PERSONAL and CONTACT DETAILS

Given Name (required)

MIDDLE NAME

SURNAME(required)

Date of Birth

NATIONALITY:(required)

Your Email (required)

HOME CONTACT PHONE: (required)

Mobile:

SEX (required)
MALEFEMALE

UNIT NUMBER:

STREET NUMBER:

STREET NAME:

SUBURB:

STATE:

POSTCODE:

NEXT OF KIN/EMERGENCY CONTACt

NAME:

RELATIONSHIP:

Of the following categories, which best describes your current employment status?

Select One

Employer Name (If applicable)

Employer Address (If applicable)

OCCUPATION IDENTIFIER:

INDUSTRY OF EMPLOYMENT:

CITY OF BIRTH:

LANGUAGE

DO YOU SPEAK ANOTHER LANGUAGE OTHER THAN ENGLISH AT HOME?
YesNo
Write your langugae If yes

HOW WELL DO YOU SPEAK ENGLISH?
Very WellWellNot WellNot at All

REASON FOR STUDY
PLEASE TICK WHICH OF THE FOLLOWING CATEGORIES BEST DESCRIBES YOUR MAIN REASON FOR UNDERTAKING THIS COURSE/TRAINEE SHIP/APPRENTICESHIP.

PRIVACY STATEMENT –I UNDERSTAND THAT

.I acknowledge that I have a right to access personal information which STAC hold about me, subject to exceptions in relevant privacy legislation. I understand that I can obtain further information about STAC in the Student Handbook

.The Education and Training Reform Act 2006 requires STAC to collect and disclose my personal information for a number of purposes including the allocation to me of a Victorian Student Number and updating my personal information on the Victorian Student Register.

.For more information in relation to how student information may be used or disclosed
please contact us on phone 1300 34 76 76 or email training@stac.edu.au

.I acknowledge and agree to the terms described in the privacy statement

If the applicant is 18 years of age and over

STUDENT NAME

If the applicant is under 18 years of age

PARENT/GUARDIAN NAME

Upload ID's 100 point (Passport/Driving License & Medicare)

Upload ID's 100 point (Passport/Driving License & Medicare)