Application for initial CRICOS registration
Introduction
Please read the introduction carefully to assist you in applying to the Australian Skills Quality Authority (ASQA) for
inclusion on the Commonwealth Register for Institutions and Courses for Overseas Students (CRICOS).
The details provided in this application will be used by ASQA to assess whether your organisation will be approved as
a CRICOS provider. Before completing the application form, it is important that you check your eligibility to apply to
ASQA. Please refer to the ASQA website for more information.
Applications for intial RTO registration and initial CRICOS registration may be submitted concurrently to ASQA by
eligible organisations.
About this form
You need to complete this form if you are seeking approval for your organisation to deliver Australian Qualifcations
Framework (AQF) award VET courses/qualifications and/or ELICOS programs to international students in Australia
except where delivered:

in the capacity of a school

in the capacity of a higher education provider

under an entry arrangement with at least one higher education provider.
There are seven sections to this application form:

Section 1—Applicant details

Section 2—Ownership, management structure and control of the organisation

Section 3—Applicant history

Section 4—Provider details and proposed delivery

Section 5—Evidence required

Section 6—Application to add an ELICOS course for CRICOS

Section 7—Statutory declaration by Principal Executive Officer
Unless otherwise indicated, you must provide a response to each question and to each part of each question.

This symbol has been used to indicate evidence that needs to be attached to the application.
The application should be read in conjunction with:

The Education Services for Overseas Students Act 2000 (ESOS Act), available at:
http://www.comlaw.gov.au/Series/C2004A00757
Form- Application for initial CRICOS registration, updated 25 September 2013
Page 1 of 31

Education Services for Overseas Students (ESOS) Regulations 2001, available at:
http://www.comlaw.gov.au/Details/F2012C00430

The National Code of Practice for Registration Authorities and Providers of Education and Training to
Overseas Students 2007 (National Code), available at: https://internationaleducation.gov.au

The National Code of Practice 2007 Explanatory Guide, available at: https://internationaleducation.gov.au

The National Vocational Education and Training Regulator Act 2011, available at:
http://www.comlaw.gov.au/Details/C2011A00012

National Standards for ELICOS Providers and Courses (ELICOS Standards), available at:
https://internationaleducation.gov.au/Regulatory-Information/Education-Services-for-Overseas-StudentsESOS-Legislative-Framework/ELICOSnationalstandards/Pages/Default.aspx

the registration and audit information provided on the ASQA website.

In completing the application form, the applicant should reference:

The Commonwealth Register of Institutions and Courses for Overseas Students (CRICOS):
http://www.cricos.deewr.gov.au/

The national register—training.gov.au
Compliance requirements
Organisations seeking CRICOS registration must demonstrate where applicable a thorough working knowledge of,
and compliance with, the:

VET Quality Framework (as defined in the National Vocational Education and Training Regulator Act 2011)

the ESOS Act, ESOS Regulations and the National Code

the ELICOS Standards
The Australian Education International website: https://internationaleducation.gov.au/regulatoryinformation/pages/regulatoryinformation.aspx explains the process and requirements for providers wishing to become
CRICOS registered, including information on membership requirements for the Tuition Protection Service (TPS) and
Entry to Market Charge (EMC)
Application fee
Please refer to the fees and charges section of the ASQA website for information about the fee that will apply to your
application.
If you wish to pay the application fee by credit card, please refer to the final section of this form to provide your credit
card details. Alternatively, you can submit a cheque (personal, business or bank) with your postal application.
Please ensure the name of the organisation (as shown on your application) and your contact details are included with
your cheque.
Please note that application fees are non-refundable.
Applicants are required to pay registration fees and charges which may include an Entry to Market Charge, Annual
Registration Charge and a Tuition Protection Service to the Department of, Innovation, Industry, Science, Research
and Tertiary Education (DIISRTE). Further information can be found at
https://internationaleducation.gov.au/regulatory-information/pages/regulatoryinformation.aspx
Form- Application for initial CRICOS registration, updated 25 September 2013
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Submitting the application
This application may be submitted by email to cricos.registration@asqa.gov.au or submitted as a printed application
to:
Australian Skills Quality Authority
GPO Box 9928
MELBOURNE VIC 3001
Your application must be accompanied by the required attachments. Incomplete applications or applications
completed incorrectly will be returned to you for completion. This form includes a Checklist for submitting an
application for initial CRICOS registration to help you ensure your application is complete.
For assistance in completing this form you can contact the registration team at enquiries@asqa.gov.au or call the
ASQA Info line on 1300 701 801.
Overview of the application process:
Once ASQA has received your complete application, it will be assessed in accordance with the Risk Assessment
Framework.
ASQA will conduct a site visit at your organisation’s premises to determine your compliance with the ESOS Act, ESOS
Regulations and National Code.
Providers offering ELICOS courses will also need to demonstrate compliance with the ELICOS National Standards
Definitions:
Executive officer—
a) A person, by whatever name called, and whether or not a director of the organisation, who is concerned in, or
takes part in the management of the organisation: or
b) If the organisation is body corporate:
(i) a person who, at any time during a period for which the organisation is registered, owns 15% or more
of dividends paid by the organisation; or
(ii) a person who, at any time during a period for which the organisation is registered, is entitled to
receive 15% or more of dividends paid by the organisation; or
(iii) the administrator of a deed of company arrangement executed by an organisation; or
(iv) a trustee or other person administering a compromise or arrangement made between the organisation
and another person or other persons; or
c) An administrator, receiver or manager, or liquidator of the organisation (other than a receiver and manager, or
liquidator, appointed by the court).
High managerial agent—
An employee or agent of the organisation with duties of such responsibility that his or her conduct may fairly be
assumed to represent the organisation in relation to the business or providing courses (‘course’ means a course of
vocational education and training).
A person or entity which exercises a degree of control or influence over the management or direction of the RTO
includes those who make, or participate in making, decisions that affect the business of the applicant, or who have the
capacity to significantly affect future operations and financial standing.
For companies, the details of all directors and shareholders must align to records held by the Australian Securities and
investment Commission (ASIC).
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Principal place of business—
The address from which the business of the applicant will be controlled and managed. This must be a street address
and not a post office box.
Trusts—
In the case of a trust, the legal name of the trustee must be used, and not the name of the trust.
An application cannot be accepted for an unnamed trustee. Registration can only be granted where ‘The Trustee’ is
clearly identified, for example, ‘Mr A Jones as trustee for the Training Family Trust’.
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Section 1
Applicant details (mandatory)
Name of Legal Entity:
Registered business
trading name
(if relevant):
RTO ID number
(if applicable):

(If submitting an RTO application concurrently, write ‘pending’)
Trusts seeking registration must provide an extract from the trust deed document that provides sufficient
information to verify the trustee and the trust.
1.1
Australian Business Number (ABN)
ABN:
1.2
Name of legal entity applying for registration
1.3
Australian Company Number (ACN) (if relevant)
ACN:
1.4

1.5

Type of legal entity
Evidence of the type of legal entity
Natural person (sole trader)
Pty Ltd company
Ltd company
Incorporated association
Partnership
Co-operative association
Government entity
Other (Specify):
Registered business (trading) name/s (if relevant)
Copy or extract of the registration of a business name as issued by the relevant authority
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1.6
Address of head office of entity applying for registration
Head office
Street Address:
Postal Address
(if different from street address):
Phone:
1.7
Website:
Principal place of business of entity applying for registration (if different from head office)
Principal place of business
Street address:
Phone:
Contact person
Title:
Surname:
Given name(s):
If contact person is not an employee of the applicant
entity, enter name of employer organisation:
Position:
Phone:
Email:
1.8
Principal purpose of the provider is to provide education
1.9
Clearly demonstrated capacity to deliver education to a satisfactory standard
Provide a brief statement of claims (no more than two pages) against 1.8 and 1.9
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Section 2
2.1
Ownership, management structure and control of the organisation
Details of all natural persons who own/are the legal entity applying for CRICOS registration
Refer to definition of ‘executive officer’ and ‘high managerial agent’ in the introduction.
Please note that all company directors and shareholders must be listed and these details must align to records held by
the Australian Securities and Investments Commission (ASIC).
Owner 1
Title:
Surname:
Phone:
Given name(s):
Mobile:
Email:
Residential address:
This person is best described as (select one):
Owner and executive officer
Owner and high managerial agent
Owner and a person who will exercise a degree of control or influence over the management or direction of
the organisation but who is not an executive officer or high managerial agent
Owner and a person who will not exercise a degree of control or influence over the management or direction
of the organisation and who is not an executive officer or high managerial agent
Describe the role this person will undertake in relation to the training organisation (position title alone is not
sufficient):
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Owner 2
Title:
Surname:
Phone:
Given name(s):
Mobile:
Email:
Residential address:
This person is best described as (select one):
Owner and executive officer
Owner and high managerial agent
Owner and a person who will exercise a degree of control or influence over the management or direction of
the organisation but who is not an executive officer or high managerial agent
Owner and a person who will not exercise a degree of control or influence over the management or direction
of the organisation and who is not an executive officer or high managerial agent
Describe the role this person will undertake in relation to the training organisation (position title alone is not
sufficient):
Owner 3
Title:
Surname:
Phone:
Given name(s):
Mobile:
Email:
Residential address:
This person is best described as (select one):
Owner and executive officer
Owner and high managerial agent
Owner and a person who will exercise a degree of control or influence over the management or direction of
the organisation but who is not an executive officer or high managerial agent
Owner and a person who will not exercise a degree of control or influence over the management or direction
of the organisation and who is not an executive officer or high managerial agent
Describe the role this person will undertake in relation to the training organisation (position title alone is not
sufficient):
Tick this box if additional tables are attached.

All owners must complete a Fit and Proper Person Requirements Declaration.
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2.2
Details of other entities (not natural persons) that own the legal entity applying for CRICOS
registration
Please note that all shareholders must be listed and these details must align to records held by ASIC or other state or
territory business registers as displayed on the Australian Business Register (ABR).
Entity 1
Name:
Entity type:
Pty Ltd company
Natural Person (Sole Trader)
Cooperative association
Trust
Incorporated association
Government entity
Ltd company
Other (specify):
Pty Ltd company
Natural Person (Sole Trader)
Cooperative association
Trust
Incorporated association
Government entity
Ltd company
Other (specify):
% share:
Entity 2
Name:
Entity type:
% share:
Tick this box if additional tables are attached.

All shareholders of the legal entity applying for registration must complete a Fit and Proper Person
Requirements Declaration.

A Certificate of Incorporation and historical company extract has been attached for each shareholder that is a
Pty Ltd or Ltd company
2.3
Details of influential non-owners of the legal entity applying for CRICOS registration
Person 1
Title:
Surname:
Phone:
Given name(s):
Mobile:
Email:
Residential address:
This person is best described as (select one):
An executive officer but not an owner
A high managerial agent but not an owner
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A person who will exercise a degree of control or influence over the management or direction of the
organisation but who is not an executive officer or high managerial agent or an owner
Describe the role this person will undertake in relation to the training organisation (position title alone is not
sufficient):
Person 2
Title:
Surname:
Phone:
Given name(s):
Mobile:
Email:
Residential address:
This person is best described as (select one):
An executive officer but not an owner
A high managerial agent but not an owner
A person who will exercise a degree of control or influence over the management or direction of the
organisation but who is not an executive officer or high managerial agent or an owner
Describe the role this person will undertake in relation to the training organisation (position title alone is not
sufficient):
Tick this box if additional tables are attached.

2.4
Influential non-owner/s must complete a Fit and Proper Person Requirements Declaration.
Existing operations within Australia
Does the entity seeking registration have any existing business operations in Australia?
No
2.5
Yes. If yes—describe the nature of those operations in the space below.
Existing operations outside Australia
Does the entity seeking registration have any existing business operations outside Australia?
No
Nature of operations
Yes. If yes—describe the nature of those operations in the space below, including the
countries involved?
Country/ countries involved
Form- Application for initial CRICOS registration, updated 25 September 2013
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Section 3
3.1
Applicant history
Does any natural person or other entity named in Section 2 currently hold registration as an RTO or
CRICOS provider registered with ASQA or with a state or territory registering body?
No
Yes. If yes—provide details in the table below.
Current registration
Which person or entity?:
Legal name of RTO:
Trading name(s):
RTO/CRICOS ID number:
State or territory registering body:
Current period of registration:
From:
ACN:
ABN:
To:
Chief executive of the RTO:
3.2
Is any natural person or other entity named in Section 2 currently associated with an RTO or CRICOS
provider registered with ASQA or with a state or territory registering body?
No
Yes. If yes—provide details in the table below.
Current association
Which person or entity?:
Legal name of RTO:
Trading name(s):
RTO/CRICOS ID number:
State or territory registering body:
Current period of registration:
From:
ACN:
ABN:
To:
Chief executive of the RTO:
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3.3
Has any natural person or other entity named in Section 2 ever been registered as an RTO or CRICOS
provider with ASQA or with a state or territory registering body (do not include current registration/s
held)?
No
Yes. If yes—provide details in the table below.
Previous registration
Which person or entity?:
Legal name of RTO:
Trading name(s):
RTO/CRICOS ID number:
State or territory registering body:
Period of registration:
From:
ACN:
ABN:
To:
Chief executive of the RTO:
Which person or entity?:
3.4
Has any natural person or other entity named in Section 2 ever been associated with an RTO or
CRICOS provider registered with ASQA or with a state or territory registering body?
No
Yes. If yes—provide details in the table below.
Previous association
Which person or entity?:
Legal name of RTO:
Trading name(s):
RTO/CRICOS ID number:
State or territory registering body:
Current period of registration:
From:
ACN:
ABN:
To:
Chief executive of the RTO:
Form- Application for initial CRICOS registration, updated 25 September 2013
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3.5
Apart from this application, does any natural person or other entity named in Section 2 have an
application for registration currently lodged with ASQA or a state or territory registering body?
No
Yes. If yes—provide details in the table below.
Other current pending registration
Which person or entity?:
Legal name of RTO:
Trading name(s):
State or territory registering body:
ACN:
ABN:
Chief executive of the training organisation:
3.6
Apart from this application, does any natural person or other entity named in Section 2 have an
association with any entity that currently has an application for registration lodged with ASQA or a
state or territory registering body?
No
Yes. If yes—provide details in the table below.
Other current pending registration
Which person or entity?:
Legal name of RTO:
Trading name(s):
State or territory registering body:
ACN:
ABN:
Chief executive of the training organisation:
Form- Application for initial CRICOS registration, updated 25 September 2013
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Section 4
4.1
Provider details and proposed delivery
Principal Executive Officer (legally responsible person for registration)
Principal Executive Officer contact details
Title:
Surname:
Given name(s):
Street address:
Position:
Address:
Phone:
Mobile (if relevant):
Email:
Fax (if relevant):


The Principal Executive Officer must complete a Fit and Proper Person Requirements Declaration.
The Principal Executive Officer must attach an employment history for the last five years.
4.2
Contact for general enquiries
General enquiries contact details (details must be provided for a person or a group)
Person—if a specific individual will be the contact for general enquiries:
Title:
Surname:
Given name(s):
Position:
Phone:
Mobile (if relevant):
Email::
Fax (if relevant):
OR
Group—if a group will be the contact for general enquiries (e.g. reception):
Group:
Phone:
Mobile (if relevant):
Email::
Fax (if relevant):
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4.3
Registration contact person
Registration contact details
Is this person an employee of the applicant (legal entity)?
Yes
No—insert name of
employer organisation:
Title:
Surname:
Given name(s):
Position:
Phone:
4.4
Mobile (if relevant):
Student capacity (mandatory)
Total number of students proposed:
(this is the total combined number of domestic and
international students that the organisation is proposing to
service)
Maximum number of overseas student places proposed:
Please note that consideration will be given to student capacity
in terms of premises, approved arrangements with other
providers, facilities, resources, equipment, materials and ratio
of staff to student numbers as per Part C, Sections 6.1b and
12.1 and Part D, Standard 14 of the National Code.
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4.5
Proposed delivery site/s for international students
An entry must be completed for every location to be used as a permanent training site.
Delivery site 1
Street address:
Contact person
Title:
Surname:
Given
name(s):
Position:
Email:
Do you own these premises?
Phone:
Yes
No
Yes
No
If no, what is the expiry date of the
current lease?
Do you have the required occupancy
approval?
Code and title of
qualification/course/programs
delivered at this site:
Proposed total number of students
for this site:
Tick this box if details of more delivery sites are attached.

Attach evidence that each proposed delivery site has approval for occupancy by the relevant regulatory body in
the relevant state or territory.
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4.6
Proposed scope of CRICOS delivery (mandatory)
Use this table to indicate the qualifications, courses or programs your organisation is proposing to deliver to international students. The information that you provide in this
table is required for entry on the Provider Registration and International Student Management System (PRISMS). If applying for an English Language Intensive Courses for
Overseas Students (ELICOS) to be added to CRICOS you MUST complete Section 6 of this application.
Please note: All fields must be completed, please refer to www.abs.gov.au for information regarding Field of Education.
Contact
Total
Total number
course or program
cost to
hours per
number of
of
title
include
week
domestic
international
program level
students
students
Detailed Field
applicable)
Narrow Field
program (if
Broad Field
course or
tuition fees
plus any
additional
costs
$
Work-Based Training
component 
Partnership
Full address of each
arrangements
(Yes/No) 
Course location site/s
Mode of study
Total hours
Course
Number of weeks
course or
qualification
Duration in weeks
Hours per week
of
Field of Education
Duration (total)
Qualification,
Duration holiday breaks
Qualification,
Duration—tuition
National code
Face-to-face at RTO premises
Face-to-face at workplace
Online
Distance
$
Face-to-face at RTO premises
Face-to-face at workplace
Online
Distance
$
Face-to-face at RTO premises
Face-to-face at workplace
Online
Distance

Please attach evidence that if the course has a work-based requirement appropriate arrangements for the supervision and assessment of overseas students
Form- Application for initial CRICOS registration, updated 25 September 2013
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4.7
Proposed operating context
Does your organisation intend to have any partnership or subcontracting
arrangements?
Yes 
No
Does your organisation intend to accept fees in advance from students?
Yes
No
Does your organisation intend to deliver VET training and/or assessment services to
school students?
Yes
No
Is it expected that your organisation will deliver training and/or assessment services
to students under the age of 18?
Yes
No

If other providers are to be involved, provide clear information about the role played by each provider in the
delivery of the course including where and how the course will be delivered and how you will ensure compliance
with the National Code.
Form- Application for initial CRICOS registration, updated 25 September 2013
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Section 5
Evidence required
The following evidence must be attached to this application:

An employment history for the Principal Executive Officer for the last five years.

A Fit and Proper Person Requirements declaration, including a current National Police Clearance Certificate
(issued within the last three months), completed by the Principal Executive Officer, executive officer/s and
high managerial agent/s.

Evidence that each proposed delivery site has approval for occupancy by the relevant regulatory body in the
relevant state or territory.

If the course includes a work-based training component you must attach evidence of how you will access
employers who will agree to provide quality work-based training and the arrangements for supervision and
assessment of overseas students.

If other providers are to be involved, provide clear information about the role played by each provider in the
delivery of the course including where and how the course will be delivered and how you will ensure
compliance with the National Code.

A copy of all the information to be provided to students prior to their enrolment.

An annual timetable, using the template provided (see Appendix A), for each qualification, course or program
listed on your proposed scope of CRICOS registration. The timetable should clearly identify that no more than
25% of training is delivered via distance and online learning. This timetable should also indicate student
numbers, class locations/sizes and trainer/assessor arrangements, and reflect the minimum 20 contact hours
per week required under Section 7.3 of the National Code.

If applying to deliver an ELICOS course you must provide all evidence required under Section 6.
Applications submitted without all of the required evidence (listed above) will be considered incomplete and returned
to the applicant.
Evidence and attachments must be clearly referenced to the relevant sections of the application form. Information that
is not compiled in a manner that renders it easily identifiable will be considered incomplete and returned.
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Section 6
Application to add an English Language Intensive Course for Overseas
Students (ELICOS) course to CRICOS
6.1
Course Overview
6.2
Course titles:
Provide the full title of the course. (Please use a separate form for each course)
6.3
Ownership of copyright details:
If the course is owned by a legal entity or individual other than the provider please attach approval from the owner of
the copyright to use the course. 
6.4
Course rationale:
Outline the rationale for the course including any relationship with other courses.
6.5
Articulation arrangements:
Provider name
Course name
Copy and complete additional tables if there are more than one articulation arrangement. Please attach a copy of all
formal articulation agreements with other providers. 
6.6
Modes and methods of delivery:
Outline the modes and methods of delivery for the course.
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6.7
Course entry requirements:
Provide details of the entry requirements for the course.
Education level
requirements
English language
requirements
Age requirements
6.8
Overall structure of course:
Complete the table to provide details of the overall structure of the course.
Actual course duration in scheduled contacts hours
Total number of weeks during which structured teaching will take place
Total number of weeks of course duration including any breaks
Total number of weeks of breaks that will occur of the duration of the course
Timetabled student face to face contact hours per week
Expected hours per week for ‘other study’ ie. personal or group study
6.9
Detailed course syllabus:
Please attach a detailed syllabus for the course. The syllabus must include the learning outcomes that students can
expect to achieve as they progress through the course.
6.10
Strategy for ongoing course evaluation and review:
6.11
Profile of target learner group:
Outline the profile of the target learner group for the course.
6.12
Strategy for monitoring learner progress against Standard 10 of the National Code
6.13
Strategy for assessing achievement of learner outcomes:
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6.14

6.15
Certification of completion and partial completion:
Please attach samples of certification of completion and partial completion.
Teaching staff experience and qualifications:
Name of staff member
Qualification/s
Experience
Copy and complete additional tables if there are more than three teaching staff.
6.16
Key and supplementary print-based and electronic resources:
Please list key and supplementary print-based and electronic resources for each course.
6.17
Maximum course fee for the course:
Tuition fees
Compulsory non-tuition fees
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Section 7
Statutory declaration by Principal Executive Officer
This statutory declaration must be completed by the Principal Executive Officer of the organisation seeking approval to
deliver qualifications/courses/programs to international students in Australia.
This declaration cannot be completed on screen. Please print the declaration and complete using a blue or black pen.
If emailing your application to ASQA, you will need to scan this declaration.
Commonwealth of Australia
Statutory Declaration
Statutory Declarations Act 1959
1 Insert the
name,
I,1 ________________________________________________________________________________
address
and
occupation
__________________________________________________________________________________
of person
making the
__________________________________________________________________________________
declaration
make the following declaration under the Statutory Declarations Act 1959:
1.
I declare that I have read and understand the National Code of Practice for Registration
Authorities and Providers of Education and Training to Overseas Students 2007 (the National
Code).
2.
I declare that if approval is granted I will accept responsibility for ensuring compliance with the
National Code of Practice for Registration Authorities and Providers of Education and Training
to Overseas Students 2007 (the National Code). the Education Services for Overseas Students
Act 2000 (ESOS Act) and the Education Services for Overseas Students Regulations 2001
3.
I declare that I understand that the Australian Skills Quality Authority (ASQA):
4.
3 Signature

may share information about this application with other state and territory registering
bodies and with other relevant authorities, bodies, persons and agencies in accordance
with the ESOS Act

will audit my organisation to assess compliance with the standards for registered
providers within the National Code, ESOS Act and the Education Services for Overseas
Students Regulations 2011.

may refuse this application if my organisation fails to provide true and correct information
of a material nature in this application or fails to fulfil the undertakings made in this
declaration.
I understand that a person who intentionally makes a false statement in a statutory declaration
is guilty of an offence under section 11 of the Statutory Declarations Act 1959, and I believe
that the statements in this declaration are true in every particular.
3
of person
making the
declaration
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4 Place
Declared at 4
on 5
of 6
5 Day
6 Month and
Before me,
year
7 Signature
7
of person
before
whom the
declaration
is made
(see over)
8 Full name,
8
qualification
and
address of
person
before
whom the
declaration
is made (in
printed
letters)
Note 1 A person who intentionally makes a false statement in a statutory declaration is guilty of an offence, the punishment for which is
imprisonment for a term of 4 years — see section 11 of the Statutory Declarations Act 1959.
Note 2 Chapter 2 of the Criminal Code applies to all offences against the Statutory Declarations Act 1959 — see section 5A of the Statutory
Declarations Act 1959.
Form- Application for initial CRICOS registration, updated 25 September 2013
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A statutory declaration under the Statutory Declarations Act 1959 may be made before–
1.
a person who is currently licensed or registered under a law to practise in one of the following occupations:
Chiropractor
Dentist
Legal practitioner
Medical practitioner
Nurse
Optometrist
Patent attorney
Pharmacist
Physiotherapist
Psychologist
Trade marks attorney
Veterinary surgeon
2.
a person who is enrolled on the roll of the Supreme Court of a State or Territory, or the High Court of Australia, as a legal practitioner (however described); or
3.
a person who is in the following list:
Agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public
Australian Consular Officer or Australian Diplomatic Officer (within the meaning of the Consular Fees Act 1955)
Bailiff
Bank officer with 5 or more continuous years of service
Building society officer with 5 or more years of continuous service
Chief executive officer of a Commonwealth court
Clerk of a court
Commissioner for Affidavits
Commissioner for Declarations
Credit union officer with 5 or more years of continuous service
Employee of the Australian Trade Commission who is:
a. in a country or place outside Australia; and
b. authorised under paragraph 3 (d) of the Consular Fees Act 1955; and
c. exercising his or her function in that place
Employee of the Commonwealth who is:
a. in a country or place outside Australia; and
b. authorised under paragraph 3 (c) of the Consular Fees Act 1955; and
c. exercising his or her function in that place
Fellow of the National Tax Accountants’ Association
Finance company officer with 5 or more years of continuous service
Holder of a statutory office not specified in another item in this list
Judge of a court
Justice of the Peace
Magistrate
Marriage celebrant registered under Subdivision C of Division 1 of Part IV of the Marriage Act 1961
Master of a court
Member of Chartered Secretaries Australia
Member of Engineers Australia, other than at the grade of student
Member of the Association of Taxation and Management Accountants
Member of the Australasian Institute of Mining and Metallurgy
Form- Application for initial CRICOS registration, updated 25 September 2013
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Member of the Australian Defence Force who is:
a. an officer; or
b. a non-commissioned officer within the meaning of the Defence Force Discipline Act 1982 with 5 or more years of continuous service; or
c. a warrant officer within the meaning of that Act
Member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the National Institute of Accountants
Member of:
a. the Parliament of the Commonwealth; or
b. the Parliament of a State; or
c. a Territory legislature; or
d. a local government authority of a State or Territory
Minister of religion registered under Subdivision A of Division 1 of Part IV of the Marriage Act 1961
Notary public
Permanent employee of the Australian Postal Corporation with 5 or more years of continuous service who is employed in an office supplying postal services to the
public
Permanent employee of:
a. the Commonwealth or a Commonwealth authority; or
b. a State or Territory or a State or Territory authority; or
c. a local government authority;
with 5 or more years of continuous service who is not specified in another item in this list
Person before whom a statutory declaration may be made under the law of the State or Territory in which the declaration is made
Police officer
Registrar, or Deputy Registrar, of a court
Senior Executive Service employee of:
a. the Commonwealth or a Commonwealth authority; or
b. a State or Territory or a State or Territory authority
Sheriff
Sheriff’s officer
Teacher employed on a full-time basis at a school or tertiary education institution
Form- Application for initial CRICOS registration, updated 25 September 2013
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Checklist for submitting an initial CRICOS registration application
To avoid any delay in the processing of your application, please ensure that your application is complete and check
that all of the required evidence has been attached.
Applications which are not accompanied by the required evidence will be returned to your organisation for completion.
Section 1 Applicant Details
1.1–1.7
Full and accurate responses have been provided to all questions
1.4
Evidence of the type of legal entity is attached
1.5
A copy or extract of a Certificate of the Registration of a Business Name, as issued by the relevant
authority for each business/trading name, is attached
Section 2 Ownership, management structure and control of the organisation
2.1–2.5
Full and accurate responses have been provided to all questions
2.1
A Fit and Proper Person Requirements declaration has been completed by each executive officer
and high managerial agent and attached
2.2
A Certificate of Incorporation and historical company extract has been attached for each
shareholder that is a Pty Ltd or Ltd company
A Fit and Proper Person Requirements declaration has been completed by each non-natural
person that owns the legal entity applying for registration and attached
2.3
A Fit and Proper Person Requirements declaration has been completed by each influential nonowner and attached
Section 3 Applicant history
3.1–3.6
Full and accurate responses have been provided to all questions
Section 4 Providers details, scope and operating context
4.1–4.9
Full and accurate responses have been provided to all questions
Approval for occupancy has been attached for each proposed delivery site
An annual timetable and structure has been attached for each listed qualification, course or
program
A Fit and Proper Person Requirements declaration has been completed by relevant personnel
Table A
Full and correct codes and titles have been used
Copies of partnership arrangements (if applicable)
Copies of work-based training agreements (if applicable)
Form- Application for initial CRICOS registration, updated 25 September 2013
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Section 5 Evidence required
The requested evidence has been provided
Section 6 Application to add an ELICOS course (if applicable)
Application has been completed and evidence provided
Section 7 Statutory declaration by Principal Executive Officer
The statutory declaration has been signed by the Principal Executive Officer and witnessed by an
authorised person
General
Credit card details have been provided—or a cheque has been attached—for the correct application
fee
Applicant to complete:
All required evidence has been included. I understand that an application submitted without a completed checklist
and/or without evidence against this condition will be considered incomplete and returned to me.
Signature:
__________________________________________________________________________
Title:
______________________________________
Form- Application for initial CRICOS registration, updated 25 September 2013
Date:
_________________________
Page 28 of 31
Application fee for Initial CRICOS registration
Payment can be made by cheque or credit card. Cheques are to be made out to the Australian Skills Quality Authority
and submitted with your application. If you wish to pay by credit card, please complete the form below
Credit Card Information
If paying by credit card please complete the following details:
MasterCard
Card type:
Visa
Card number:
Expiry Date:
Name on card:
CCV:
/
Signature:
Payment amount:
$
Date:
/
/
Please send receipt
for this payment to
(postal or email
address):
Form- Application for initial CRICOS registration, updated 25 September 2013
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Appendix A: CRICOS timetable summary form
Use this table to indicate the qualifications, courses or programs that your organisation is proposing to deliver to international students. Examples have been provided. Extra
rows can be added as required. If additional pages are required, you can download the CRICOS timetable summary form from the ASQA website as a separate document.
Qualifications — please list entire scope
National Code of qualification, course or
Qualification, course or program title
Class *
program (if applicable)
Example
BSB40207
Student
Shift **
Course dates
Breaks (holidays)
1
4 Jan – 1 Oct 2010
1 – 12 March 2010
numbers
Certificate IV in Business
BIV-A
23
3 – 14 May 2010
19 – 30 July 2010
N/a
English for Tertiary Entrance
HIII-A
15
2
4 Jan – 1 Oct 2010
1 – 12 March 2010
3 – 14 May 2010
19 – 30 July 2010
*
Colleges with more than one class, please identify the name or number of the class e.g. BIV-A BIV-B etc.
**
Shifts times to be indicated below
Shifts—please provide a summary of shifts
Example
3 shifts
Shift 1 – Monday to Friday morning – 8.30 am to 12.45 pm
Shift 2 – Monday to Friday afternoon – 1.00 pm to 5.15 pm
Shift 3 – Monday to Friday evening – 5.30 pm to 9.45 pm
Form- Application for initial CRICOS registration, updated 25 September 2013
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Timetable
Qualification, course or program title and code
Trainer
Class (student number)
Times
Days
Room
Example
Certificate IV in Business BSB40207
John Smith
BIV-A (23)
8.30 am – 12.45 pm
Monday to Friday
Room 5 level 1
English for Tertiary Entrance
Mary Jones
HIII-A (15)
8.30 am – 12.45 pm
Monday/Tuesday
Room 4 level 1
1.00 pm – 5.15 pm
Wed/Thurs/Fri
Green Street Kitchen
Delivery and assessment schedule per qualification
Qualification, class and commencement date:
Example: Certificate III in Hospitality, HIIIA, commencing 4 January 2010
Week (indicate date)
Subject/unit/module
Assessment schedule
Example ***
Week 1
SITXOHS001A Follow health, safety and security procedures
Learning activity only in week one. Assessments will begin in week 2.
Beginning 4 Jan 2010
SITXOHS002A Follow workplace hygiene procedures
Week 2
SITXOHS001A Follow health, safety and security procedures
Assessment Task 1 – Written and oral Q and A: Legislative OH&S requirements.
Beginning 11 Jan 2010
SITXOHS002A Follow workplace hygiene procedures
Assessment Task 2 – Practical activity/observation: Student demonstrates skills in lifting, handling, stacking and storing goods.
SITHCCC003A Receive and store kitchen supplies
***
Example is only given for first 2 weeks. Please complete the timetable for study period indicating all assessment weeks.
Form- Application for initial CRICOS registration, updated 25 September 2013
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