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Date of Birth (DD/MM/YYYY)
If you have completed a course with us in the past and your details have remained the same you may skip this section.
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Please select where the invoice/receipt should be sent
Please select where the qualification should be sent
If you were referred to us by a previous student of ours, please name here:
The Unique Student Identifier (USI) is a new Australia-wide student number which will introduce the capacity for students to track their training records across all Australian states and territories.
If known please state your Unique Student Identifier (USI). Your USI is 10 characters long and is a combination of numbers and letters:
USI - Unique Student Identifier
If you do not know your Unique Student Identifier (USI), please complete the fields below and our staff will check to see if you have a USI. If you do not have a USI our staff will create one for you.
Town/City of Birth
Drivers licence details (If you do not hold a current drivers licence please contact our office (07 4724 4543) for an alternative document for proof of your identity:
Drivers Licence Number
As part of our data collection requirements we ask that you please answer the following questions, should you have any concerns please contact our office (07 4724 4543).
1. In which country were you born?
If Other please specify
2. Do you speak a language other than English at home?
If Yes please specify
3. How well do you speak English?
4. Are you Aboriginal or Torres Strait Islander origin?
5. Do you consider yourself to have a disability, impairment or long-term condition?
6. If YES, then please indicate the areas of disability, impairment or long-term condition:
7. What is your highest COMPLETED school level?
8. In which YEAR did you complete that school level?
9. Are you still attending secondary school?
10. Have you SUCCESSFULLY completed any of the following qualifications in Question 11?
11. If YES, then select ANY applicable boxes.
12. Of the following categories, which BEST describes your current employment status?
13. Of the following categories, which BEST describes your main reason for undertaking this course/traineeship/apprenticeship?
On-the-job hrs and modules completed will vary according to the endorsement on the students Training Permit. Nil hours unsupervised.
Students must hold a current Restricted Electrical Work Training Permit issued by the Queensland Electrical Safety Office in order to complete this course
Please contact our office (07 4724 4543) or the Electrical Safety Office (1300 362 128) if you require further information in regards to the Training Permit
Module 1 Compulsory: UEENEEE101A - Apply Occupational Health and Safety regulations, codes and practices in the workplace
Module 2 Compulsory: Disconnect - reconnect equipment connected to low voltage installation wiring (UEENEEP010A, UEENEEP012A, UEENEEP013A, UEENEEP014A, UEENEEP015A)
Module 3: Locate and rectify faults in low voltage equipment using set procedures (UEENEEP016A, UEENEEP017A, UEENEEP018A, UEENEEP019A, UEENEEP020A)
Module 4: Attach cords and plugs to electrical equipment for connection to a single phase 230 Volt supply (UEENEEP024A)
Module 5: Attach cords, cables and plugs to electrical equipment for connection to 1000 Va.c. or 1500 Vd.c. supply (UEENEEP025A)
Please select the modules you would like to complete:
Queensland residents working in the Construction Industry (Plumbing, Refrigeration etc.) may be eligible for a subsidised course fee through Construction Skills Queensland (CSQ). Please tick the box below if you would like to receive an application form to apply for the subsided course fee, the amounts subsidised for each unit of competency follow:
Queensland residents working in the Construction Industry that are either apprentices or within 12 months of completing their Trade Certificate may be eligible to receive full funding for the units they complete. The amounts subsidised for each unit of competency follow:
CSQ funding is available to Queensland residents or those permanently employed in Queensland currently working in the Building and Construction Industry (Most Queensland Plumbers and Refrigeration mechanics are eligible).
Members of the Master Plumbers' Association Queensland, MPAQ members are eligible for a discounted course fee. Please complete the box below if you are applying for this discount:
Tick this box if you would like to apply for funding through Construction Skills Queensland. To confirm your eligibility for this funding please download the following CSQ application form and return the completed form along with evidence to firstname.lastname@example.org.
Students have 12 months from the first day of class to satisfactorily complete the assessment requirements of the course. The modules/units of competency above are assessed using Competency Based Assessment (CBA). Each student is given two opportunities to satisfactorily complete a task or answer a question. Should a student receive an unsatisfactory result on both attempts or not complete any assessment item within the required 12 month period then the student may receive a Not Yet Competent (NYC) result for the module/unit of competency. Should the student wish to resit any of the theoretical or practical assessments then the student may incur an additional fee of $375.00 per module/unit of competency (This fee is charged at the discretion of the trainer).
Note: The supply of an Education Course is a GST-free supply and therefore the course fee does not include GST.
I wish to pay by:
Post to: 43 Primrose Street, Belgian Gardens Qld. 4810
Company Order Number
NOTE - If you are paying by Direct Deposit, please use your surname as a reference so we can align the payment to you.
Electro-Training Institute will contact you for your credit card details.
Please note: Full payment is required one week prior to commencement of this course.
Recognised Prior Learning (RPL) process: Please contact our office 4724 4543 and ask to speak with the Business Trainer should you believe that you may have already met the requirements of the unit of competency from prior learning and/or experience.
Student Cancellation: A fee of 20% of total course will apply for written cancellations received seven-fourteen days prior to commencement of the course. Cancellations received less than seven days prior to the course are not refundable however substitutes on same dates are welcome.
Institute Cancellation: The Electro-Training Institute guarantees that the training and assessment will be completed by a qualified person on the date specified on the student’s confirmation. Should the Electro-Training Institute not provide the training and assessment on the specified date a full refund will be given to the student within two working days of their bank details being received in writing by the Electro-Training Institute office.
Confirmation: Full confirmation details and course instructions will be sent to you upon receipt of booking.
Certificates/Statements of Attainment and Academic Records of Achievement: Upon successful completion, of the course, Electro-Training Institute will provide a qualification in the form of a Certificate/Statement of Attainment as well as an Academic Record of Achievement. This qualification will be mailed out to the indicated address on the students enrolment form. It is the responsibility of the student to provide Electro-Training Institute with the correct mailing address. A fee of $35.00 will apply for any re-prints of the Certificate/Statement of Attainment and Academic Record of Achievement.
Student deemed Unsuccessful/Not Yet Competent: If a student fails to complete an assessment or is unsuccessful in completing an assessment task/exam they are deemed as ‘Not Yet Competent’ by the assessor and the assessor will nominate a time for re-assessment within class time. This second assessment will be free of charge. If the student remains ‘Not Yet Competent’ after the second assessment, he or she will be notified that this result is final and he or she will be unable to successfully complete the unit of competency in which they are enrolled. Any further assessment will be fee for service and the student will need to have a meeting with the Institute Director to create an individual learning plan before their re-enrolment in the course is confirmed.
Professional development: This course is designed to meet your Electrical Safety Office requirements. A Statement of Attainment documenting your attendance and results will be awarded at the end of the course. This will serve as evidence as to your eligibility to apply for the Restricted Electrical Work license.
Access of records and progress: If at any time you wish to have access to your records or you have any questions regarding your participation or progress please contact our office.
Complaints and Appeals: We welcome any feedback about the course delivery and/or content, if you have any complaints or you wish to appeal any decision made regarding your participation please view our complaints and appeals procedure on our website or contact our office for a hard copy.
Privacy Notice: Under the Data Provision Requirements 2012, Electro-Training Institute is required to collect personal information about you and to disclose that personal information to the National Centre for Vocational Education Research Ltd (NCVER).
Your personal information (including the personal information contained on this enrolment form and your training activity data) may be used or disclosed by Electro-Training Institute for statistical, regulatory and research purposes. Electro-Training Institute may disclose your personal information for these purposes to third parties, including:
Personal information disclosed to NCVER may be used or disclosed for the following purposes:
You may receive an NCVER student survey which may be administered by an NCVER employee, agent or third party contractor. You may opt out of the survey at the time of being contacted.
NCVER will collect, hold, use and disclose your personal information in accordance with the Privacy Act 1988 (Cth), the VET Data Policy and all NCVER policies and protocols (including those published on NCVER’s website at www.ncver.edu.au).
Student Declaration and Consent
Cairns • Townsville • Brisbane
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