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					Expression of Interest Form
The information that you provide below is essential to determine the suitability of your submission for
funding under the Critical Skills Investment Fund. Priorities for each funding round are available to view on
the website:
This website contains the Critical Skills Investment Fund Guidelines, Fact Sheets, and Draft Funding
Agreement, including detailed information, definitions, and useful examples.
The expression of interest (EOI) must be submitted using this electronic form. The information you provide
is essential to enable effective assessment of your submission’s suitability against the Critical Skills
Investment Fund Guidelines and the priorities of the Funding Round. EOIs that do not use this form will not
be considered for the Application stage .

Submission Details
Successful EOIs will be invited to submit an Application to the Critical Skills Investment Fund.
Privacy Notice
The Department of Education Employment Workplace Relations collects personal information on this form
including your name, position, email address and company for the purpose of assessing your eligibility to
apply for the Critical Skills Investment Fund in accordance with the Privacy Act 1988. Your personal
information will not be otherwise disclosed without your consent unless authorised or required by law.
SECTION A: Lead Organisation, Sector and Priority Details
Legal name of Lead Organisation                                    Australian Business Number(ABN)
Legal Name of Lead Organisation
Trading name
Legal Name of Lead Organisation
Registered business or company address details
Street address                Suburb/Town           State/Territory               Postcode

       Postal address is the same as the street address.
Postal address                Suburb/Town           State/Territory               Postcode

Contact details for the Project - Contact who would be available and have the authority to answer any
queries DEEWR may have about this Project.
Title            First name          Surname                       Position

Phone            Mobile              Fax                           Email

Please indicate which industry sectors your project addresses
       Resources
       Construction
       Infrastructure
       Renewable Energy
       Other
Sector: Workforce Plan Priorities:                  In order of priority complete as many workforce plan
                                                    priorities that your project addresses
Please provide a brief description of the Proposal including the gap analysis; training to be provided; how
the training is responsive and innovative; recipients to receive the training and proposed qualifications and
skill sets.
You must limit your response to 500 words
Five participating employers have identified a skills shortage in shot firing and drilling occupations. The
training solutions involved will up-skill existing workers and then backfill the positions of those existing
workers with new workers. The training will be delivered within the enterprise and within an RTO and will
consist of RPL and regular qualification instruction for existing workers and . A number of existing workers
will also complete skill sets to qualify as leading hand roles.
The project is working with JSA provider and a large recruitment company to source new workers and is
targeting job seekers from the under-represented labour market segments.
103 / 500 words
Government Funding-Have you or do you intend to apply for other Australian and/or State Government
funding for the proposed training element under the Project?                              Yes No
Note: Critical Skills Investment Funding cannot be used in situations where any member of a Partnership
organisation has already secured funding for that particular Project's purpose. Complementary government
funding for pre training activity; and/or concurrent literacy and numeracy and mentoring support, and/or
or post employment placement support is possible
Workforce plan - Will the training activity be based on a completed workforce plan and/or skills needs
analysis at the level of individual employers?
Note: A workforce plan is a necessary requirement for the assessment stage.                       Yes No
Co-investment - Does the Project have agreed enterprise/employer co-investment for each training
activity funded?                                                                           Yes No
Note: Successful training Projects under a proposal will be supported on a sliding scale by the Australian
Government, i.e. the Australian Government would fund 50% of the cost of training places for large
organisations (200 or more employees), and up to 90% of the costs of training places for small businesses
(less than 100 employees). Guidelines
Participating employers and breakdown of training places allocated to existing workers, new workers,
and job seekers
If there is only one participating employer, you are to complete the number of rows equal to the number
of job roles that correspond to training qualification or skill set within that employer. If there are more
than one participating employer, please complete a new row for each job roles available within each of
those employers.
In other words, if a project partnership includes four participating employers with five job roles each, you
are required to complete 20 rows.
Name of   Enterprise         Postcode of   Job role that              Existing     New workers     New workers
employers size               Employmen     corresponds to training    workers      to be trained   to be trained
                             t location    qualifications or skill    to be        with position   without
                                           set                        trained                      position
PE 1        0-99          4000             Mining Support worker                   10              2
PE 2        100-199       6040             Shotfirer                  10
PE 3        200+          4440             Driller’s Assistant                     10              2
PE 4        0-99          4040             Driller Leading Hand       10
PE 5        0-99          6000             Shotfirer Leading Hand     10
To add another row, click the + button.
Note: Skill sets are only eligible for Learners who already posses a Qualification at Certificate III or above.
RTO and Qualification details corresponding job role, number of Learners and cost per Learner
Main site of training delivery
Name of the participating RTO                             WA Advanced Training Solutions
Location                                                  Metro
Address                                                   10 14/22 Gray Road
Suburb/State/Postcode                                     Midvale           WA                  6056
Training delivery                                         Enterprise Based/onsite
Post Code of training delivery                            6040

Qualification or skill set      Qualification Job Role                  Number of Cost per Total
                                Code                                    Learners    Learner      Cost
For each qualification and corresponding job role you are required to add another row, click the + button
Cert II in Mining               RII20609        Mining Support          25          1            25
Field/Exploration Operations                    Worker
Cert III in Underground         RII30309        Shotfirer               19          1            19
Metalliferous Mining
Certificate II in Drilling      RII20909        Driller's Assistant     20          1            20
Certificate III in Drilling     RII31809        Driller                 15          1            15

For each RTO engaged you are required to add another section, click the + button.
Note: Training that is not an Eligible Qualification (see Guidelines) will not be considered for funding. The
following link provides detail of all Eligible Qualifications. http://www.ntis.gov.au
Project duration
Expected project start date                Expected project end date
1/7/2011                                   1/7/2012

Partner Member Details
Name of the recruitment organisation                         Mine recruitment
Address of recruitment organisation                          Big Road
Employment Service Area where new workers will be recruited
For each additional ESA where new workers will be recruited, to add another section, click + button
Please breakdown the following labour markets your project will target
Mature age
Mature age
Mature age
Mature age
How many participants identify as a person with a disability and/or other special requirement?
This section is for information only, the values cannot be changed.
Total cost of training                                 New workers to be trained with job
Total number of learners                               New workers to be trained without job
Average cost of learners                               Existing workers to be trained
Total number of RTOs
confirm that:
       I am a person authorised to make this declaration on behalf of my organisation and all relevant
        partner organisations mentioned have been consulted and have agreed roles and responsibilities.
       The information provided in this form and all appended documents is complete and correct and has
        been submitted on the basis of a comprehensive workforce plan being undertaken.
       I understand the financial commitment that participation in the Critical Skills Investment Fund
        places on the participating employing organisation/s.
The Department of Education, Employment and Workplace Relations (DEEWR) is authorised to undertake
the necessary steps to
assess the proposal from my organisation by checking the information provided in this proposal, or by
obtaining additional information
DEEWR and Other Commonwealth databases and records;
       State or Territory agencies;
       Law enforcement agencies;
       Credit reference agencies;
       Courts or Tribunals;
       Any other appropriate organisation or person as reasonably required as part of these checks.
To the best of my knowledge, there is no conflict of interest that would prevent my organisation from
proceeding with this project.
I understand that should any new information arise (which may affect the outcome of the application) it
must be submitted as soon as possible, in writing to DEEWR.
I understand that:
       my personal information on this form is collected by DEEWR in order to assess my Organisation's
        application for funding under the Critical Skills Investment Fund;
       my personal information will not be otherwise disclosed without my consent unless authorised or
        required by law;
       should funding be awarded to my Organisation, my name [and other relevant information] may be
        published on the DEEWR website;
       In other instances, my personal information on this form may be disclosed without my consent
        where authorised or required by law.
I understand that giving false or misleading information is a serious offence under the Criminal Code.
The 'Save to my computer' button allows you to save a draft copy of your form to your
local computer so you can access the form without being connected to the Internet.
If you have not yet completed your application and want to work on it later click:
When you want to check the form click:

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