AgSkilled Form Section 1: EligibilityI am 15 years or older and no longer at school.(Required) Yes No You are not eligible for AgSkilled funded trainingI live and work (my physical office or home base) in NSW.(Required) 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. Do you hold a current NSW Drivers Licence?(Required) Yes No Upload image of NSW Drivers Licence.(Required)Max. file size: 50 MB.Requirement: Letter of Support, from the Employer to validate this application.(Required)Max. file size: 50 MB.You are not eligible for AgSkilled funded trainingWere you born in Australia?(Required) Yes No I am/hold(Required) Australian or New Zealand Residency An Australian citizen A Humanitarian Visa None of the above What city were you born in?(Required) Do you identify as Indigenous, Torres Strait Islander or Neither?(Required) Highest level of school completed? (Also include what year you completed this)(Required) Have you completed any Prior Education after Secondary School? (If so List details of Course completed)(Required) USI (Unique Student Identifier) Number? If you do not know this, do you give consent for Ironbark Training to obtain this on your behalf?(Required) You are not eligible for AgSkilled funded trainingHave you completed funded training 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) DD slash MM slash YYYY Address e.g Street/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 Unemployed Role / interest in industry sector(Required) Primary producer / On-farm owner On-farm employee On-farm contractor Consultant / Agronomist Researcher / Research technician Jobseeker Please describe your current role and industry, and your interest for this course/industry.(Required)Job title(Required) Employer (Trading Name)(Required) Employer Contact Details (First & Last Name + Phone Number)(Required) Section 4: Industry & CropsIndustry - check all that apply(Required) Cotton Grains Production horticulture Rice Viticulture Fodder Crops Hay Agrifutures/other plant production Livestock Please list your cropsSection 5: Courses (Select all that apply)Truck Driver Licensing - Car to Heavy Rigid Licence to drive a heavy rigid vehicle (TLILIC2016) Please note, You must complete a Driver Knowledge Test prior to applying for this course. Call Service NSW or Book Online for your Driver Knowledge Test for a Rigid Vehicle Phone: 13 22 13 or book online. Pass the Driver Knowledge Test Purchase the Learners Logbook and Guides from Service NSW.Driver Knowledge Test - Rigid Licence Driver Knowledge Test - Rigid: Completed Driver Knowledge Test - Rigid: Not Completed Please outline why you will use the truck in your workplace? What tasks will you be completing?Truck Driver Licensing - Heavy Rigid to Heavy Combination Licence to drive a heavy combination vehicle (TLILIC3017) Please note, You must complete a Driver Knowledge Test prior to applying for this course. Call Service NSW or Book Online for your Driver Knowledge Test for a Rigid Vehicle Phone: 13 22 13 or book online. Pass the Driver Knowledge Test. Purchase the Learners Logbook and Guides from Service NSW.Driver Knowledge Test - Combination Licence Driver Knowledge Test - Combination: Completed Driver Knowledge Test - Combination: Not Completed Please outline why you will use the truck in your workplace? What tasks will you be completing?Other Courses Provide First Aid (HLTAID011) White Card - Prepare to work safely in the construction site (CPCWHS1001 ) 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) Conduct civil construction backhoe/loader operations (RIIMPO319E) 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 60 tonnes) (TLILIC0023) 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) CAPTCHA
