Apply to study Certificate IV in Disability

Please complete and submit the following details to apply for FSSI’s Certificate IV in Disability CHC43115 (RMIT C4365).

Important note: Your application information will be used to create your student record in the RMIT University system and to admit you in the program. It is therefore mandatory to input accurate information. Your application will not be considered if you do not complete the required application fields.

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* 1. Full name as per passport and/or birth certificate:

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* 2. Role/position:

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* 3. Organisation:

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* 4. Date of birth

Date

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* 5. Gender:

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* 6. Email

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* 7. Phone number:

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* 8. Address:

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* 9. What is your Unique Student Identifier?

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* 10. Please select your citizenship:

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* 11. Is your organisation a member of the Victorian Council of Social Service (VCOSS)?

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* 12. What services does your organisation deliver, and where do you deliver them?

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* 13. Is your organisation a registered NDIS service provider?

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* 14. If you answered 'no' above, is your organisation considering applying to be an NDIS service provider?

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* 15. How did you hear about this course?

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* 16. How many hours do you work or volunteer per week with a disability service organisation?

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* 17. Will your disability service organisation support you to attend course workshops held once every three weeks in 2019, and validate your work practice?

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* 18. It is mandatory to provide the following documentation when enrolling:
·  Your passport or original birth certificate; AND
·  Your green Medicare card
Do you confirm you are able to provide these:

Thank you for your application for FSSI’s Certificate IV in Disability CHC43115 (RMIT C4365). We will be in contact soon to advise when we will be holding an information session for the upcoming July 2019 intake.

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