.

Certificate III in Individual Support

Certificate IV in Mental Health

Assist Clients with Medication

Mental Health First Aid

Certificate IV in Disability Support

Certificate IV Mental Health Peer Work

Trauma Informed Care

Certificate IV in Ageing Support

Certificate III Allied Health Assistance

Provide First Aid & CPR

Please select your enrolment type:

NSW Government funded enrolment

QLD Government funded enrolment

Self-funded enrolment

Fee for Service

Please select your enrolment type:

NSW Government funded enrolment

QLD Government funded enrolment

Self-funded enrolment

Fee for Service

Please select your enrolment type:

NSW Government funded enrolment

QLD Government funded enrolment

Self-funded enrolment

Fee for Service

Please select your enrolment type:

NSW Government funded enrolment

QLD Government funded enrolment

Queensland Funding

Self-funded enrolment

Fee for Service

Please select your enrolment type:

NSW Government funded enrolment

QLD Government funded enrolment

Self-funded enrolment

Fee for Service

Please select your enrolment type:

NSW Government funded enrolment

QLD Government funded enrolment

Self-funded enrolment

Fee for Service

Please complete your Assist Clients with Medication Enrolment below.

Fee for Service Enrolment Form

"*" indicates required fields

Step 1 of 5

20%

Course name*

Are you enrolling in a scholarship program?*

Delivery Method*

Please indicate your location*

Name*

First Middle Last

Date of birth*

DD slash MM slash YYYY

Town / City of birth*

Gender*

Male

Female

Other

Home phone

Work phone

Mobile*

Email*

Alternative email address

Emergency contact name*

Relationship*

Mobile*

How did you hear about this course?*

Please specify:*

What is the address of your usual residence?
Please provide the physical address (street number and name NOT post-office box) where you usually reside rather than any temporary address at which you reside for training, work or other purposes before returning to your home. If you are from a rural area use the address from your state or territory’s rural property addressing’ or ‘numbering’ system as your residential street address. Building/property name is the official place name or common usage name for an address site, including the name of a building, Aboriginal community, homestead, building complex, agricultural property, park or unbounded address site.

Building /property name

Flat / unit details

Street or lot number*

Street name*

Suburb, locality or town*

State / territory*

Postcode*

What is your postal address (if different from above)?

Building /property name

Flat / unit details

Street or lot number

Street name

Postal delivery information

Suburb, locality or town

State / territory

Postcode

Australian Residency Status*

Australian citizen

Permanent resident visa

Humanitarian Visa

New Zealand citizen

Temporary visa

Do you hold or are enrolled in, a certificate III or higher-level qualification, not including qualifications completed at school and foundation skills training?*

Yes

No

If yes, tick any applicable boxes below*

Bachelor’s degree or higher degree

Advanced Diploma or associate degree

Diploma (or associate diploma)

Certificate IV (or advanced certificate/technician)

Certificate III (or trade certificate)

Certificate II

Certificate

Other education (not specified/overseas qualifications)

Please specify:*

Language, literacy and numeracy, prior education, disability, employment status, cultural background

In which country were you born?*

Australia

Other

Please specify:*

Do you speak another language other than English at home?*

No, English only

Other

Please specify:*

Do you identify as Aboriginal/Torres Strait Islander descent?*

No

Yes, Aboriginal

Yes, Torres Strait Islander

Yes, both Aboriginal and Torres Strait Islander

Do you consider yourself to have a disability, impairment or long-term condition?

No

Yes

Please indicate the area/s of disability, impairment or long-term condition from the following list:

Hearing/deaf

Physical

Intellectual

Learning

Mental illness

Acquired brain impairment

Visual

Medical condition

Other

Please specify:*

Are you still enrolled in secondary or senior secondary education?*

No

Yes

Which best describes your current employment status?*

Full-time

Part-time

Casual

Unemployed - seeking full-time work

Unemployed - seeking part-time work

Unemployed - not seeking employment

Employed - unpaid worker in a family business

Employer

Self-employed

Select the one which best describes the main reason you are undertaking this course?*

To get a job

To develop my existing business

To start my own business

To try a different career

To 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 or self-development

To get skills for community/voluntary work

Other

Please specify:*

How well do you read?*

Very well

Well

Require assistance

How well do you write?*

Very well

Well

Require assistance

Do you have a reasonable level of physical fitness? (i.e. ability to bend and complete manual handling tasks)*

Yes

No

Do you have access to a computer / laptop with high- speed internet?*

Yes

No

Are you employed in the community services industry as a support worker, or in a similar occupation?*

Yes

No

Employer name*

Street address*

Contact person*

Phone*

Email*

Do you have any experience or qualification(s) relevant to the course you are applying for?*

Would you like to apply for Recognition of Prior Learning (RPL) or a Credit Transfer?*

Please refer to your Learner Handbook for more information about RPL and Credit Transfers. Alternatively, you can contact a breakthru staff member if you need more information.

Do you require any assistance in order to complete your course?*

Privacy Notice

To learn how we use your personal information for enrolment, please visit our privacy policy page.

Student Declaration

I declare that:

All information I have provided to breakthru College, in connection with this application is true, accurate and not misleading in any way;
I confirm that I have been provided with the details of the fee chargeable;
I confirm that I have read and understood the information specified in the breakthru Learner Handbook. I accept the responsibilities of my actions and agree to abide by the conditions outlined in the breakthru Learner Handbook
I have understood the course requirements including the entry requirements by accessing our website at breakthru College - Disability & Community Services Training.

Student Declaration and Consent

By signing this enrolment form, you agree with all the information outlined in the Student Declaration and the breakthru Learner Handbook

Student signature*

Date*

MM slash DD slash YYYY

Parent/guardian signature

(Parent/guardian signature is required for all students under the age of 18)

Date

MM slash DD slash YYYY

Media Release*

I hereby grant breakthru the irrevocable and unrestricted right to use, reproduce and publish photographs and recordings taken of me, including my image and likeness as depicted therein, and any statement or testimonial made by me for editorial, trade, advertising or any other purpose in any manner and medium, and to alter the same without restriction.

Yes

No

Do you have a Unique Student Identifier (USI)?*

Yes

No

Unique Student Identifier (USI)

From 1 January 2015, Breakthru can be prevented from issuing you with a nationally recognised VET qualification or statement of attainment when you complete your course if you do not have a Unique Student Identifier (USI). In addition, we are required to include your USI in the data we submit to NCVER. If you have not yet obtained a USI you can apply directly at https://www.usi.gov.au/students/create-your-usi on a computer or mobile device.

Enter your Unique Student Identifier (USI) (if you already have one)
You may already have a USI if you have done any nationally recognised training, which could include training at work, completing a first aid course or RSA (Responsible Service of Alcohol) course, getting a white card, or studying at TAFE or training organisation. It is important that you try to find out whether you already have a USI before attempting to create a new one. You should not have more than one USI. To check if you have already have a USI, use the “forgotten USI” link on the USI website at https://www.usi.gov.au/faqs/i-have-forgotten-my-usi/ The USI is a reference number made up of ten numbers and letters.

My Unique Student Identifier (USI) is:*

USI application through your RTO (if you do not already have one) If you would like Breakthru to apply for a USI on your behalf you must authorise us to do so and declare that you have read the privacy information at < https://www.usi.gov.au/about-us/privacy > You must also provide some additional information as noted so that we can apply for a USI on your behalf.

Consent

I authorise breakthru to apply pursuant to sub-section 9(2) of the Student Identifiers Act (Cth) 2014, to create a USI on my behalf. I have read and I consent to the collection, use and disclosure of my personal information (which may include sensitive information) pursuant to the information detailed at https://www.usi.gov.au/documents/privacy-notice-when-rto-applies-their-behalf

Student signature*

Date*

MM slash DD slash YYYY

Please upload forms of identity document below to allow for creation of your USI:

Please upload 100 points of identification, including at least 1 primary document (i.e. Driver's License) and 1 secondary document (i.e. Medicare Card)

Drop files here or

Max. file size: 100 MB.

In accordance with section 11 of the Student Identifiers Act (Cth) 2014, breakthru will securely destroy personal information which we collect from individuals solely for the purpose of applying for a USI on their behalf as soon as practicable after we have made the application or the information is no longer needed for that purpose. The following is provided to you on behalf of the Student Identifier Registrar (Registrar).

You are advised and agree that you understand and consent that the personal information you provide in connection with your application for a Unique Student Identifier (USI):

Is collected by the Registrar as authorised by the Student Identifiers Act (Cth) 2014.
Is collected by the Registrar for the purposes of:
- Applying for, verifying and giving a USI;
- Resolving problems with a USI; and
- Creating authenticated vocational education and training (VET) transcripts;
May be disclosed to:
- Commonwealth and State/Territory government departments and agencies and statutory bodies performing functions relating to VET for :
  - The purposes of administering and auditing VET, VET providers and VET programs;
  - Education related policy and research purposes; and
  - To assist in determining eligibility for training subsides;
- VET Regulators to enable them to perform their VET regulatory functions;
- VET Admission Bodies for the purposes of administrating VET and VET programs;
- Current and former Registered Training Organisations to enable them to deliver VET courses to the individual, meet their reporting obligations under the VET standards and government contracts and assist in determining eligibility for training subsides;
- Schools for the purposes for delivering VET courses to the individual and reporting on these courses;
- The National Centre for Vocational Educational Research for the purpose of creating authenticated VET transcripts, resolving problems with USIs and for collection, preparation and auditing of national VET statistics;
- Researchers for education and training related research purposes;
- Any other person or agency that may be authorised or required by law to access the information;
- Any contractually engaged by the Student Identifiers registrar to assist in the performance of his or her functions in the administration of the USI system; and
Will not otherwise be disclosed without your consent unless authorised or required by or under law.

The consequences for not providing the Registrar with some or all of your personal information are that the Registrar will not be able to issue you with a USI.
You can find further information on how the registrar collects, uses and discloses the person information about you in the Registrar’s Privacy Policy or by contacting the Registrar on usi@education.gov.au or telephone 1300 857 536, international inquiries +61 2 6240 8740. The Registrar’s Privacy Policy contains information about how you may access and seek correction of the person information held about you and how you make a complaint about a breach of privacy by the Registrar in connection with USI and how such complaints will be dealt with. You may also make a complaint to the Information Commissioner about an interference with privacy pursuant to the Privacy Act 1988, including in relation to the misuse or interference of or unauthorized collection, use, access, modification or discloser of USIs.

Name

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In the spirit of reconciliation, Royal Rehab acknowledges the Traditional Custodians of Country throughout Australia and their connections to land, sea, and community. We pay our respects to their Elders past, present and future and we extend our respects to all Aboriginal and Torres Strait Island peoples.

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