CHC33021 CERTIFICATE III IN INDIVIDUAL SUPPORT (DISABILITY) ENROLMENT APPLICATION FORM

This qualification will provide you with the skills and knowledge to be effective in a disability care worker role in the community and/or within a residential setting. You will learn to use a person-centred approach to assist with personal care by following individualised plans to look after people with a disability. By promoting healthy lifestyles and social inclusion, and supporting their emotional wellbeing, you will discover how to empower and facilitate the independence of disabled people.

To achieve this qualification, the candidate must have completed at least 120 hours of work as detailed in the Assessment Requirements of the units of competency. For more details, please visit https://www.asuriatraining.com.au/courses/certificate-iii-in-individual-support-disability/

When completing this enrolment application form, it is recommended that you complete it using the Google Chrome browser via a computer or laptop. Upon receiving your enrolment application, our Admissions Specialist will review and confirm your suitability to undertake this training.

IMPORTANT

We are accepting application for the October 2025 intake until 10th October 2025, 5pm AEST. To join the intake and commence the course, applicant must submit a complete enrolment application form by 10th October 2025 and complete all steps in the enrolment process successfully no later than 17th of October 2025, 5pm AEST.

If you have any questions about completing this form, please contact admissions@asuria.com.au.

AETS (Australian Employment and Training Solutions, ABN: 45 123 653 752, RTO Code: 21912) would like to advise that we will be changing the business name of the company to Asuria Training, effective from 1st December 2023. All other company information and registration details remained unchanged.

Under the Data Provision Requirements 2012, Asuria Training (formerly known as AETS) is required to collect personal information about you and to disclose that personal information to the National Centre for Vocational Education Research Ltd (NCVER). https://www.asuriatraining.com.au/ncver-privacy-policy

COURSE AND INTAKE SELECTION
Please select the intake you would like to commence your CHC33021 Certificate III in Individual Support (Disability) course.

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CSEAUS03633 - Certificate III in Individual Support [CHC33021_DIS_2023] (CHC33021_DIS_TAS_25T4)
10 Oct 2025 - 09 Oct 2026 Blended
Available

PERSONAL PROFILE

Title

First Name

Middle Name

Surname

Birth Date

Please select your age group

I'm under 18 years old

I'm 18 years old and above

JobSeeker or CRN ID

Residency Status

Nationality

Gender

Female

Male

Other

Mobile Number

E-mail Address

Home Address

Address - Home - Unit/Flat Number

Address - Home - Street/Lot number

Address - Home - Street Name

Address - Home - Suburb

Address - Home - Post Code

Address - Home - State

Address - Home - Country

Postal Address - if different from home address

Address - Billing - Unit/Flat Number

Address - Billing - Street/Lot number

Address - Billing - Street Name

Address - Billing - Suburb

Address - Billing - Post Code

Address - Billing - State

Address - Billing - Country

How long have you been living in Tasmania?

Under 6 months

6 months and more

CULTURAL, EDUCATIONAL AND EMPLOYMENT BACKGROUND

In which country were you born?

Do you speak a language other than ENGLISH at home?

Yes

What other language do you speak? Please choose from the drop down menu

Are you Aboriginal or Torres Strait Islander origin?

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

Yes

If you indicated the presence of a disability, impairment of long term condition, please select the area(s) in the following list:
(You may indicate more than one area) Please refer to the Disability supplement for an explanation of the following disabilities.

Please indicate disability assessment type

Recipient of disability support pension

Assessed by specialist support professional as a student with disability

Not assessed by a specialist

Do you have any special learning needs?

Yes

Please specify the additional support you require in your learning journey

What is your highest COMPLETED school level?
If you are currently enrolled in secondary education, the highest school level completed refers to the highest school level you have actually completed and not the level you are currently undertaking. For example, if you are currently in Year 10, the highest school level completed is Year 9.

Are you still enrolled in secondary or senior secondary education?

Yes

Have you SUCCESSFULLY completed any qualifications listed in the next question?

Yes

If YES, tick ANY applicable boxes

Please provide the name of the qualification you had/are undertaking under government subsidy.
Please include the full title of qualification and code e.g. CHC33015 Certificate III in Individual Support

In the past 5 years, please confirm if you have or you are

Currently undertaking a government subsidised course

Completed a government subsidised course

N/A

Of the following categories, which BEST describes your current employment status?
For casual, seasonal, contract- and shift work, use the current number of hours worked per week to determine full time (35 hours or more per week) or part-time employed (less than 35 hours per week).

Which of the following classifications BEST describe the industry of your current employer?

Which of the following classifications BEST describe your current occupation?

Of the following categories, select the one which BEST describes the main reason you are undertaking this course/traineeship/apprenticeship.

As you are applying for a fee-free training, we will require additional information regarding your current employment. Please provide the following information for our reference. Kindly note that AETS reserve the rights and may contact your employer for verification purposes.

What is the name of your employer?

Name of your position in the company

Name of your supervisor

Your supervisor's position title

Your supervisor's contact number

Your supervisor's email address

Core Skills Initial Assessment

This Core Skills Initial Assessment tool will assist us in identifying your current reading, writing and numeracy levels to assist you with your specific learning needs. Please answer each question as completely as possible.

Read the following information about DURO-TUSS Dry Cough Liquid Forte 200mL and answer the questions below:

General information about the medicine:

1. Do not use this medicine in children under 6 years, if the seal is broken, or if it is past the expiry date.

2. May cause drowsiness. If it does, do not drive a vehicle or operate machinery. Avoid alcohol.

3. May have a laxative effect or cause diarrhoea.

Instructions for use:
Store below 30°C.

Shake the bottle before use.

Age: Adults and children 12 years and over.

1. Dosage 5mL.

2. How Often: Every 6-8 hours as required (maximum 4 times a day).

Age: Children 6-11 years (only on the advice of a doctor, pharmacist or nurse practitioner).

1. Dosage 2.5mL

2. How Often: Every 6-8 hours as required (maximum 4 times a day).

Source: https://www.chemistwarehouse.com.au/buy/3787/duro-tuss-dry-cough-liquid-forte-200ml?gclid=CjwKCAiAvaGRBhBlEiwAiY-yMBL9tTrhJQEIZcowcBnas_duiHW7kuPtNw3eOQ2hcCfRbOKCS4Jm7xoCNJ4QAvD_BwE&gclsrc=aw.ds

1. Answer the following questions in your own words (do not copy the text directly).

a) When should you avoid driving a vehicle?

b) Should you give this cough medicine to a 5 year old child? Why or why not?

2. Using the dosage recommendations above, perform the following calculations.

a) How many mL of cough medicine should you give an adult?

b) If cough medicine was given at 10am to an adult, what time is the earliest you can give the next dose?

This course content and assessments are mostly online. How much support do you feel you would need to undertake learning in an online environment?

Little to no support

Some support

A lot of support, I'm not confident with online learning at all.

As a self-assessment on your digital literacy, Please tick all tasks you are comfortable with performing on your own?

Sending Emails (examples are sending, replying, and drafting new emails).

Uploading and downloading documents (examples are attaching documents to emails and applications, downloading forms or guides).

Using Microsoft office (E.g. Word) or any similar programs used for creating resumes and cover letters (other examples are Google Docs)

Using a computer or laptop (basic trouble shooting skills)

Do you have access to the following? Please tick most relevant. As all our content and assessments will need to be accessed and submitted online and printed copies are not available.

Personal Computer/Desktop (with camera and mic) and reliable internet connection

Laptop (with camera and mic) and reliable internet connection

No, I do not have access to above mentioned devices

Work Placement

This course has a work placement component that will require a level of physical fitness to complete the tasks. Are you willing and able to complete a work placement that includes such tasks listed below? Do you foresee anything that may impact your ability to do work placement (e.g. planned surgery/ extended leave)

Individual Support: manual handling, lifting, assisting people, bathing, dressing, toileting, grooming, carrying cleaning, bending. This could include hands on care for any gender, age or disability.

Yes

Work Placement (work placement component in the centre are generally unpaid)

Are you aware or have identified any centres that you can complete your work placement component? If no, are you willing to travel up to 1 hour to a centre and complete your work placement?

Yes

Work Placement

You will be require to provide a Police Check and Working With Children Check or Working With Vulnerable People before commencing your work placement term. Do you have one already? If no, are you willing to obtain them?

Yes

This course may require you to participate in scenarios where you will be interacting with your fellow students. examples are:

- turn on your camera during webinars

- participate in group work or interact with your fellow students

- record yourself with others doing a role-play activity.

Are you comfortable with this?

Yes

UNIQUE STUDENT IDENTIFIER (USI)

From 1 January 2015, we Asuria Training 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).

Please enter USI below if you already have one.

If you do not yet have a USI, please apply for one at https://www.usi.gov.au/students/get-a-usi on your computer or mobile device.

Australian Passport, Australian Birth Certificate, Citizenship Certificate or Medicare Card

Visa Grant Document

PROOF OF ACADEMIC RECORD

Please upload a completion certificate or academic record based on the highest school level completed or qualification you have completed. If you have completed or are undertaking any accredited studies within the last 5 years, please grant Asuria Training access to view your USI VET Transcript. Please refer to www.asuriatraining.com.au/access-to-usi-transcript for the instruction.

PROOF OF HOME ADDRESS

If your identification document does not display or does not match your home address, please upload a copy of other evidence displaying your name and home address. Example, a copy of energy bill that is no more than 3 months old.

STUDENT DECLARATION AND AGREEMENT

Thank you for completing this form. Before you sign and submit this application, please acknowledge the following:

1. Terms and Conditions of enrolment as per Asuria Training Student Handbook, please click Here

2. NCVER and Asuria Training Privacy Policy, please click Here

3. Have viewed the course overview, delivery and units offered on the website, please click Here

4. Course payment, additional fees and refund policy (if applicable)

5. Verification of the Unique Student Identifier (USI) provided in my application. If I did not provide a USI, I give permission to Asuria Training to create, find and or verify a USI on my behalf.

6. Granting Asuria Training permission to perform verification of visa entitlement using Visa Entitlement Verification Online system (VEVO) if applicable.

I declare that I have read, understood and agree to ALL of the above mentioned items.

I provide my consent for Asuria Training to contact me during my enrolment and post studies for any services offered by the organisation.

I understand that my enrolment in this qualification/s is being subsidised by the Tasmanian Government. I understand that enrolling in this qualification/s may affect my future training options and eligibility for further government subsidised training.

The information I provided in this form is accurate to my knowledge.

Student Signature

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Clear

Date

PARENT OR LEGAL GUARDIAN DECLARATION (if student is under 18 years of age)

Parent or Legal Guardian Full Name

Parent or Legal Guardian Contact Number

Parent or Legal Guardian Email Address

Please specify your relationship with the student

I, the parent/guardian of the student, understand that by signing this form, I am declaring that:

1. I have read the Privacy Policy, and consent to the collection, use and disclosure of personal information in accordance with the Privacy Policy; and

2. I give permission for him/her to attend the course he/she is enrolled in, and undertake all of the requirements for the course.

Parent or Legal Guardian Signature

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Clear