Al-Taqwa - Application Form

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First Name
Entity Data - Profile - First Name
Surname
Entity Data - Profile - Surname
Birth Date
Entity Data - Profile - Birth Date
Street Address 
Entity Data - Address - Home - Street Address 1
Suburb
Entity Data - Address - Home - Suburb
State
Entity Data - Address - Home - State
Country
Entity Data - Address - Home - Country
Post Code
Entity Data - Address - Home - Post Code
Student Mobile Number
Entity Data - Contact - Home - Mobile Number
Student  E-mail Address
Entity Data - Contact - Home - E-mail Address
Unique Student Identifier(USI)

Students are required to have a USI Number for VET Studies. If you do not have a USI Number, please go to the USI Registry and apply for one
Entity Data - AVETMISS - Unique Student Identifier (USI)
Party - Group: Home School
Entity Data - Profile - Group: Home School
VSN - Victorian Student Number
Basic - Text

Contacts

Parent/Guardian Name
Basic - Text
Parent/Guardian Email
Basic - Text
Parent/Guardian Phone Number
Basic - Text
Emergency Contact Name
Basic - Text
Emergency Contact Email
Basic - Text
Emergency Contact Phone Number
Basic - Text

Further Information

In 2023. Is the student in Year 10, VCE or VCAL?
Basic - Radio buttons
Do you identify as having a disability?
Entity Data - AVETMISS - Disability Flag
If yes, what type of disability do you have?
Entity Data - AVETMISS - Disability Type
 Indigenous Status
Entity Data - AVETMISS - Indigenous Status
 Main Language
Entity Data - AVETMISS - Main Language
Private Health Insurance?
Basic - Smart Question
Ambulance Subscription?
Basic - Smart Question
Health Care Card Holder?
Basic - Smart Question

Declarations

Student Name
Basic - Text
Student Signature
Basic - Digital Signature
 Declaration Date
Basic - Date
Parent/Guardian Name
Basic - Text
Parent/Guardian Signature
Basic - Digital Signature
Declaration Date
Basic - Date