SKILLS FIRST DECLARATION "*" indicates required fields 1Step2Step Name* First Last Contact Number:*Email Address;* SKILLS FIRST PROGRAM (EVIDENCE OF ELIGIBILITY AND STUDENT DECLARATION FORM) Student Declaration To be completed by the student - don’t leave any question blank unless you are asked to skip a question or go to the declaration. Please ask Hammond Institute for help if you don’t understand a question. Q1 Write the name of the course/s you’re applying for?*CHC30121 - Certificate III in Early Childhood Education and CareCHC33021 – Certificate III in Individual Support (Disability)CHC33021 – Certificate III in Individual Support (Ageing)CHC40221 - Certificate IV in School Based Education SupportCHC43015- Certificate IV in Ageing SupportCHC43121- Certificate IV in DisabilityCHC43315- Certificate IV in Mental HealthCHC43415- Certificate IV in Leisure and HealthCHC43515- Certificate IV in Mental Health Peer WorkCHC53315 - Diploma of Mental HealthCHC50221- Diploma of School Age Education and CareCHC53415 - Diploma of Leisure and HealthCHC52021 - Diploma of Community ServicesCHC50121 - Diploma of Early Childhood Education and CareCHC50221 - Diploma of School Age Education and CareCHC62015 - Advanced Diploma of Community Sector Management22529VIC - Course in Performing Allied Health Tasks and Supporting People with Disability22532VIC - Course in Supporting People with Psychosocial Disability22540VIC - Course in Supporting People with Complex Personal Care Needs, including Behaviours of Concern22558VIC - Course in Supporting People with Disability to use MedicationsCHCSS00070 - Assist Clients with Medication Skill SetCHCSS00093 - Alcohol and Other Drugs Skill SetCHCSS00102 - Mental Health Co-existing Needs Skill SetCHCSS00103 - Mental Health Peer Work Skill SetCHCSS00129 - Individual Support - AgeingCHCSS00130 - Individual Support – DisabilityCHCSS00131 - Individual Support – Home and Community (Ageing)CHCSS00132 - Individual Support - Home and Community (Disability)CHCSS00137 - Palliative ApproachQ2 Are you doing, or have you done any other Skills First training in 2025? Tick your response.* No Yes Write the course name(s) below. Include training you haven’t started yet.*Q3 Are you enrolled in a school, including government, non-government, independent, Catholic or home school?* No Yes Q4 Are you enrolled in the Commonwealth Government’s Skills for Education and Employment program?* No Yes Student declaration – read and complete the declaration below. • I understand that my enrolment may be subsidised by the Victorian and Commonwealth Government under the Skills First Program. I understand my enrolment may affect my eligibility for more Skills First training. • I understand that the Department of Jobs, Skills, Industry and Regions may contact me to participate in a survey or interview. • I declare the information in this form is true and accurate.Full name:*Signature:*Date:* DD slash MM slash YYYY