Secondary School Pathways - Expression of Interest

Which Pathways option are you enquiring about?*

Requested Course*

Pathways Requested Course*

Credit Program Requested Course*

Year you're applying for*

Applicant's Details

Name*

First Middle Last

Email*

Phone*

Date of Birth*

Gender*

Female
Male
Rather Not Say

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent/Guardian's Contact Details

Parent/Guardian's Name*

First Last

Parent/Guardian's Phone*

Parent/Guardian's Email*

Applicant's Secondary School

2022 Year Level*

Name of Secondary School*

Class Day Availabilities*

Monday
Tuesday
Wednesday
Thursday
Friday

School Coordinator's Details

School's Coordinator's Name*

Coordinator's Email*

Coordinator's Primary Phone*

Coordinator's Secondary Phone

If applicable.

Have you successfully completed any previous qualifications or received any statment of attainments for units?*

Yes
No

Please list each previous qualification*

Fee Concessions*

Neither
Health Care Card
Pensioner Concession or Disability Pension Card

Health Care Card*

Max. file size: 50 MB.

Pensioner Concession or Disability Pension Card*

Max. file size: 50 MB.

Do you have any disabilities that may impact your training?*

Yes
No

Please list disabilities.

Do you have any learning difficulties that may impact your training?*

Yes
No

Learning Difficulites*

Do any of the following apply to you? (Tick all that apply)

Asperger's / Autism
Learning Difficulties
Dyslexia
ADD / ADHD
Language or Literacy Difficulties
Numeracy Difficulties
Other

Other - Learning Difficulties*

Employment

Upload Resume*

Max. file size: 50 MB.

Areas of Interest for Employment*

Please list all areas of employment student is interested in.

Has a Host Employer already been arranged?*

Yes
No

Would you like to apply for the ITS Job Readiness Program?*

Yes
No

Host Employer Company*

Host Employer Contact Name*

Host Employer Primary Contact Phone*

Host Employer Secondary Contact Phone

If applicable.

Hidden

Host Employer Contact Email*

Please list any previous work experience?*

In 2-3 sentences state why you would like to apply for this course.*

For Secondary School Pathway enquires, please fill out the form below.

Applicant's Details

Parent/Guardian's Contact Details

Applicant's Secondary School

School Coordinator's Details

Employment

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