Werribee Secondary College - 2027 Course Application Form

Certificate II in Community Services

Student Details

All fields are mandatory unless otherwise noted. If you don't have the required details close this page and start a new form.
First Name (Legal Name)
Entity Data - Profile - First Name
Surname (Legal Name)
Entity Data - Profile - Surname
Known By (Nickname) - Optional
Entity Data - Profile - Known By
Date of Birth
Entity Data - Profile - Birth Date
Gender
Entity Data - Profile - Gender
Street Address
Entity Data - Address - Home - Street Address 1
Street/Lot Number
Entity Data - Address - Home - Street/Lot Number
Street Name
Entity Data - Address - Home - Street Name
Suburb
Entity Data - Address - Home - Suburb
State
Entity Data - Address - Home - State
Post Code
Entity Data - Address - Home - Post Code
Country
Entity Data - Address - Home - Country
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 (This can be found on Compass)
Basic - Text

Contacts

Provide at least one Parent/Guardian contact for emergency purposes which will be shared with the Host School/RTO.
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

Additional information required for student wellbeing and compliance purposes.
In 2027. Is the student in VCE or VM?
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

Declarations

By clicking Submit you provide consent to share your application with third parties in accordance with the Privacy and Data Protection Act 2014 (Vic) and Health Records Act 2001 (Vic).
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