Robinson College Step 1 of 4 25% Student InformationCourse Name(Required)Course Date MM slash DD slash YYYY USI NumberSearch for or create USI(Required) YES NO Name(Required) Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Middle Last Gender(Required) Male Female Date of Birth(Required) MM slash DD slash YYYY Phone Number(Required)Email(Required) Residential Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÃ…land Islands Country Emergency Contact Name(Required)Phone Number(Required)Relationship to you(Required) Background and Funding Eligibility (Must Complete)Are you 15 years old or older?(Required) YES NO Are you currently at school(Required) YES NO if yes, your are eligible for fundingDo you live or work in NSW?(Required) YES NO Do you live in social housing?(Required) YES NO Are you aged 15-24 OR over 55 years(Required) aged 15-24 aged 55 or over NO Citizenship Status(Required) Australian Citizen Australian Permanent Resident New Zealand Citizen Visa None Apply You must be an Australian citizen, permanent resident, New Zealand Citizen or humanitarian visa for fundingDo you receive a Commonwealth Benefit?(Required) YES NO Are you a dependent of a recipient on Commonwealth benefits(Required) YES NO if YES, what is your CRNExpiry Date MM slash DD slash YYYY If YES, which benefits do you receive(Required) Jobseeker Youth Allowance Austudy Abstudy Family Tax Benefit Parenting Payment Carer Payment Disability Support Pension Age Pension Widow Allowance Veterans Affairs Farm Household Allowance Name of Job Seeker AgencyJob Seeker IDDo you identify as Aboriginal or Torres Strait Islander?(Required) NO YES, Aboriginal YES, Torres Strait Islander YES, Aboriginal & Torres Strait Islander Are you employed?(Required) YES NO Do you work more than 30 hours per week?(Required) YES NO Funding(Required)If you have ticked any of the boxes below, you are eligible for funding regardless of employment hours. Aged between 15-24 or over 55 Indidenous Unemployed Work less than 30 hours per week Receiving Commonwealth benefits or a recipient Are you eligible for funding?(Required) YES NO *Funding is only available for one day courses * High risk and plant machinery courses are not funded Disability & Language, Literacy and Numeracy LLNDo you need Help with Reading and Writing?(Required) YES NO If yes, select what you need help with?(Required) Reading Wtiting Both Do you consider yourself to have a disability or impairement?(Required) YES NO If yes, Which?(Required) Hearing Deaf Physical Intellectual Learning Mental Illness Vision Acquired Brain Impairment Medical Condition MarketingHow did you hear about Robinson College and your course?(Required) Employer Employment Service Provider Flyers Google/Search Engine Newspaper Radio Social Media Word of Mouth Returning Student Evidence of IdentificationProof of citizenship (Australia or New Zealand Green Medicare Card OR Passport OR Birth Certificate) – (Certificate of Australian Citizenship) – (VEVO Check and Overseas Passport) (Choose 1 Only)ID TYPE(Required) Medicare Card Birth Certificate Passport Certificate of Australian Citizenship VEVO Check and Overseas Passport Number(Required)Expiry Date(Required) MM slash DD slash YYYY Ref NO (Medicare Only)Country of Issue ( Passport Only)Proof of NSW AddressDriver Licence, Centrelink Card, Photo Card, Utility Bill (Choose 1 Only)ID Type(Required) Driver Licence Centrelink Card Photo Card Utility Bill Employer Issued Document Confirming employment in NSW (only if you do not reside in NSW) Number(Required)Card Number(Required)Expiry Date(Required) MM slash DD slash YYYY State(Required)
