ABN No. 55973871518
RTO No. 91735
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Course Selection

Please Choose The Course

Personal Details

1. Enter Your Full Name*

* 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 and want [name of RTO] to apply for a USI on your behalf, you must write your name, including any middle names, exactly as written in the identity document you choose to use for this purpose. See section on the USI at the end of this form for a detailed explanation.

2. Enter Your Birth Date

3. Sex (tick one box)

   4. Enter Contact Details

5. What is the address of your usual residence?

Please provide the physical address (street number and name not post office box) where you usually reside rather than any temporary address at which you reside for training, work or other purposes before returning to your home. If you are from a rural area use the address from your state or territory’s ‘rural property addressing’ or ‘numbering’ system as your residential street address.

6. What is your postal address (if different from above)?

Language and Cultural Diversity

   7. In which country were you born?

8. Do you speak a language other than English at home?

(If more than one language, indicate the one that is spoken most often)

9. How well do you speak English?

10. Are you of Aboriginal or Torres Strait Islander origin?

(For persons of both Aboriginal and Torres Strait Islander origin, mark both ‘Yes’ boxes)


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

12. If you indicated the presence of a disability, impairment or long-term condition, please select the area(s) in the following list:

(You may indicate more than one area)


13. What is your highest COMPLETED school level?

14. In which YEAR did you complete that school level?

15. Are you still attending secondary school?

Previous qualifications achieved

16. Have you SUCCESSFULLY completed any of the following qualifications?

  • Bachelor degree or higher degree
  • Advanced diploma or associate degree
  • Diploma (or associate diploma)
  • Certificate IV (or advanced certificate/technician)
  • Certificate III (or trade certificate)
  • Certificate II
  • Certificate I
  • Certificates other than the above

17. If YES, then tick ANY applicable boxes.


18. Of the following categories, which BEST describes your current employment status?

Study reason

19. Of the following categories, which BEST describes your main reason for undertaking this course/traineeship/apprenticeship?

Unique Student Identifier

From 1 January 2015, we Rainbows Senior First Aid 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). If you have not yet obtained a USI, we can provide one for you by completing the next section.

20. Enter your Unique Student identifier (if you already have one)

Additional Information for USI Application – only required if you do not already have a USI

1. Enter your Town or City of Birth

(please write the name of the Australian or overseas town or city where you were born)

We will also need to verify your identity to create your USI. Please provide details for one of the forms of identity below and please ensure that the name written in ‘Personal Details’ section is exactly the same as written in the document you provide below.

2. a) Australian Driver Licence

2. b) Medicare Card

Card colour: (select which applies)


2. c) Australian Birth Certificate

2. d) Australian Passport

2. e) Non-Australian Passport (with Australian Visa)

2. f) Immicard

2. g) Citizenship Certificate

2. h) Certificate of Registration by Descent

In accordance with section 11 of the Student Identifiers Act 2014, Rainbows Senior First Aid will securely destroy personal information which we collect from individuals solely for the purpose of applying for a USI on their behalf as soon as practicable after we have made the application or the information is no longer needed for that purpose, unless we are required by or under any law to retain it.