Multi Trades and Heavy Industries Participant Registration Survey

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* 1. Participant Details

Name

Address

Suburb

Postcode

Phone Number

Date of Birth

Gender

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* 2. Are you Aboriginal or Torres Strait Islander Origin

Yes

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* 3. Are you currently at school?

Yes

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* 4. Which program are you applying for? (tick all that apply)

Heavy Industry and Trades Mutli Skills Program (20 weeks)

Engineering Taster (4 weeks)

Electrical/Renewable Energy Taster (4 weeks)

Construction Taster (4 weeks)

Civil/Mining Taster (4 weeks)

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* 5. Are you currently employed?

Yes

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* 6. If yes, please indicate employment type below:

Full Time

Part Time

Casual

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* 7. If yes, please indicate hours per week

Less than 15 hours

Greater than 15 hours

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* 8. Job Seeker Number (if applicable):

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* 9. Do you have a USI (Unique Student Identification) Number?

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* 10. Are you registered with an employment service provider?

Yes

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* 11. If yes, please provide details

Sureway

MADEC

YourTown

Other (please specify)

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* 12. What is the highest level of education you have completed?

Did not attend school

Year 9 or lower

Year 10

Year 11

Year 12/13

Trade/Certificate

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* 13. What was your main activity before registering for this project?

Working

Studying

Volunteering

Not actively looking for work

Unemployed and looking for work

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* 14. If you are unemployed and looking for work, how long for:

Less than 3 months

3-6 months

6-12 months

over 12 months

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* 15. Have you got a drivers licence

Yes

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* 16. Please list any other licences or tickets

Forklift Driving

Welding

Machining

First Aid

Bobcat

Front End Loader

Confined Space

Working at Heights

Other (please specify any others)

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* 17. Do you have any health problems that may restrict the work you can do?

Yes

If yes please specify

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* 18. Are you currently taking medication for any health concerns?

Yes

If yes, please provide brief details:

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* 19. What are your reasons for wanting to be part of Multi Trades Heavy Industries Program

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* 20. How did you hear about Multi Trades and Heavy Industries Project

Family Member/Friend

Employment Provider

Television

Jobs Fair

Social Media

From an employer involved in the project

Other (please specify)

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* 21. Some employment opportunities may require relocation to another city or town or commuting. Are you prepared to (please select if yes):

Relocate

Commute

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* 22. I give permission for any photographs taken of me whilst in the programme being used for promotional or media purposes

Yes

Multi Trades and Heavy Industries Participant Registration

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* 1. Participant Details

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* 2. Are you Aboriginal or Torres Strait Islander Origin

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* 3. Are you currently at school?

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* 4. Which program are you applying for? (tick all that apply)

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* 5. Are you currently employed?

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* 6. If yes, please indicate employment type below:

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* 7. If yes, please indicate hours per week

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* 8. Job Seeker Number (if applicable):

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* 9. Do you have a USI (Unique Student Identification) Number?

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* 10. Are you registered with an employment service provider?

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* 11. If yes, please provide details

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* 12. What is the highest level of education you have completed?

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* 13. What was your main activity before registering for this project?

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* 14. If you are unemployed and looking for work, how long for:

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* 15. Have you got a drivers licence

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* 16. Please list any other licences or tickets

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* 17. Do you have any health problems that may restrict the work you can do?

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* 18. Are you currently taking medication for any health concerns?

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* 19. What are your reasons for wanting to be part of Multi Trades Heavy Industries Program

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* 20. How did you hear about Multi Trades and Heavy Industries Project

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* 21. Some employment opportunities may require relocation to another city or town or commuting. Are you prepared to (please select if yes):

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* 22. I give permission for any photographs taken of me whilst in the programme being used for promotional or media purposes

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* 23. Is there anything else you would like to add?