PERSONAL DETAILS BASIS FOR APPLICATION

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "PERSONAL DETAILS BASIS FOR APPLICATION"

Transcription

1 APPLICATION FM (for transitional arrangements only) APS SUPERVISED PRACTICE ASSOCIATE MEMBER - MASTERS ROUTE APS COLLEGES PERSONAL DETAILS Dr c Mr c Mrs c Ms c Miss c Other c Family name: Former name (if applicable): Given names: Date of birth: / / Preferred mailing address: Other details: Position/title: Organisation: State: Postcode: APS Member Number: APS Grade: Preferred telephone:( ) Mobile: BASIS F APPLICATION Master of Psychology 1a. I have completed an APAC accredited and College approved Master of Psychology in: 1b. I have completed an APAC accredited and College approved PhD/Master of Psychology in: c Clinical Neuropsychology c Counselling Psychology c Health Psychology c Clinical Psychology c Educational & Developmental Psychology c Organisational Psychology c Community Psychology c Forensic Psychology c Sport & Exercise Psychology AND 2. I wish to be elected to the grade of Associate Member of this College YES c 1 OF 5

2 APS MEMBER WITH AN APAC ACCREDITED AND COLLEGE APPROVED MASTERS PHD/MASTERS IN PSYCHOLOGY These guidelines have been prepared to assist applicants for the grade of Associate Member of an APS College under the transition rules. The provisions of the relevant transition rules are as follows (APS Generic Rules for Colleges 2011): 9. TRANSITIONAL PROVISIONS F MEMBERSHIP 9.1 To qualify for election to the grade of Member of a College under the previous criteria for grades of membership of a College as set out in the Generic Rules in force and effect on 30 September 2010, an applicant must have: (a) completed an Accredited and College Approved Masters program or the coursework and practicum components of a combined PhD/Masters program in psychology in the specialist field of the College, and: (i) have commenced a supervision program by 30 September 2010; and (ii) notified the Society of having commenced supervision by 30 December 2010; and (iii) subsequently completed that supervision program by 30 June 2013; and (iv) the supervision program must be assessed by the College as sufficient for qualification for election to the grade of Member of that College; (b) been enrolled in an Accredited and College Approved postgraduate professional psychology program on 30 June 2010 and completed all degree requirements and any necessary period of Supervised Practice; (c) completed an Accredited and College Approved postgraduate professional psychology program between 30 June 2005 and 30 June 2010 and completed any necessary period of Supervised Practice by 30 June Note: To progress from Associate Member grade to Member grade of a College, under the transition rules, the successful completion of one year full time equivalent Supervised Practice is required. This Supervised Practice can be registered with the APS by completing the APS Supervised Practice: Registration and Agreement Form. Progress reports are required at six (6) monthly intervals. Supervised Practice definition in the Generic Rules for Colleges: Supervised Practice means, for each one year full-time equivalent; a) A minimum of 40 hours of supervision during psychological practice by an *Approved Supervisor; and b) A minimum of 40 hours **active professional development during psychological practice; and c) Such requirements may be further stipulated in the Standing Orders of the Society. Approved Supervisor (Transition provisions under Standing Orders) * Approved Supervisor means a person holding the grade of Member of the relevant College of at least two years standing, or who has been eligible to hold the grade of Member of the relevant College for a minimum of at least two years, who: (a) has completed a training program in psychology supervision approved by the Society^; (b) holds general registration as a psychologist without restriction or conditions; (c) is not a member of the supervisee s immediate family or household; and (d) is not or has not been engaged in a therapeutic relationship with the supervisee. ^ At the time that a training program in Supervision is approved by the Society, any person who at that time is an Approved Supervisor will have until 30 June 2013 to complete the training program. Any person who has not previously been approved as a supervisor for the relevant College at the time a training program in psychology supervision is approved by the Society, will have to complete the training program in addition to fulfilling the other requirements for approval as a supervisor prior to being approved as a supervisor for the relevant College. During psychological practice includes the provision of direct clinical care or using professional knowledge in a direct nonclinical relationship with clients, working in management, administration, education, research, advisory, regulatory or policy development roles, and any other roles that impact on safe, effective delivery of services in the profession. **Active professional development means:.. activities that engage the participant in active training through written or oral activities designed to enhance and test learning - refer APS CPD requirements: 2 OF 5

3 ACADEMIC RECD Please list below all undergraduate and postgraduate qualifications in psychology that you have been awarded. Name of institution Qualification(s) Month and year completed IMPTANT! Documentation of qualifications If you do not submit supporting documentation in the manner outlined below, your application cannot be processed. Transcripts For each degree, please attach official academic transcripts, that itemise each subject undertaken and show completion or conferral of each degree. Academic transcripts may be submitted in either original format or as a *certified photocopy. Documentation submitted to the APS in support of your application will not be returned. If your transcripts are in another name to that listed on the front of this form, please provide certified documentation of your change of name (for example, Marriage Certificate or Change of Name Certificate). Please notify the College Assessment Team if you believe the APS already holds the relevant transcript(s). *Certified photocopy Photocopies of documentation must be certified as true copies of the original by one of the following certifying officers: Member of the Society (MAPS, FAPS, Hon FAPS), accountant, Justice of the Peace, lawyer, pharmacist, physiotherapist, police officer, psychologist. Each photocopied page should be marked certified as a true copy of the original and include the signature and printed name, profession, registration number and telephone number of the certifying officer. The certifying officer must not be a family member or spouse. Major research thesis title(s) Thesis Title Supervisor s Name 3 OF 5

4 PROPOSER F APPLICANT As part of the APS College application process, all applicants need to be proposed by one current Member of the APS College they are applying for. I, the undersigned, propose and believe that she/he is a fit and proper person to be elected to the grade of Associate Member of the APS College of (insert College name) Psychologists. Last Name: Given Name: Telephone W: ( ) Mobile: ( ) YES c NO c APS College Grade of Member: APS Member Number: Signature: Date: / / APPLICANT S DECLARATION YES NO (a) Are you under investigation by the Psychology Board of Australia (PsyBA) as the result of a notification? (b) Have you had an adverse finding made against you by the PsyBA? (c) Have you been convicted of an offence involving a criminal charge, or is there any charge pending? Note: If you responded YES to any of the above questions, please attach an explanation to this application (including details of the outcome). Mark it IN CONFIDENCE and address it to the Executive Manager: Science, Education and Membership. In evaluating your application, the Executive Manager: Science, Education and Membership will consider your response to these questions and may request further information. A positive answer to any of the above questions will not automatically result in rejection of the membership application. Each application will be considered individually. I hereby declare that: 1. All information submitted by me in this application is true to the best of my knowledge. I understand that any misleading statement, or omission, may be cause for rejection of this application. 2. I understand that if my application is unsuccessful, or if I withdraw or don t complete my application, I will be charged a processing fee of up to a maximum of $ If I become a Member of an APS College, I will be bound by the Generic Rules for Colleges and any other rules or regulations adopted by the APS including the Terms and Conditions for APS College Applications and the APS Privacy Policy (Copies of the above documents are available on the APS website or alternatively from the National Office of the APS). 4. I have read and understood the Terms and Conditions for APS College Applications and the APS Privacy Policy. Signature: Date: / / PAYMENT Membership for the Subscription year ending 31 May 2016 The College membership assessment fee includes complimentary College membership. There are three payment periods for Members, depending on when you join: If you join between 1 June 2015 and 30 November 2015 _ you pay $ (incl GST) If you join between 1 December 2015 and 10 February 2016 you pay $ (incl GST) If you join between 11 February 2016 and 31 May 2016 _ you pay $179.00^ (incl GST) ^ When joining between 11 February and 31 May 2016 you will receive College Membership until 31 May 2017 which means getting up to 3 months complimentary College Membership. 1. If you are paying by cheque, please make it payable to: The Australian Psychological Society Limited (Australian dollars only please). 2. If you are paying by credit card, please complete the following details: c APS American Express c American Express c Mastercard c VISA Amount: $ Card number: Expiry date: / Card holder s name (please print clearly): Card holder s Signature: Date: / / The Australian Psychological Society Limited ABN: This document becomes a Tax Invoice for GST upon payment. Please photocopy this form for your records. 4 OF 5

5 COLLEGE MEMBERSHIP DIRECTY The College has developed a Membership Directory for each College which assists members to network and connect within their College. Only members of the same College can access the College Membership Directory. The following details would be disclosed: Title, First name, Last name, Telephone number, Work place, State/Territory. Further options include provisions for expressing interest in peer consultation and providing supervision to provisional psychologists. c Please tick the box if you would like to be listed in the College Membership Directory. CHECKLIST Processing is dependent on receipt of all of the following documents. Please tick boxes to indicate inclusion: c This completed application form c Completed academic record c Certified copies of all relevant transcripts c Supervised Practice: Registration and Agreement form (if applicable) c Application for Approval as a Supervisor form (if applicable) c Proposers signatures and details c Signed declaration c Payment of fee SEND FM TO... Once you have completed this form, please send it together with all relevant documents and payment to: Attention: APS College Assessment Team The Australian Psychological Society Limited PO Box 38, Flinders Lane VIC 8009, AUSTRALIA Telephone enquiries to APS Colleges on or toll free enquiries to Application outcome: APPROVED c NOT APPROVED c Name of assessor Signature of assessor Date: / / 5 OF 5 15APSCOL-F-SP-T-AMMR-P2

STUDENT SUBSCRIBER. Application for admission. psychology.org.au. April 2015

STUDENT SUBSCRIBER. Application for admission. psychology.org.au. April 2015 STUDENT SUBSCRIBER Application for admission April 2015 psychology.org.au STUDENT SUBSCRIBER Belonging to the Australian Psychological Society (APS) means you are part of an active, progressive organsiation

More information

APPLICATION FORM ASSESSMENT OF PSYCHOLOGY QUALIFICATIONS

APPLICATION FORM ASSESSMENT OF PSYCHOLOGY QUALIFICATIONS APPLICATION FORM ASSESSMENT OF PSYCHOLOGY QUALIFICATIONS REGISTRATION, EMPLOYMENT OR UNIVERSITY ENTRY This form is for the assessment of psychology qualifications for registration, employment or entry

More information

APPLICATION FORM ASSESSMENT OF PSYCHOLOGY QUALIFICATIONS

APPLICATION FORM ASSESSMENT OF PSYCHOLOGY QUALIFICATIONS APPLICATION FORM ASSESSMENT OF PSYCHOLOGY QUALIFICATIONS MIGRATION This form is for the assessment of psychology qualifications for the purposes of migration to Australia under the General Skilled Migration

More information

APPLICATION for ACCREDITATION as an AACBT Ltd. COGNITIVE and BEHAVIOURAL THERAPIST

APPLICATION for ACCREDITATION as an AACBT Ltd. COGNITIVE and BEHAVIOURAL THERAPIST APPLICATION for ACCREDITATION as an AACBT Ltd. COGNITIVE and BEHAVIOURAL THERAPIST General Information Members of AACBT Ltd. who meet the AACBT s national standards for CBT training and practice can apply

More information

ACCREDITATION as an AACBT COGNITIVE and BEHAVIOURAL THERAPIST RENEWAL

ACCREDITATION as an AACBT COGNITIVE and BEHAVIOURAL THERAPIST RENEWAL ACCREDITATION as an AACBT COGNITIVE and BEHAVIOURAL THERAPIST RENEWAL General Information Accredited AACBT Cognitive and/or Behavioural Therapists must meet the AACBT s criteria for professional registration,

More information

Title (eg Mr, Mrs, Ms) Family Name / Surname Given Name/s. Sex: Male Female EMAIL. Day Month Year

Title (eg Mr, Mrs, Ms) Family Name / Surname Given Name/s. Sex: Male Female EMAIL. Day Month Year Submit to: International Relations Australia Supplement to International Application Form Please provide all information as requested in this supplement document, and in the parent International Student

More information

Generic Rules For Colleges. Post 2014 AGM

Generic Rules For Colleges. Post 2014 AGM Generic Rules For Colleges Post 2014 AGM GENERIC RULES TABLE OF CONTENTS Page No 1. PRELIMINARY... 1 2. ROLE... 2 3. PURPOSE AND OBJECTS... 2 4. PROCEDURES FOR FORMATION... 3 5. CRITERIA FOR FORMATION...

More information

ADDITIONAL APPLICATION FORM FOR ADMISSION TO THE POSTGRADUATE CLINICAL PSYCHOLOGY PROGRAM

ADDITIONAL APPLICATION FORM FOR ADMISSION TO THE POSTGRADUATE CLINICAL PSYCHOLOGY PROGRAM ADDITIONAL APPLICATION FORM FOR ADMISSION TO THE POSTGRADUATE CLINICAL PSYCHOLOGY PROGRAM Applicants should note that in order to commence the program they will need to have Provisional Registration status

More information

Master of Clinical Psychology (Program 7601- coursework) Doctor of Philosophy (Clinical Psychology) (Program 9064 research)

Master of Clinical Psychology (Program 7601- coursework) Doctor of Philosophy (Clinical Psychology) (Program 9064 research) Graduate Programs in Clinical Psychology Master of Clinical Psychology (Program 7601- coursework) Doctor of Philosophy (Clinical Psychology) (Program 9064 research) In 2015, the Research School of Psychology

More information

Renewal of registration Building surveying contractor (individual) Form 63

Renewal of registration Building surveying contractor (individual) Form 63 Government of Western Australia Department of Commerce Renewal of registration Building surveying contractor (individual) Form 63 Use of this form This form is to be used by building surveyors who are

More information

Registration as a Physiotherapist within the Special Purpose Scope of Practice: Postgraduate Physiotherapy Student

Registration as a Physiotherapist within the Special Purpose Scope of Practice: Postgraduate Physiotherapy Student APPLICATION FORM Registration as a Physiotherapist within the Special Purpose Scope of Practice: Postgraduate Physiotherapy Student Please complete this Application Form with reference to the Application

More information

LAST NAME GIVEN NAME(S) DATE CEASED / / LAST NAME GIVEN NAME(S) DATE CEASED / /

LAST NAME GIVEN NAME(S) DATE CEASED / / LAST NAME GIVEN NAME(S) DATE CEASED / / Application by an INDIVIDUAL FOR A NSW SECURITY LICENCE under the Mutual Recognition Act 1992 and/or Trans-Tasman Mutual Recognition Act 1997 OFFICE USE ONLY Application No: - Receipt No: - Trim No: To

More information

Scholarship application form

Scholarship application form King & Amy O Malley Trust PO Box 120, Camberwell, Vic 3124 Tel: (03) 9811 9904 Email: enquiries@omalleytrust.org.au Web: www.omalleytrust.org.au Scholarship application form 1. Use this form to make an

More information

Agents financial administration Form 4

Agents financial administration Form 4 Agents financial administration Form 4 Collection agent application for authority to open a trust account Agents Financial Administration Act 2014 Debt Collectors (Field Agents and Collection Agents) Act

More information

Application for Accreditation by Testing

Application for Accreditation by Testing Application for Accreditation by Testing OFFICE USE ONLY AUS NZ OS Please use blue or black ball point pen to complete this form. Please print in BLOCK LETTERS. NAATI Number: (if known) Part 1 Please provide

More information

HOW TO APPLY ADVICE FROM POTENTIAL SUPERVISORS

HOW TO APPLY ADVICE FROM POTENTIAL SUPERVISORS !!!" #$!!" %&'&'& ()*(+',,,,- HOW TO APPLY The following application form can be used by potential international students to apply for admission to postgraduate research/higher degree research programs

More information

2016 Application & Registration Form ARF

2016 Application & Registration Form ARF ABN 82 055 042 852 Training Assessment 2016 Application & Registration Form ARF This form applies to medical practitioners who will be training in Australia and New Zealand. You can apply or register at

More information

Generic Rules For Colleges. Post 2015 AGM

Generic Rules For Colleges. Post 2015 AGM Generic Rules For Colleges Post 2015 AGM GENERIC RULES TABLE OF CONTENTS Page No 1. PRELIMINARY... 1 2. ROLE... 3 3. PURPOSE AND OBJECTS... 3 4. PROCEDURES FOR FORMATION... 3 5. CRITERIA FOR FORMATION...

More information

Application for a real estate salesperson registration certificate

Application for a real estate salesperson registration certificate New registration application Form 3 1 Notes Application for a real estate salesperson registration certificate Property Occupations Act 2014 This form is effective from 1 December 2014 ABN: 13 846 673

More information

CRICOS Provider Number: 00120C International Postgraduate Research Program and/or Scholarship Application

CRICOS Provider Number: 00120C International Postgraduate Research Program and/or Scholarship Application Notes: CRICOS Provider Number: 00120C International Postgraduate Research Program and/or The University will not be able to process or to consider your application unless all sections have been satisfactorily

More information

Recognition of Prior Learning Application Diploma of Financial Services (Financial Planning) FNS50804 and RG 146

Recognition of Prior Learning Application Diploma of Financial Services (Financial Planning) FNS50804 and RG 146 Recognition of Prior Learning Application Diploma of Financial Services (Financial Planning) FNS50804 and RG 146 1. WHAT IS RECOGNITION OF PRIOR LEARNING (RPL)? RPL stands for recognition of prior learning.

More information

Form 11 Application for electrical work licence/permit (other than apprentice)

Form 11 Application for electrical work licence/permit (other than apprentice) Electrical Safety Office Form 11 Application for electrical work licence/permit (other than apprentice) V15.06-2014 Electrical Safety Act 2002 If you are applying for an additional electrical work training

More information

APPLICATION FOR ASSESSMENT: Special Education Teacher (not elsewhere classified) (ANZSCO 241599)

APPLICATION FOR ASSESSMENT: Special Education Teacher (not elsewhere classified) (ANZSCO 241599) Effective: 01 January 2014 APPLICATION FOR ASSESSMENT: Special Education Teacher (not elsewhere classified) (ANZSCO 241599) The Australian Institute for Teaching and School Leadership (AITSL) Ltd has been

More information

Application for registration Building contractor (company)

Application for registration Building contractor (company) Government of Western Australia Department of Commerce Application for registration Building contractor (company) Refer to the application guidelines for assistance in completing this application form.

More information

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care.

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care. Aged Care Education and Training Incentive Programme COMPLETION PAYMENT This application form is to be completed by applicants who have completed studies and have already received a commencement payment

More information

Application Form for Assessment of Senior Management Skills for Migration

Application Form for Assessment of Senior Management Skills for Migration Australian Institute of Management Application Form for Assessment of Senior Management Skills for Migration Please fully complete the form incomplete applications may be returned Provide the supporting

More information

Form 47 Application for trainer approval in Responsible management of licensed venues course

Form 47 Application for trainer approval in Responsible management of licensed venues course Form 47 Application for trainer approval in Responsible management of licensed venues course Liquor Act 1992 s. 142B V2 Aug 2013 Office use only Receipt no.... Amount $... Date... Instructions Please complete

More information

REQUEST FOR WITHDRAWAL

REQUEST FOR WITHDRAWAL REQUEST FOR WITHDRAWAL If you need help For assistance call NGS Super Customer Service Team on 1300 133 177. Step 1. Complete your personal details Please print in black or blue pen, in uppercase, one

More information

To apply for the Swinburne Astronomy Online course go to http://astronomy.swinburne.edu.au/sao

To apply for the Swinburne Astronomy Online course go to http://astronomy.swinburne.edu.au/sao Direct Application form Certificate IV, Diploma, Advanced Diploma, Associate Degree, Degree, Degree (Honours), Pathways Direct, Postgraduate (Coursework) Studies Instructions to applicants Please follow

More information

Mutual Recognition. Who can apply? Build better.

Mutual Recognition. Who can apply? Build better. Build better. Mutual Recognition Mutual Recognition is a process whereby an individual who holds a licence in one state, territory or New Zealand is entitled to be licensed in another state, territory

More information

Application for adoption information: Relative or guardian of adopted person who is deceased or does not have capacity

Application for adoption information: Relative or guardian of adopted person who is deceased or does not have capacity The purpose of the application for adoption information: is deceased or does not have capacity form This form is for use by a relative or guardian of an adult adopted person to apply for adoption information

More information

Application Form Ordinary Membership

Application Form Ordinary Membership Member ID: Office Use Only. Application Form Ordinary Membership 1 January - 31 December 2016 Join from 2 December and receive membership until 31 December 2016. Use this form if you are applying for Association

More information

Registration Building surveying contractor (company) Form 38

Registration Building surveying contractor (company) Form 38 Government of Western Australia Department of Commerce Registration Building surveying contractor (company) Form 38 Use of this form This form is to be used by unincorporated bodies, body corporate and

More information

4. A personal statement (please aim for a maximum of 400-500 words).

4. A personal statement (please aim for a maximum of 400-500 words). Applying to the University of Adelaide The University of Adelaide usually charges a AU$100 application fee. Study Options can waive this for qualified applicants, though not for those applying for medicine

More information

Information for temporary residents departing Australia

Information for temporary residents departing Australia Information for temporary residents departing Australia MLC Superannuation What is a Departing Australia Superannuation Payment? The Departing Australia Superannuation Payment (DASP) is the payment of

More information

Application to register a change of name (adult 18+ years)

Application to register a change of name (adult 18+ years) Application to register a change of name (adult 18+ years) July 2014 Recognising the significance of life events Important information about your change of name application If you require access to a translation

More information

Graduate Coursework Application for International Students

Graduate Coursework Application for International Students Graduate Coursework Application for International Students please read the enclosed Instructions before completing the form Lodging Applications By Mail: University Admissions The Australian National University

More information

Title Mr Mrs Miss Ms Dr Other Family Name Given Names Previous Name (if applicable)

Title Mr Mrs Miss Ms Dr Other Family Name Given Names Previous Name (if applicable) SYDNEY MEDICAL SCHOOL FOUNDATION PuraPharm PhD Scholarship in Integrated Medicine APPLICATION FORM 1. Full name of applicant This application, complete with supporting documentation, must be submitted

More information

1. Applicant details. 2. Corporate applicant. Individual / Partner 1 Given names (do not abbreviate) Surname (include maiden name if married)

1. Applicant details. 2. Corporate applicant. Individual / Partner 1 Given names (do not abbreviate) Surname (include maiden name if married) Application for a Licence to Sell Poisons for Purposes other than Human Therapeutic Use (please refer to the Fact Sheet at the back of this form when completing this application) Are you: a sole trader

More information

Application for Admission to QUT as an International Student in a Research Program

Application for Admission to QUT as an International Student in a Research Program Queensland University of Technology Student Business Services Victoria Park Road Kelvin Grove Q 4059 Phone +61 7 3138 2000 Fax +61 7 3138 3529 www.international.qut.edu.au CRICOS No. 00213J ABN: 83 791

More information

International student Foundation, Degree Transfer, TAFE, Undergraduate and Postgraduate Coursework Application form

International student Foundation, Degree Transfer, TAFE, Undergraduate and Postgraduate Coursework Application form International student Foundation, Degree Transfer, TAFE, Undergraduate and Postgraduate Coursework Application form Representative/agent stamp (if applicable) If you are a permanent resident of Australia,

More information

Combined Master s Program Application

Combined Master s Program Application Chartered Professional Accountants of Ontario 25 York Street Suite 1100 Toronto ON M5J 2V5 T. 416 977.7741 F. 416 977.6079 Toll Free 1 800 387.2991 www.cpaontario.ca Candidate No: (Office use only) Combined

More information

Completion Certificate Application Form (New Zealand Degree Holders Only) [Effective 15 March 2016]

Completion Certificate Application Form (New Zealand Degree Holders Only) [Effective 15 March 2016] PERSONAL DETAILS [Please Print] Full Legal Name* Completion Certificate Application Form (New Zealand Degree Holders Only) [Effective 15 March 2016] Surname First Name Middle Name(s) Name Used Surname

More information

Request to Increase Insurance Life Event

Request to Increase Insurance Life Event Request to Increase Insurance Life Event Accumulation Scheme (Division 5) members only Use this form to apply to increase your insurance cover when a specific life event has occurred. As an accumulation

More information

Fair Trading will aim to make a decision on your application within 6 weeks after receiving all relevant information from you and other agencies.

Fair Trading will aim to make a decision on your application within 6 weeks after receiving all relevant information from you and other agencies. Application No. OFFICE USE ONLY Form PL-21 ABN 81 913 830 179 Property, Stock and Business Agents Act 2002 Application for a CERTIFICATE OF REGISTRATION FEE: $129.00 - applicable from 1 July 2015 to 30

More information

Fixed insurance cover

Fixed insurance cover Fact sheet and form Fixed insurance cover When it comes to insurance cover, one size doesn t necessarily fit all. That s why you have the ability to convert your Death and Total & Permanent Disablement

More information

APPLICATION FOR ADMISSION

APPLICATION FOR ADMISSION MGSM POSTGRADUATE AND MBA PROGRAMS APPLICATION FOR ADMISSION Applications must be lodged by the closing date in accordance with the instructions on the back page of the form. Applications by fax or email

More information

Application for superannuation benefits temporary residents departing Australia permanently

Application for superannuation benefits temporary residents departing Australia permanently GPO Box 89 Melbourne Vic 3001 VicSuper Member Centre 1300 366 216 vicsuper.com.au Application for superannuation benefits temporary residents departing Australia permanently * Indicates that providing

More information

PA01 July 2015 - Page 1 of 12

PA01 July 2015 - Page 1 of 12 Provider approval PR- (Office Use Only) Before you begin You must read the following information before completing and submitting this form. Use this form to... Apply for provider approval. You must have

More information

Fund Restructure Request

Fund Restructure Request Fund Restructure Request SC no. (office use only) Campaign Code (if applicable) The Service About the service For more information Any changes to your fund (e.g. new fund name, adding or removing trustees,

More information

Advance Retirement Suite Super Early Release Financial Hardship Application

Advance Retirement Suite Super Early Release Financial Hardship Application Advance Retirement Suite Super Early Release Financial Hardship Application Trustee: BT Funds Management Ltd (BTFM) ABN 63 002 916 458 AFSL 233724 GUIDE TO COMPLETING THIS FORM > > Use this form if you

More information

Applying to the Australian National University (ANU)

Applying to the Australian National University (ANU) Applying to the Australian National University (ANU) Application fee NOT required ANU usually charges an application fee. Study Options can waive this please do not enter any payment information on the

More information

ONLINE GRADUATE COURSEWORK COURSES APPLICATION FOR ADMISSION

ONLINE GRADUATE COURSEWORK COURSES APPLICATION FOR ADMISSION ONLINE GRADUATE COURSEWORK COURSES APPLICATION FOR ADMISSION HOW TO COMPLETE THIS FORM Include one set of supporting documents with this application including a copy of your curriculum vitae. All documents

More information

ANU Agent Manager (Apply Online) for Undergraduate

ANU Agent Manager (Apply Online) for Undergraduate ANU Agent Manager (Apply Online) for Undergraduate This is not an application form and must not be sent to the University as a paper-based application. It is a form to be used only by ANU agents to register

More information

Complete this form to withdraw part or all of your benefit as a lump sum, roll over to another GESB account and/or to another complying super fund.

Complete this form to withdraw part or all of your benefit as a lump sum, roll over to another GESB account and/or to another complying super fund. Benefit access Gesb Super and West State Super SUP E R ANNUATION Complete this form to withdraw part or all of your benefit as a lump sum, roll over to another GESB account and/or to another complying

More information

Application for Registered Social Worker Full Registration

Application for Registered Social Worker Full Registration Application for Registered Social Worker Full Registration Licensure Exam Requirement: In addition to completing the Application Package, new applicants will be required to complete a competency based

More information

Restricted (Corporate Lawyer)

Restricted (Corporate Lawyer) 2015-2016 Application for a Restricted (Corporate Lawyer) Local Practising Certificate and Membership te: Legal practitioner employed by an entity (excluding a government agency or law practice) and limited

More information

Early release of super

Early release of super Early release of super You can apply for early release of your super on compassionate grounds or for financial hardship What do you need to do? Just follow the steps we ve outlined for the type of early

More information

Applying to Bond University

Applying to Bond University Applying to Bond University How to apply Print this form and complete it. Send the completed form to Study Options, 83 Alma Road, Clifton, Bristol, BS8 2DP, with your supporting documents. Supporting documents

More information

Submission: National Registration and Accreditation for Psychology

Submission: National Registration and Accreditation for Psychology Submission: National Registration and Accreditation for Psychology Contact Details: Dr Jillian Horton Clinical Psychologist President of the Institute of private practicing Clinical Psychologists Mail

More information

Postgraduate Psychology/Counselling Application Form (International)

Postgraduate Psychology/Counselling Application Form (International) Postgraduate Psychology/Counselling Application Form (International) Murdoch International Admissions Murdoch University South St, Murdoch 6150 Western Australia Telephone: +61 8 9360 6063 Facsimile: +61

More information

Please indicate the register in which you wish to be included: First name(s) Surname Title. Country (if not UK)

Please indicate the register in which you wish to be included: First name(s) Surname Title. Country (if not UK) Office use only Date Received App No No Allocated Approved Comments General Optical Council Application for registration 2014-15 (individual) Section 1 Application for registration Please indicate the

More information

Blue Care Income Protection Claim Form

Blue Care Income Protection Claim Form Blue Care Income Protection Claim Form INCOME PROTECTION CLAIMS In order to alleviate any delay in the processing time of your claim, please ensure the following: The claim form is returned with all fields

More information

APPLICATION PROCEDURES AND REQUIREMENTS FOR SPECIALIST ASSESSMENT

APPLICATION PROCEDURES AND REQUIREMENTS FOR SPECIALIST ASSESSMENT APPLICATION PROCEDURES AND REQUIREMENTS FOR SPECIALIST ASSESSMENT Australian Medical Council The purpose of the Australian Medical Council is to ensure that standards of education, training and assessment

More information

New Graduates of Canadian or U.S. Accredited Programs

New Graduates of Canadian or U.S. Accredited Programs New Graduates of Canadian or U.S. Accredited Programs In order to apply for registration with the Saskatchewan Association of and Audiologists (SASLPA), a new graduate is required to submit the following:

More information

Form 18 Application for a Queensland electrical contractor licence

Form 18 Application for a Queensland electrical contractor licence Electrical Safety Office Form 18 Application for a Queensland electrical contractor licence V17.06-2014 Electrical Safety Act 2002 INSTRUCTIONS: Read the guidelines when completing this application form.

More information

Saskatchewan College of Psychologists (SCP) Registration and Authorized Practice Endorsement: Policy and Procedures:

Saskatchewan College of Psychologists (SCP) Registration and Authorized Practice Endorsement: Policy and Procedures: Approved December, 2002 Saskatchewan College of Psychologists (SCP) Registration and Authorized Practice Endorsement: Policy and Procedures: A. SCP does not require that a psychologist, registered with

More information

4. A personal statement (please aim for a maximum of 400-500 words).

4. A personal statement (please aim for a maximum of 400-500 words). Applying to the University of Canterbury How to apply Print this form and complete it. Send the completed form to Study Options, 83 Alma Road, Clifton, Bristol, BS8 2DP, with your supporting documents.

More information

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care.

As an aged care worker, this incentive is for you to upgrade your qualifications and build your career in aged care. Aged Care Education and Training Incentive Programme COMMENCEMENT PAYMENT This application form is to be completed by eligible aged care workers who have enrolled and commenced studies to enhance their

More information

and MASTERS DEGREE BY THESIS (and Qualifier)

and MASTERS DEGREE BY THESIS (and Qualifier) P.O. Box 157, LISMORE NSW 2480 Telephone: (02) 6620 3414 Fax: (02) 6626 9145 APPLICATION FOR ADMISSION DOCTOR OF PHILOSOPHY (and Qualifier) and MASTERS DEGREE BY THESIS (and Qualifier) INSTRUCTION SHEET

More information

Pension Application Form

Pension Application Form PITCHER RETIREMENT PRP PLAN Pension Application Form Member Details Mr Mrs Miss Ms Other First given name Middle names Family name Date of Birth / / Residential address Suburb/town State Postcode Daytime

More information

APPLICATION FOR CERTIFIED ACCOUNTING TECHNICIAN (CAT) STATUS

APPLICATION FOR CERTIFIED ACCOUNTING TECHNICIAN (CAT) STATUS APPLICATION FOR CERTIFIED ACCOUNTING TECHNICIAN (CAT) STATUS This form should be completed if you satisfy the exam, Foundations in Professionalism and experience requirements to qualify for Certified Accounting

More information

APPLICATION FOR ASSESSMENT: Secondary School Teacher (ANZSCO 241411)

APPLICATION FOR ASSESSMENT: Secondary School Teacher (ANZSCO 241411) Effective: 01 January 2014 APPLICATION FOR ASSESSMENT: Secondary School Teacher (ANZSCO 241411) The Australian Institute for Teaching and School Leadership (AITSL) Ltd has been gazetted by the Department

More information

Practitioner Indemnity Insurance Policy Application Form

Practitioner Indemnity Insurance Policy Application Form Practitioner Indemnity Insurance Policy Application Form Avant Mutual Group Limited ABN 58 123 154 898 Membership with Avant Mutual Group Limited ABN 58 123 154 898 Practitioner Indemnity Insurance with

More information

Postgraduate Coursework Degree

Postgraduate Coursework Degree how to apply for a Postgraduate Coursework Degree There are five main steps when applying for admission to a postgraduate coursework degree at Macquarie University: step 1 Research your study options step

More information

NEW ZEALAND PSYCHOLOGICAL SOCIETY MEMBERS INSURANCE COVER As the insurance brokers to the NZ Psychological Society, Rothbury-Wilkinson Insurance

NEW ZEALAND PSYCHOLOGICAL SOCIETY MEMBERS INSURANCE COVER As the insurance brokers to the NZ Psychological Society, Rothbury-Wilkinson Insurance NEW ZEALAND PSYCHOLOGICAL SOCIETY MEMBERS INSURANCE COVER As the insurance brokers to the NZ Psychological Society, Rothbury-Wilkinson Insurance Brokers Ltd have arranged an insurance policy designed to

More information

CPA AUSTRALIA APPLICATION TO TRADE WITH A NON-MEMBER / APPLICATION FOR AN AUTHORITY TO TRADE AS CERTIFIED PRACTISING ACCOUNTANTS INTRODUCTION

CPA AUSTRALIA APPLICATION TO TRADE WITH A NON-MEMBER / APPLICATION FOR AN AUTHORITY TO TRADE AS CERTIFIED PRACTISING ACCOUNTANTS INTRODUCTION CPA AUSTRALIA APPLICATION TO TRADE WITH A NON-MEMBER / APPLICATION FOR AN AUTHORITY TO TRADE AS CERTIFIED PRACTISING ACCOUNTANTS INTRODUCTION PLEASE READ THESE INSTRUCTIONS CAREFULLY This is an interactive

More information

ACCOUNT APPLICATION FORM & IDENTIFICATION FORM

ACCOUNT APPLICATION FORM & IDENTIFICATION FORM ACCOUNT APPLICATION FORM & IDENTIFICATION FORM This form may be used to apply for a new Account or to verify the identity of an existing Provisional account holder. INSTRUCTIONS Please complete Section

More information

Application for Master of Visual Arts or Master of Music AND Application for a Postgraduate Research Scholarship

Application for Master of Visual Arts or Master of Music AND Application for a Postgraduate Research Scholarship OFFICE USE: ID # APPL # Application for Master of Visual Arts or Master of Music AND Application for a Postgraduate Research Scholarship Instructions There are TWO parts to this application: Part A To

More information

Portability and rollover

Portability and rollover Fact sheet and form Portability and rollover What this fact sheet covers This fact sheet explains how to make a rollover of all or part of your UniSuper account to another complying super fund. Who is

More information

Life Events/Salary Increase cover

Life Events/Salary Increase cover Fact sheet and form Life Events/Salary Increase cover What this fact sheet covers This fact sheet provides information about Life Events insurance cover and Salary Increase cover available through our

More information

APPLICATION FOR NEW CERTIFICATE OF COMPETENCE

APPLICATION FOR NEW CERTIFICATE OF COMPETENCE APPLICATION FOR NEW CERTIFICATE OF COMPETENCE This is an application form for a certificate of competence under the Health and Safety in Employment (Mining Operations and Quarrying Operations) Regulations

More information

International Student Offer Acceptance form

International Student Offer Acceptance form International Student Offer Acceptance form Read these instructions carefully before you complete the acceptance form. This acceptance together with your letter of offer, forms your written agreement with

More information

Application for benefit payment or transfer

Application for benefit payment or transfer Application for benefit payment or transfer Use this form if you want to cash in your benefit or transfer all or part of your super balance to another super fund. This form should not be used by temporary

More information

WMI Master Class in Wealth Management Application Form

WMI Master Class in Wealth Management Application Form MCWM Intake 2 WMI Master Class in Wealth Management Application Form General Instructions for Completing Your Application Thank you for your interest in the WMI Master Class in Wealth Management (MCWM).

More information

Graduate Diploma of Family Dispute Resolution Practice (FDRP)

Graduate Diploma of Family Dispute Resolution Practice (FDRP) Graduate Diploma of Family Dispute Resolution Practice (FDRP) WORKSHOPS HELD IN OUR SYDNEY, BRISBANE, MELBOURNE AND PERTH OFFICES. EMAIL US fdrp@collaw.edu.au CALL US 1300 506 402 VISIT US collaw.edu.au/fdrp

More information

ARCHITECTS BOARD OF WESTERN AUSTRALIA

ARCHITECTS BOARD OF WESTERN AUSTRALIA ARCHITECTS BOARD OF WESTERN AUSTRALIA Application for Registration in Western Australia under Mutual Recognition Form 02 3 August 2015 Use of this Form This form is to be used by people wishing to apply

More information

Skilled Occupation List (SOL) 2015-16

Skilled Occupation List (SOL) 2015-16 Skilled List (SOL) 2015-16 Tracking Code: N2AZ94 Name Individual * Sabine Hammond Organisation Australian Psychological Society What are the industry/industries and ANZSCO occupation/s that you or your

More information

Application for Registration as an Agent s Representative

Application for Registration as an Agent s Representative Application for Registration as an Agent s Representative Agents Licensing Act Please print in block letters. If there is insufficient space, attach extra sheets. All questions must be answered and full

More information

Applications accepted by email to queries@lia.ie or by Fax to 01 4554530 or by Post to LIA, 183 Kimmage Road West, Dublin 12.

Applications accepted by email to queries@lia.ie or by Fax to 01 4554530 or by Post to LIA, 183 Kimmage Road West, Dublin 12. APA () Designation Application Form (Transition Period 1st Nov 2011 31st Dec 2012) Please use BLOCK CAPITALS. Complete the sections of the application form AS INDICATED, and ensure you SIGN and DATE the

More information

Applying to the University of Sydney

Applying to the University of Sydney Applying to the University of Sydney University application fee charges an application fee of AU$100 to all applicants. Study Options can waive this fee for very strong candidates. If you would like to

More information

APA Physiotherapist Title Program

APA Physiotherapist Title Program APA Physiotherapist Title Program Information Booklet This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without permission from

More information

Form 20 Application for additional/change of qualified person for a contractor licence

Form 20 Application for additional/change of qualified person for a contractor licence Department of Justice and Attorney-General Electrical Safety Office Form 20 Application for additional/change of qualified person for a contractor licence V12.06-2014 Electrical Safety Act 2002 INSTRUCTIONS:

More information

Licence Application Form COMPANY

Licence Application Form COMPANY Licence Application Form COMPANY Completing this form Use BLACK pen only Print clearly in BLOCK LETTERS DO T use correction fluid any amendments should be crossed out and initialled 1. COMPANY DETAILS

More information

10030NAT Diploma of Positive Psychology and Wellbeing. RTO No: 40655 INFORMATION

10030NAT Diploma of Positive Psychology and Wellbeing. RTO No: 40655 INFORMATION 10030NAT Diploma of Positive Psychology and Wellbeing RTO No: 40655 INFORMATION Welcome Diploma of Positive Psychology & Wellbeing Thank you for enquiring about our exciting 10030NAT Diploma of Positive

More information

Early Childhood Intervention Postgraduate Scholarship Scheme Guidelines for Applicants

Early Childhood Intervention Postgraduate Scholarship Scheme Guidelines for Applicants Early Childhood Intervention Postgraduate Scholarship Scheme Guidelines for Applicants Program Information Who can apply for a scholarship? Scholarships are available to support early childhood intervention

More information

CHARTERED BANKER MBA. Application Form BANGOR BUSINESS SCHOOL - EXECUTIVE EDUCATION. www.charteredbankermba.co.uk

CHARTERED BANKER MBA. Application Form BANGOR BUSINESS SCHOOL - EXECUTIVE EDUCATION. www.charteredbankermba.co.uk BANGOR BUSINESS SCHOOL - EXECUTIVE EDUCATION CHARTERED BANKER MBA TM Application Form www.charteredbankermba.co.uk Notes on Completing the Application Form Please read the notes below before completing

More information

Graduate research courses

Graduate research courses Faculty of Education Graduate research courses The Faculty of Education views research as one of its core responsibilities. Our research activities aim to inform and lead professional practice, public

More information

APPLICATION FOR REGISTRATION:

APPLICATION FOR REGISTRATION: APPLICATION FOR REGISTRATION: POSTGRADUATE EDUCATION - 2015 CANADIAN MEDICAL SCHOOL GRADUATES MATCHED TO AN ONTARIO RESIDENCY PROGRAM Dear Applicant: The College is pleased to provide this application

More information

Application for Admission to Graduate/ Postgraduate Certificate and Diplomas and Coursework Masters

Application for Admission to Graduate/ Postgraduate Certificate and Diplomas and Coursework Masters Application for Admission to Graduate/ Postgraduate Certificate and Diplomas and Coursework Masters Kaplan Singapore Campus City, 8 Wilkie Road, Wilkie Edge, Singapore 228095 Telephone: +65 6733 1877 Facsimile:

More information