Student Details Note: Please write the name that you used when you applied for
your Unique Student Identifier
(USI), including any middle
names. If you do not yet have
a USI please apply at https://www.usi.gov.au/students/create-your-usi/ on computer or mobile device. (Tick this box if you have one name only that cannot be written in the following format. Write your single name in the ‘Family name section). Company/Employer Details How did you hear about us? Do you wish to receive email updates/newsletter? Emergency Contact Cultural Diversity Aboriginal Torres Strait Islander Aboriginal and Torres Strait Islander Neither Schooling Are you currently attending school? Year 12 or equivalent Year 11 or equivalent Year 10 or equivalent Year 9 or equivalent Year 8 or equivalent Never attended school Other Employment Which of the following best describes your current employment status? Note, for casual, seasonal, contract and shift work, use the current number of hours worked per week to determine whether full-time (35 hours or more) or part-time employee (less than 35 hours per week). Full-time Part-time Self-employed - not employing others Self-employed - employing others Employed - unpaid in a family business Unemployed -seeking full-time work Unemployed -seeking part-time work Not employed -not seeking work Language Do you speak another language other than English at home? Disability Previous Qualifications Achieved Have you successfully completed any of the following qualifications? (You may tick more than one) Study Reason To get a job To get skills for community/voluntary work To get a better job or promotion For personal interest or self-development I wanted extra skills for my job To start my own business To develop my existing business To try for a different career It was a requirement of my job Do you intend applying for RPL (recognition of Prior Learning)? Language, Literacy and Numeracy DATS may be able to assist participants who are not confident in their language, literacy or numeracy skills.
It is important to advise DATS of any learning difficulties or special requirements (you may have) as soon as possible prior to the scheduled training date. Do you feel you may need assistance with any aspect of this course?
Please read the following text and answer the LLN Indicator questions:
Minezone is a large mining company that employs approximately 7000 workers. The company has become increasingly concerned about workplace safety as there had been a growing number of incidents, including one death in 2007. Minezone’s CEO, Martha Henderson, was committed to improving the safety of their workers, so in 2008 they undertook a large scale training program to educate their workforce about work safety. Some successful aspects of the program included:
• all workers were given the opportunity to offer their point of view on what would make a difference to their safety in the workplace
• all workers were retrained in aspects of safety
• a system of rewards was offered to work teams that demonstrated a decrease in the number of workplace incidents
• new workers were provided with extensive training in the correct use of equipment.
PART A 1. Approximately how many workers are employed at Minezone? 2. In what year did the death of a worker occur? 3. What was Minezone’s management committed to? 4. Who is the CEO of Minezone? 5. Note two successful aspects of the workplace safety program. 6. The main purpose of this text is:
PART B The following graph shows the number of workplace injury incidents during 2008. This covers all incidents ranging from very minor incidents (e.g. cuts and bruises) to more serious ones requiring hospitalisation. Look at the graphs and answer the following questions. 7. Which month had the highest number of workplace injuries? 8. Which month had the lowest number of workplace injuries? 9. What is the total number of injuries in September and October combined? Show your working out. 10. What is the difference in the number of incidents between July and October 2008?
Show your working. 11. What is the general trend in the number of incidents? 12. Do you think that the safety program was effective? Explain your answer. Payment Please contact your local DATS office to make payment before your course commences. Privacy Notice
Why we collect your personal information As a registered training organisation (RTO), we collect your personal information so we can process and manage your enrolment in a vocational education and training (VET) course with us.
How we use your personal information We use your personal information to enable us to deliver VET courses to you, and otherwise, as needed, to comply with our obligations as an RTO.
How we disclose your personal information We are required by law (under the National Vocational Education and Training Regulator Act 2011 (Cth) (NVETR Act)) to disclose the personal information we collect about you to the National VET Data Collection kept by the National Centre for Vocational Education Research Ltd (NCVER). The NCVER is responsible for collecting, managing, analysing and communicating research and statistics about the Australian VET sector.
We are also authorised by law (under the NVETR Act) to disclose your personal information to the relevant state or territory training authority.
How the NCVER and other bodies handle your personal information The NCVER will collect, hold, use and disclose your personal information in accordance with the law, including the Privacy Act 1988 (Cth) (Privacy Act) and the NVETR Act. Your personal information may be used and disclosed by NCVER for purposes that include populating authenticated VET transcripts; administration of VET; facilitation of statistics and research relating to education, including surveys and data linkage; and understanding the VET market.
The NCVER is authorised to disclose information to the Australian Government Department of Education, Skills and Employment (DESE), Commonwealth authorities, State and Territory authorities (other than registered training organisations) that deal with matters relating to VET and VET regulators for the purposes of those bodies, including to enable:
• administration of VET, including program administration, regulation, monitoring and evaluation
• facilitation of statistics and research relating to education, including surveys and data linkage
• understanding how the VET market operates, for policy, workforce planning and consumer information.
The NCVER may also disclose personal information to persons engaged by NCVER to conduct research on NCVER’s behalf.
The NCVER does not intend to disclose your personal information to any overseas recipients.
If you would like to seek access to or correct your information, in the first instance, please contact your RTO using the contact details listed below.
DESE is authorised by law, including the Privacy Act and the NVETR Act, to collect, use and disclose your personal information to fulfil specified functions and activities. For more information about how the DESE will handle your personal information, please refer to the DESE VET Privacy Notice at https://www.dese.gov.au/national-vet-data/vet-privacy-notice.
Surveys You may receive a student survey which may be run by a government department or an NCVER employee, agent, third-party contractor or another authorised agency. Please note you may opt out of the survey at the time of being contacted.
Contact information At any time, you may contact DATS to:
• request access to your personal information
• correct your personal information
• make a complaint about how your personal information has been handled
• ask a question about this Privacy Notice Student Declaration and Consent
• I declare that the information I have provided is true and correct. I am aware of the consequences that may arise from providing false,
misleading or incomplete information.
• I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice above.
• I have notified DATS if I have any disability, physical impairment, language, literacy or numeracy problems, or any health
problems/conditions which may affect my training.
• I have read and understood the Student Handbook (available on our website).
• I have read and understood the course flyer for the course in which I am enrolling (available on our website).
• I meet the pre-requisites for the course in which I am enrolling (if applicable).
• I agree to my photo or comments in the evaluation sheet being used for promotional purposes.
• I understand I am required to present appropriate Identification on the day of the course i.e. Driver’s Licence.
• I give DATS permission to undertake a search for my USI.
• I understand that SafeWork NSW or WHS QLD may request that a High Risk Work Licence holder be re-assessed anytime and that
SafeWork NSW or WHS QLD may suspend, cancel, refuse to issue or renew a High Risk Licence if the licence holder refuses or fails to
• I am aware, accept and understand that training activities conducted by Dickens Assessment & Training are potentially hazardous,
physically strenuous and/or emotionally stressful. I accept all hazards as briefed to me, relating to, associated with or arising from my
participation in such activities or practical exercises.comply, without reasonable excuse, with the requirements set out in a written notice.
• Irrespective of who is paying, I am aware of the fees associated with my training course. I give my consent to DATS to forward a copy of my Statement of Attainment/Statement of Completion
to my employer on my behalf. Submit