Application for a copy of student records

About student records

If the Registered Training Organisation (RTO) that originally issued your qualification or statement of attainment has closed, the Australian Skills Quality Authority (ASQA) may hold a copy of your student records. However, the only information ASQA requests from RTO’s is as follows:

·  Family name and first name of student

·  Residential post code

·  Date of birth

·  Enrolment/commencement date

·  Code and title of qualification completed

·  Codes and title of units of competency completed

·  Unit of competency result (Competent or Not Yet Competent)

·  Credentials (qualification or statement of attainment) and date issued

·  Unique Student Identifier (if known)

Note
Some state and territory training regulators operating before ASQA’s establishment in July 2011 did not collect records from closed training providers. Therefore, ASQA may not hold a copy of your student record.

About this form

ASQA is committed to protecting information collected through this process and the handling of data in accordance with the Privacy Act 1988. All information we collect from you will be kept secure and confidential.

All requests for student records must be signed by the student. ASQA is unable to process requests for student records made by person(s) other than the student.

A fee of $60 applies to the successful return of student records. Processing your application may take up to 30 working days.

Section 1  Personal information

Unique Student Identifier
(USI - if known):
Title / Mr / Mrs / Ms / Other (please specify):
First name:
Family name:
Previous family name
(if applicable):
Date of birth:
Current address:
Town/Suburb: / State / Postcode
Email:
Mobile: / Alternative daytime phone number:
Name and number of former registered training organisation that issued the Certificate or Statement of Attainment:
Qualification or Units of Competency completed:

Section 2  Release of student records to a Third Party

Please complete this section if you would like your student records directly released to a third party (eg a new RTO you have enrolled with, your employer etc):

I hereby give my approval to release my student records to:
Print name of third party:
Email address of third party:
Your signature:
Your full name:
Date signed:

Section 3  Applicant declaration

I declare that the information provided by me is, to the best of my knowledge, true and correct.

Signature:
Print name:
Date:

Section 4  Identity verification

You must show a verifying officer original identity documents that add up to at least 100 points. A list of permitted verifying officers is provided on page 6. Alternative documentation that will be accepted for Aboriginal applicants and applicants under 18 is listed below.

Category / Type of document / Value / Points
Category A
70 points / Birth certificate or extract / 70 / _____
Australian citizenship certificate
Passport
Australian driver’s licence or permit
Proof of age card
Category B
30 points. / Department of Veterans’ Affairs (DVA) card / 30 / _____
Centrelink pensioner / health care card
Government employee identification card
Secondary or Tertiary student identification card
Seniors / Medicare / private health card
Category C
15 points / Council rates / property insurance papers / 15 / _____
Professional or trade association card
International driver’s licence
Bank or credit card
Utilities bill (telephone, gas, electricity or water)
Tax notice / superannuation statements
Motor vehicle registration / insurance papers
Rental property lease agreement
TOTAL / _____

For Aboriginal applicants who reside in remote or isolated locations, apart from the standard identity items above, there is an added option of two letters of verification provided by Community Leaders (recognised as leaders of the community to which the applicant belongs). Each verification scores 50 points.

For applicants under 18: One Category A document must be provided. However, a statement from an educational institution, signed by the principal or deputy principal, confirming that the child attends the institution (statement must be on the institution’s letterhead) may also be provided. Such a statement scores 50 points.

Section 5  Verifying Officer declaration and details

You must ensure that Section 5 is completed by a verifying officer before your application can be processed.

I declare that I have sighted and confirmed the applicant’s original or certified true copy personal identity documents and that verification has been achieved using the 100 point check. I am satisfied as to the correctness of the applicant’s identity. I have confirmed that I meet the requirements for a Verifying Officer as set out on page 6.

Full name of applicant as per identification:
Name of Verifying Officer:
Position:
Organisation:
Business address:
Business email:
Mobile: / Alternative daytime phone number:
Signature:

Applicant Identify – Permitted Verifying Officers

Public Officials / Commissioner for Oaths (or Affidavits or Declaration)
Justice of the Peace / Notary Public
Ombudsman / Public Advocate
Parliamentarians and Councillors / Elected Member – Parliament of the Commonwealth of Australia or State Parliament or Territory Legislature
Mayor / Deputy Mayor / Councillor in a local government authority
Courts and Law Enforcement / Justice / Judge / Magistrate / Master – any Australian court of law
Registrar / Clerk / Sheriff / Bailiff – any Australian court of law
Lawyer (however described) of any Australian jurisdiction
Police Officer (federal or state or territory police force)
Government Officials / Permanent employee of any department or authority of the federal government, state government, or local municipality
Principal of, or Student Counsellor in, a school
School Teacher or University Lecturer (only if employed full-time)
Manager of a Post Office
Commissioned Officer (only if current) – Australian Defence Force
Community Leaders / Minister of Religion / Marriage Celebrant
In relation to an applicant from an Aboriginal community in an isolated or remote location, an individual is a Community Leader if he or she:
·  is a recognised Elder (by others in the community)
·  serves as Chairperson, Secretary or CEO of an incorporated indigenous land council / community council / housing association
·  is a Coordinator of Aboriginal community development employment
·  manages or works as the treating health professional in an Aboriginal medical service relevant to the applicant, or
·  is the Principal of, or a Counsellor in, a school in the community.
Medical and Allied Health Professionals / Person currently registered or licensed to practise as:
·  Medical Practitioner / Dentist / Veterinary Surgeon
·  Nurse / Psychologist
·  Physiotherapist / Chiropractor
·  Optometrist / Pharmacist
Other occupations / Member of the Institute of Engineers / Mining and Metallurgy Institute

Section 6  Application fee for a copy of student records

Payment will only be accepted by credit card. Please complete the form below. Please note: If no records are found you will not be charged the application fee.

Credit Card Information
Card type: / MasterCard / Visa
Card number: / Expiry date: / /
Name on card: / CCV:
Signature:
Payment amount: / $60.00 / Date: / /
Please send receipt to (postal or email address):

Submitting this form

Before submitting this form:

·  Ensure that you have completed all sections of the form

·  Ensure Section 5 ‘Identify verification’ has been completed by a person who is a permitted verifier (as per page 6)

We prefer that you submit this form electronically to: . Alternatively, you can submit this form by post, with the required attachments, to:

Student Records
ASQA
GPO Box 9928
Adelaide SA 5001

Note
Hard copy applications may take longer to process. If you need help understanding this form, contact the ASQA Info line on 1300 701 801 or email .

Form - Application for copy of student records, updated 29 February 2016 Page 2 of 7