AgSkilled Form Section 1: EligibilityI am 15 years or older and no longer at school. Yes No You are not eligible for AgSkilled funded trainingI live and work (my physical office or home base) in NSW. Yes No - I live outside of NSW, but my physical office/home base is in NSW. No - My physical office/home base is outside of NSW, but I live in NSW. No - Both my residence and physical work office/home base are outside NSW, but my job is servicing NSW. No - Both my residence and physical work office/home base are outside NSW. You are not eligible for AgSkilled funded trainingI was born in Australia? Yes No I am/hold(Required) Australian or New Zealand Residency An Australian citizen A Humanitarian Visa None of the above You are not eligible for AgSkilled funded trainingHave you completed funded training with Ironbarktraining in the past? If yes, please list courses below.(Required)Section 2: Applicant informationApplicant name (Please enter full legal name)(Required) First Last DOB(Required) MM slash DD slash YYYY Township(Required) State(Required) Post Code(Required) Contact Number(Required)Email(Required) Unique email address required. Your account for the online learning environment is created using your email address. Therefore, you cannot share an email address with a fellow course participant.Do you have any dietary requirements?(Required) Section 3: EmploymentEmployment type(Required) Full time Part time Casual Contractor Self-employed Role / interest in industry sector(Required) Primary producer / On farm owner On-farm employee Agronomist/Consultant/Advisor Contractor Please describe your current role and industry, and your interest for this course/industry.(Required)Job title(Required) Employer(Required) Section 4: Industry & CropsIndustry - check all that apply(Required) Cotton Grains Production horticulture Rice Viticulture Agri futures/ Plants None of the above Please list your cropsSection 5: Training Requirements (Select all that apply)Truck Driver Licensing - Car to Heavy Rigid Licence to drive a heavy rigid vehicle (TLILIC2016) Truck Driver Licensing - Heavy Rigid to Heavy Combination Licence to drive a heavy combination vehicle (TLILIC3017) Civil Construction Machinery Operations Conduct civil construction dozer operations Technology (RIIMPO323E) Conduct civil construction excavator operations (RIIMPO320F) Conduct civil construction skid steer loader operations (RIIMPO318F) Conduct civil construction wheeled front end loader operations (RIIMPO321F) Tele Handler Conduct telescopic materials handler operations (RIIHAN309F) Work in Confined Spaces Enter and work in confined spaces (RIIWHS202E) Work Safely at Heights Work safely at heights (RIIWHS204E) Crane Operation Licensing Licence to operate a non-slewing mobile crane (greater than 3 tonnes capacity) Safety (TLILIC0008) Licence to operate a slewing mobile crane (up to 20 tonnes) (TLILIC0010) Elevated Work Platform Licensing Licence to operate a boom-type elevating work platform (boom length 11 metres or more) (TLILIC0005) Forklift Licensing Licence to operate a forklift truck (TLILIC0003) Dogging Licensing Licence to perform dogging (CPCCLDG3001) Rigging Licensing Licence to perform rigging basic level (CPCCLRG3001) Section 6: QuestionsHow is this training relevant to your current role or future career plans?(Required) To get a job To develop my existing business To start my own business To get a better job or promotion To try for a different career/change of career It is a requirement of my job Extra skills for my job What changes do you hope, or expect to make as a result of this training?(Required) Improved efficiency on farm Improved productivity on farm Better use of resources Improved on-farm safety Improved leadership capacity Improved communication/people skills Improved business skills Able to complete more tasks on farm Secure a promotion or new job Other Please expandSection 7: HousekeepingThe information contained in this application will be provided to the AgSkilled Industry Steering Committee and NSW State Training Services for the purpose of determining eligibility and to secure your fee free training. I acknowledge and accept.(Required) Yes Direct Marketing - I would like to receive direct marketing information.(Required) Yes No How did you hear about this course?(Required)