TRACK RIDER PROGRAM 2015 TRACK RIDER PROGRAM – EXPRESSION OF INTEREST To be considered for a place on the Racing Victoria Track Rider Program this Expression of Interest (EoI) form must be completed. To take part in the Racing Victoria Track Rider Program, experience with working with horses and previous riding experience is essential. Applicants must submit: 1. Video evidence of their riding ability. This video evidence must include vision of canter and extended canter or gallop in an open area demonstrating the ability to ride in a two point position; and 2. The form entitled ‘Horse-related Practical Activities – Participant Self Assessment’ (Self Assessment Form). Details of where the above footage and form are to be submitted is provided at end of this form. Successful applicants will be chosen by Racing Industries Skills Centre (RISC), Bendigo based on their skill level, control and balance, as determined after the RISC has reviewed the video evidence and considered the Self Assessment Form. Students are also selected based on their availability to pursue a track rider traineeship and employment after the initial two week course as this course is ultimately aimed at placing skilled participants into employment within the racing industry. Upon commencement of the Program, should the RISC determine that the applicant’s experience is not as described in the Self Assessment Form or video evidence, RISC reserves the right to immediately remove the applicant from the Program. Neither RISC nor Racing Victoria will be liable for any loss whatsoever, including loss of the enrolment fee in the event that an applicant is removed from the Program. It should be noted that completion of the Program does not guarantee the attainment of Stable Employee registration with Racing Victoria. TRAINING Track Rider Program Students participate in training from the following six training units from the RGR30108 Certificate III in Racing (Track Rider) Unit Code Unit Title RGRPSH201A Handle Horses RGRCMN201A Follow OHS procedures and observe environmental work practises RGRPSH205A Perform Basic Riding Tasks RGRPSH304A Identify factors that affect racehorse performance RGRPSH206A Develop riding skills for flatwork Racing Victoria Track Rider Program EOI -1- RGRPSH306A Develop basic track work riding skills PROGRAM DATES DATE LOCATION 30 March to 10 April 2015 (excluding weekends) Hillcrest College, Clyde North and Cranbourne Training Complex, Cranbourne CONDITIONS Applications close Wednesday 25th March 2015 10 places available. If an applicant is offered a place in the Program, enrolment must be done on line and the course must be paid for before commencing. A place in the Program will not be secured until payment is made in full. Fees: Enrolment fees o The cost of the course will vary for each individual depending on whether you are eligible for government funding or not. o If you have completed some of the units at another TAFE institute your fees may be reduced. Evidence of prior completion of units must be sent with your enrolment form to RISC. The decision as to whether fees may be reduced is at the discretion of RISC. o If you are unsure whether you are eligible or ineligible or have any other questions regarding fees, please contact John Randles john.randles@hrtcbendigo.com.au If you have a concession card you fees may be reduced. When your place is secured, you will be sent a timetable of the Program activities You must bring your own helmet that adheres to the following safety standards and must not be older than 5 years from date of manufacture (can be found inside helmet) o o o You must also bring a vest/back protector if you have one. If not, there will be vests available to borrow. Vests must be a minimum of the following safety standards: o o o ASNZ 3838 ASTM F1163 EN 1384 ARB Standard 1.1998 SATRA Jockey Vest standard European Standard EN 13158 level 1 There is a weight limit of 75kgs for all riding programs and all riders must be of a reasonable fitness level Racing Victoria Track Rider Program EOI -2- RACING VICTORIA LIMITED ACN 096 917 930 Human Resources and Workforce Development 400 Epsom Road Flemington VIC 3031, Australia Telephone: (+61 3) 9258 4328 Facsimile: (+61 3) 9258 4685 Email: l.coffey@racingvictoria.net.au EXPRESSION OF INTEREST Intermediate Track Rider Program Section 1: Personal Information Family Name: D.O.B: Given Name(s): Gender (please tick): Preferred Name: *Age: F Height: Weight: M Shoe Size: * Applicants must be at least 15 years of age at the commencement of the program. Residential Address: Suburb Postal Address: Post Code: Post Code: (only if differs from above): Contact Telephone: Mobile: Email Address: Section 2: Language and Cultural Diversity Country of Birth: Australia Other: Please specify: Are you an Australian Citizen or Permanent Resident of Australia? Yes: No: Are you of Aboriginal or Torres Straight Islander origin? Yes: No: Language spoken at home: English: Other: Please specify: Well Very well Yes: No: Or a holder of a permanent visa of Australia? Yes: No: Or a holder of a Special Category Visa (sub-class 444)? Yes: No: Or a Temporary Protection Visa Holder? Yes: No: How well do you speak English? Not at all Not well Section 3: Citizenship Are you an Australian Citizen? If no, please continue. Or an East Timorese Asylum Seeker? Yes: No: Please provide a copy of Birth Certificate OR Green Medicare Card & Proof of Age (Drivers Attached Licence) Section 4: Concession Status and Job Seeker Referral (JSA) I have a Concession Card. Racing Victoria Track Rider Program EOI Yes: No: -3- If yes, a copy of current concession document must be attached if a concession Tuition Fee Attached is required. E.g. Copy of Health Care Card Do you have a Job Seeker (JSA) referral? Yes: No: The original Job Seeker Referral form must be attached if Yes is selected. Attached Section 5: Parent / Guardian Details (if applicant is under 18 years of age) Name (s): Residential Address: Suburb Post Code: Contact Telephone: Mobile: Email Address: Section6: Emergency Contact (in an emergency, the person to be contacted on your behalf) Name: Relationship: Address: Home: Work: Mobile: Section7: Racing Victoria Registration Are you currently registered with Racing Victoria as a stable employee: Yes – please provide registration number ____________________ No Section 8: Education Details Highest completed school level: Are you currently attending school? Yes No If yes, please provide school name, address and your school level : If no, year last attended and please provide school name, address and highest school level completed. Section9: Qualifications (Certificates (indicate level), Diplomas, Degree obtained) Qualification(s) Example: Certificate II in Racing – Stablehand Year Obtained Currently Studying 2011 n/a Section 10: Work History Current Employment Status Of the categories listed, which BEST describes your current employment status? (tick one box only) Racing Victoria Track Rider Program EOI Full time employee Part time employee Self employed – not employing others Employer -4- Employed – Unpaid worker in family business Unemployed – Seeking full time work Unemployed – seeking part time work Not employed – not seeking employment Company / Employer FT , PT, Casual Start Date Finish Date Job Title Held Section 11: Riding Experience and Achievements Sport Example: Pony Club Experience Horsham Pony Club member for 5 yrs Trackrider / Stablehand for local Trainer Achievements Various placements at events – results attached Section 12: Medical Information Have you experienced or do you suffer from any of the following conditions below (please tick)? Ref. Condition/Injury/Illness 1. Nervous disorders including, nerves, depression, nervous breakdown, mental or emotional instability, anxiety or attempted suicide. Yes No 2. Headaches or Migraines Yes No 3. Fits, Convulsions, turns, blackouts, giddiness or epilepsy Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No 4. 5. 6. 7. 8. 9. 10. 11. 12. Lung or chest infections, pneumonia, bronchitis, asthma or tuberculosis Heart disease, high or low blood pressure, rheumatic fever or angina pectoris Indigestion, pain after eating, gastric or duodenal ulcers, hiatus hernia, gall bladder disease, recurrent diarrhoea or appendicitis Kidney or bladder problems, cystitis (inflammation of the bladder) or stones Diabetes, goitre, thyroid disease or any disease of the lymphatic glands Anaemia or blood disease Perforated ear drums, deafness, tinnitus (noises in the ears) ear discharge or blocked ears Sinusitis, frequent head colds, blocked nose, hay fever or other allergies Back, spine or neck injuries, pain or arthritis Racing Victoria Track Rider Program EOI -5- 13. Fractures or dislocations Yes No 14. Head injuries, knocks or falls during sports or other activities, seen a Doctor or Hospitalised for head injuries, blackouts or loss of consciousness Yes No 15. Skin disease, eczema or dermatitis Yes No 16. Speech impairments or defect Yes No 17. Surgical procedures or hospital admission Yes No 18. Any other illnesses or injuries not mentioned above If yes, please provide details below: Yes No 19. Have you ever made a claim for Workers Compensation Yes No 20. Do you consider yourself to have a disability, impairment or long term condition? (If yes, please specify below). Yes No Hearing/Deaf Physical Intellectual Mental Illness Acquired Brain Impairment Vision Medical Condition Learning Other Unspecified If you have answered ‘yes’ to any of the medical information questions, please provide further details below in the “Details of Condition, Injury and/or Illness” and please ensure you provide the correct reference number. Ref Number Racing Victoria Track Rider Program EOI Details of Condition, Injury and/or Illness -6- Date of last Tetanus Injection / Booster: Do you smoke? (if yes, please provide the number of cigarettes or other tobacco products you smoke per day) No Yes No * Do you consume alcohol? (if yes, please provide the number of standard drinks per day) Yes * Prescriptions Please provide details of any oral, intravenous or topical medications currently prescribed for you by a Medical Practitioner or which have been prescribed for you by a Medical Practitioner in the past. Also, include any of the following items: herbal preparations you use or have used whether prescribed or otherwise vitamins or supplements you use or have used in the past Details of Prescribed Medications by a Medical Practitioner Section 13: Privacy Statement RISC If you do not wish for marketing and promotional material to be sent to you, please tick this box. If you do not wish for your photograph to be used for media articles, advertising or promotional material, please tick this box. I understand that I will incur fees to undertake training. I understand that the RISC (RTO) (TOID: 22215) is required to provide the Victorian Government, through Racing Industry Skills Centre (Contract Body), with student and training activity data which may include information I provide in this enrolment form. Information is required to be provided in accordance with the Victorian VET Student Statistical Collection Guidelines (which are available at www.education.vic.gov.au). The Contract Body may use the information provided to it for planning, administration, policy development, program evaluation, communication, resource allocation, reporting and/or research activities. For these and other lawful purposes, the Contract Body may also disclose information to its consultants, advisers, other government agencies, professional bodies and/or other organisations. The RTO will use the information requested on this form for research, statistical and internal management purposes. In supplying the requested information, the participant is deemed to have consented to use the information for these purposes. The Education and Training Reform Act 2006 requires the RTO to collect and disclose my personal information for a number of purposes including the allocation to me of a Victorian Student Number and updating my personal information on the Victorian Student Register. For more information in relation to how student information may be used or disclosed please contact the RTO on 03 5449 3590or email john.randles@hrtcbendigo.com.auRacing Victoria All personal information collected and retained by Racing Victoria will be treated in accordance with Racing Victoria’s privacy policy. I acknowledge and agree to the terms described in this privacy statement: Signed ____________________________________ Date:_______________________ Section 14: Declaration By signing the Authorisation below, I: • declare that I understand that it is my responsibility to provide all relevant and required documentation; • agree and acknowledge that the giving of false or incomplete information may lead to the refusal of my application or cancellation of my enrolment in the Program; Racing Victoria Track Rider Program EOI -7- • declare that the information provided in the EoI to be provided to the RTO in application for study and any supporting documentation is to the best of my knowledge true, correct and complete at the time of my enrolment/application for the Program; • acknowledge that providing any false information and/or failing to disclose any information relevant to my application for enrolment and/or failure to complete an application/enrolment form may result in the withdrawal of any offer, particularly as it relates to my eligibility to obtain an offer for the government subsided training and/or cancellation of my enrolment at the discretion of RISC. This includes information regarding my standard of riding ability contained in the video footage and the Self Assessment Form; • declare that all information that I have provided within this EoI, including Medical Information (Section 13), video footage, Self Assessment Form and any other attachments are correct and that I have not withheld any information that is relevant to this EoI; • declare that if I am diagnosed with any of the conditions listed in Section 13 or the circumstances of any of the listed conditions I currently have should change, I agree to immediately advise Racing Victoria; • consent to Racing Victoria collecting health information about me for the purposes of assessing my suitability to participate in the Program; • agree to provide all relevant health information regarding my EoI to be offered a place in the Program, including information from other medical practitioners/specialists and access to all my pathology and radiology reports; • If it is not reasonable and practicable for me to provide my health information, I authorise consent for Racing Victoria’s Chief Medical Officer to obtain and collect all relevant clinical information regarding my EoI in participating in the Program. This includes approval to obtain information from other medical practitioners/specialists and access to all pathology and radiology reports; • Also provide consent for Racing Victoria’s CMO, at his or her discretion, to discuss the above health information with nominated representatives of Racing Victoria and external health and allied service providers contracted to Racing Victoria. I am aware that information will be used for the purposes of assessing my suitability to participate in the Program; and • Declare that I understand that l am able to gain access to my health information that is collected by Racing Victoria. Section 15: Authorisation Applicants Name Applicants Signature Date Please note: if the Applicant is under 18 years of age, their legal guardian must complete the following section. Parent / Guardian Name Parent/Guardian Signature Date Please attach relevant documentation listed in the checklist on the following page. Once this form has been completed, please return it and all accompanying documentation to the address below: Racing Victoria –Workforce Development Officer Attention: Lisa Coffey 400 Epsom Road, Flemington VIC 3031 This form and copies of supporting documents can be emailed to l.coffey@racingvictoria.net.au Racing Victoria will forward this form and the accompanying documentation to RISC. Racing Victoria Track Rider Program EOI -8- Racing Victoria Office use only Date Received: EoI Lodged: Logged By: Information Provided to EoI: Racing Victoria Track Rider Program EOI -9- RACING VICTORIA LIMITED ACN 096 917 930 EXPRESSION OF INTEREST Intermediate Track Rider Program Human Resources and Workforce Development 400 Epsom Road Flemington VIC 3031, Australia Telephone: (+61 3) 9258 4328 Facsimile: (+61 3) 9258 4685 Email: l.coffey@racingvictoria.net.au CHECKLIST Section 1: Checklist – Documents to be provided with the EoI Submission Copy of Birth Certificate or Drivers License Yes Copy of Medicare Card (if applicable) Yes Copy of Certificate II or III in Racing (if applicable) Note: If you have completed any racing training e.g. Mandatory Training, a statement of attainment from the TAFE provider is required Yes Video footage demonstrating riding skills Yes Self Assessment Form Yes Please note: EoIs received that are not fully completed and or do not include copies of all documents requested will not be considered. 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