APPLICANT DETAILS

Please provide the following personal information by writing in the space below.

Full Name
(Do Not abbreviate)

Postal Address
(Number & Street Name

Date of Birth
(dd/mm/yyyy)

Date
(enter date)

INSTRUCTIONS

Please answer the following questions by placing a tick against the answer that most applies to you.

Communication

Reading

Writing

Maths

Speaking and Listening

INSTRUCTIONS:

Please read the following information and write your answers in the ANSWERS space provided.

The answers can be found within this document. Please DO NOT use your own information to answer the questions.

Basic Numeracy

ANSWERS

66 + 13

2000 ÷ 250

8 x 100

650 – 600

A garden area 2 metres wide and 5 metres long needs to be sprayed. How many square metres are there in the garden area?

You are filling a backpack with chemical and you realise you need to add 10% more. You have already put in 600mls. How much more do you need to add?

Comprehension

Please read the following information and answer the questions in the space provided.

The name of the course you will be undertaking is: Level 3 Chemical Safety provided by SpraySMART. It is made up of the following Units of Competency:

Code

AHCCHM303

AHCCHM304

Name

Prepare and apply chemicals

Transport and store chemicals

The course has been designed to provide the learner with the basic knowledge to enable them to be able to use, transport and store chemicals safely in their workplace.

The course is ideal for people who apply chemicals in workplaces such as:

  1. Farms
  2. Golf courses
  3. Landscapes
  4. Council parks & streets
  5. Bushland
  6. Tree maintenance programs.

Course Duration: The face to face component of the course takes 1 day to complete over an 8½ hour period, normally between the hours of 8:30am to 4:00pm. There is also some pre-course reading and post-course assessments to complete.

Trainers: The course is delivered by professional trainers with the relevant industry experience. They all must hold a TAE40110 Certificate IV in Training and Assessment plus have industry experience to be able to train this course.

Course Cost: The price for learners who have not undertaken this course in the past is: $340.00.

There is NO GST associated with this course.

PLEASE ANSWER THE FOLLOWING QUESTIONS

What is the name of the course?

Who is providing the course?

What is the Code for Prepare and apply chemicals?

Name one (1) of the workplaces where people may work who need to do this course.

How many hours does this course run for?

What certificate do the trainers need to have?

How much does this course cost and do you have to pay GST?

Course Cost

GST

APPLICANT’S VALIDATION OF AUTHENTICITY

I certify that the responses that I have provided in this questionnaire are my own and have not be influenced in any part by a third party.

Have you had a third party read this questionnaire to you?

Have you had a third party write your responses?

Applicant’s Name

Applicant’s Signature




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