Full Real Estate Agent’s Licence

Email *

First Name *

Middle Name

Last Name *

Gender Male
Female

Date of Birth *

Company Name (if required for invoicing)

Country of Birth *

Town of Birth *

Are you an overseas student studying in Australia on a STUDENT VISA? Yes
No

If you speak a language other than English at home, please advise what language

How well do you speak English? Very WellWellNot WellNot At All

Are you of Aboriginal origin? Yes
No

Are you of Torres Strait Islander origin? Yes
No

Building/Property Name

Flat/Unit No.

Street No *

Street Name *

Suburb/Town *

State *

Postcode *

Country *

Phone/Mobile

Alt Phone/Mobile

Work Phone

PO Box

Building/Property Name

Flat/Unit No.

Street No

Street Name

Suburb/Town

State

Postcode

Country

USI number (if you have one)

Drivers Licence No *

Drivers Licence Card No *

State Issued *

Medicare No

Card colour

Expiry Date

Ref No

Passport No

Country of Issue

Passport Expiry Date

Name as it appears on proof of identity document *

Do you consider yourself to have any disability, impairment or long-term condition? * Yes
No

Medical Conditions (tick those that apply) Hearing/Deaf
Physical
Intellectual
Learning
Mental Illness
Vision
Acquired Brain Impairment

If you have other medical conditions, please provide a brief description of the sort of support which would best suit your individual needs and a Company representative will contact you. If you are not sure if your English language, literacy & numeracy skills are at the standard required to achieve competency, please contact our office and we can provide you with a short Literacy & Numeracy test to complete, which will enable us to ascertain if you will need additional assistance.

Other Medical Conditions

What year did you complete High School? *

Highest year completed at High School *

Are you still enrolled in secondary or senior secondary education? NoYes

Have you completed any of the following qualification? Bachelor
Masters
Advanced Diploma/Assoc Degree
Diploma/Assoc. Diploma
Cert IV
Cert III or Trade Cert
Cert II
Cert I

Other Qualifications

Are you applying for RPL or Credit Transfer? *If yes we will contact you to discuss your training Yes
No

Employer

Employer Address

Job Role

Employment Status Select ...Full TimePart TimeSelf EmployedUnpaid worker-family businessUnemployed, seeking full-time workUnemployed, seeking part-time workNot seeking employment

Study Reasons To get a jobTo develop my existing businessDifferent CareerExtra skills of jobTo get a better job/promotionRequirement of my jobGet into another coursePersonal interest/self developmentTo get skills for community/voluntary workOther

Would you like additional support with any special needs (literacy, numeracy, physical)? Yes
No

If yes, please provide a brief description of the sort of support which would best suit your individual needs and the CEO of there representative will contact you.

I authorise Complete Property Training to apply for a USI on my behalf and confirm I have read the privacy information in the terms & conditions. *

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