for the 2018 (1 January to 30 June 2018) Activity Period
This application must be read in conjunction with the Smart and Skilled Subcontracting and Brokering Arrangement Approval Policy, the Smart and Skilled Contract Terms and Conditions and the Smart and Skilled Operating Guidelines (see https://www.training.nsw.gov.au/smartandskilled/contract_policy_2018.html).
A copy of the Agreement with the proposed third party broker should be attached to this application.
Please forward the completed signed application and third party agreement by email to .
PART 1: Provider Details
1.1 Provider NSW RTO ID:1.2 Provider Legal Name:
1.3 Provider Trading Name: (if applicable)
1.4 Provider National Code:
1.5 Name and Role of person applying: / Name:
Role:
PART 2: Proposed Broker (Third Party)
2.1 / Legal Name of proposed broker:Trading Name of proposed broker:
NSW RTO ID:
(if applicable) / National RTO Code:
(if applicable)
ABN: / ACN:
2.2 / Does the proposed broker comply with the definition of a Passive Intermediary (as per the Smart and Skilled Subcontracting and Brokering Arrangement Approval Policy)? / YES NO
2.3 List the full names and positions of persons with organisational control of the proposed broker
(as per the Smart and Skilled Operating Guidelines). / Name:
Position:
Name:
Position:
Name:
Position:
2.4 What is the proposed broker's Principal Place of Business (as defined by the Australian Securities Investment Commission)? / Street:
Suburb:
State: Postcode:
2.5 Is the proposed broker currently a TAFE provider other than TAFE NSW? / YES NO
2.6 Is the proposed broker currently a VET Student Loans Provider? / YES NO
2.7 Does the proposed broker have a Smart and Skilled Contract? / YES NO
2.8 Has the proposed broker previously applied for a Smart and Skilled Contract? / YES NO
PART 3: Details of Proposed Brokering Arrangement
3.1 Does this brokering application relate to the delivery of a full qualification? / YES NOIf YES, please answer Questions 3.4 then 3.7 onwards.
If NO, please answer Question 3.2.
3.2 Does this brokering application relate to the delivery of:
a part qualification
or
Unit(s) of Competency
with the intention of leading to a full qualification for the Enrolled Student?
PLEASE NOTE: Only one Unit of Competency or set of Units of Competency can be selected for each application. / YES NO
If YES, please answer Questions 3.4 onwards.
If NO, please go to Question 3.3.
3.3 Therefore this brokering application relates to delivery of a part qualification or Unit(s) of Competency which are not intended to lead to a full qualification for the Enrolled Student.
PLEASE NOTE: For ACE and TPPPQ Programs only.
PLEASE NOTE: Only one Unit of Competency or set of Units of Competency can be selected for each application. / Please go to Question 3.5.
3.4 Which Approved Full Qualification does this application refer to?
PLEASE NOTE: Only one qualification can be selected for each application. / Qualification Code:
Qualification Name:
3.5 Which set of Units of Competency (UoCs) does this brokering application relate to?
PLEASE NOTE: Only one set of UoC(s) may be selected for each application. / UoC Code / UoC Name
3.6 Are the UoC(s) on the Provider's ASQA scope of registration for delivery in NSW? / YES NO
3.7 Select the Smart and Skilled Program which is the subject of this application.
PLEASE NOTE: Only one Program can be selected for each application. / Smart and Skilled Entitlement Apprenticeships and Traineeships Program (EAT)
Smart and Skilled Entitlement Full Qualifications Program (EFQ)
Smart and Skilled Entitlement Foundation Skills Program (EFS)
Smart and Skilled Targeted Priorities Full Qualifications Program (TPQ)
Smart and Skilled Targeted Priorities Prevocational and Part Qualifications Program (TPPPQ)
School Based Apprenticeships and Traineeships Program (SBAT)
Adult and Community Education (ACE) Programs
3.8 Which Regions are covered by this application?
(Tick all that apply) / All Regions
Capital Region
Central Coast
Central West
Coffs Harbour - Grafton
Far West and Orana
Hunter Valley Excl Newcastle
Illawarra
Mid North Coast
Murray / New England and North West
Newcastle and Lake Macquarie
Richmond – Tweed
Riverina
Southern Highlands and Shoalhaven
Sydney
3.9 Start date of intended arrangement: / / (dd / mm / yyyy)
3.10 Is the start date selected at least 28 days after the date of this application? If not, please review the date. / YES NO
3.11 End date of intended arrangement:
(The end date must be within the current Smart and Skilled Contract Activity Period) / / (dd / mm / yyyy)
PART 4: Activities Proposed in the Brokering Arrangement
4.1 Which of the following activities (as defined in Schedule 1 of the Smart and Skilled Contract Terms and Conditions), including in part, are proposed in the Brokering Arrangement?(Tick all that apply) / Recruiting for Subsidised Training
Marketing and/or advertising Subsidised Training
Enrolling students
Receiving or otherwise dealing with student Fee collection and/or payments
eReporting
Other – please specify
4.2 For each of the Brokering Arrangement activities identified above, please explain why it is proposed that the third party carries out these responsibilities instead of the Provider.
1. Recruiting for Subsidised Training:
2. Marketing and/or advertising Subsidised Training:
3. Enrolling students:
4. Receiving or otherwise dealing with student Fee collection and/or payments:
5. eReporting:
6. Other:
4.3 What is the total expected number of Enrolled Students (as defined in Schedule 1 of the Smart and Skilled Contract Terms and Conditions) who would be subject to the proposed Brokering Arrangement?
4.4 Of the expected total number of Enrolled Students (as defined in Schedule 1 of the Smart and Skilled Contract Terms and Conditions) how many would be associated with NSW Government priorities? Including: / Disadvantaged groups
Type – please identify:
Regional and rural communities
Apprenticeships
The NSW Infrastructure Skills Legacy Program
Jobs of Tomorrow Scholarships
National Disability Insurance Scheme (NDIS) workforce development
Other (please specify)
4.5 Do you have an Agreement with the proposed broker (third party) for the Brokering Arrangement that clearly identifies roles and responsibilities and includes the Schedule of Fees? / YES NO
If YES, please provide this agreement as part of your application.
If NO, this application cannot proceed.
4.6 What risks has the Provider identified in connection with this proposed Brokering Arrangement application?
(Set out all risks (contingent or otherwise) including all potential negative impacts on students) / NVR Standards risks
Smart and Skilled Contract compliance risks
Financial Cap risks
Student risks
Reputational risks
Capacity of the Provider to fulfil their obligations
Other risks
4.7 How will the Provider manage these risks?
(Set out all details including references to the relevant parts of any agreement with the proposed broker (third party))
1. NVR Standards risks:
2. Smart and Skilled Contract compliance risks:
3. Financial Cap risks:
4. Student risks:
5. Reputational risks:
6. Capacity of the Provider to fulfil their obligations
7. Other risks:
4.8 Is there anything else you would like to tell us about your Brokering Arrangement application for our consideration? For example, is there an innovation or unique outcome which would be achieved to benefit Enrolled Students and/or NSW?
PART 5: Declaration
The Provider acknowledges and agrees that by submitting this application:
§ the person submitting this application is authorised to do so on behalf of the Provider;
§ all information provided in connection with this application (the Application Information) is true, complete, accurate and not misleading in any way;
§ will not substantially change the terms of the attached Agreement or the accompanying Schedule of Fees.
The Provider:
§ has read and understood the Smart and Skilled Contract Terms and Conditions, Smart and Skilled Operating Guidelines and Smart and Skilled Subcontracting and Brokering Arrangement Approval Policy;
§ is not aware of anything which might result in an adverse change to the Application Information;
§ has the Approved Full Qualification on the Provider’s Smart and Skilled Approved Qualifications Activity Schedule(s) for the Program identified in this application;
§ will not exceed their Financial Cap as a result of the activities included in this application;
§ will provide the Department with any additional information relevant to this application within 3 business days of a request made by the Department; and
§ will provide all other assistance reasonably requested by the Department in connection with the Department's assessment of this application.
The Provider also acknowledges and agrees that the proposed Broker:
§ has not had an Approved Providers List (APL) Contract or Smart and Skilled Contract terminated for non-compliance and/or unsatisfactory performance before the end of its term in the last three years;
§ has not had its registration under the National Vocational Education and Training Regulator Act 2011, or relevant equivalent legislation, refused, cancelled or revoked in the last three years;
§ has no current suspension(s), sanction(s) and/or condition(s) imposed on its registration under the National Vocational Education and Training Regulator Act 2011 (if the proposed broker is an RTO);
§ has not had a Commonwealth or State Government vocational education and training funding contract or agreement terminated prior to the expiration of that contract or agreement in the last three years;
§ has not been responsible, either by act or inaction/omission, for causing the outcomes listed above to apply to another organisation or individual in the last three years.
Confirmed
Signature: / Date:Provider Representative Name: / Position:
Provider Legal Name: / NSW RTO ID:
E-mail: / Phone number:
NSW DEPARTMENT OF INDUSTRY / PAGE 2 OF 9 / 28 FEBRUARY 2018