Health Management Internship Program - Application Form (Vic) - 2022 Intake

Please ensure you have carefully read all supporting documents and guidelines on our website prior to completing this application. Thank you.

Question Title

* 1. Personal Information:

Title:

Family Name:

Given Name/s:

Date of Birth:

Driver's Licence Number:

Residential Address: (include suburb/state)

Postal Address (if different from residential): (include suburb/state)

Phone:

Mobile:

Email:

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* 2. Mandatory Declarations

	Yes	No
I am an Australian citizen, have permanent Australian residency or full work rights in Australia until at least the end of 2023.	I am an Australian citizen, have permanent Australian residency or full work rights in Australia until at least the end of 2023. Yes	I am an Australian citizen, have permanent Australian residency or full work rights in Australia until at least the end of 2023. No
I am an Aboriginal and/or Torres Strait Islander person.	I am an Aboriginal and/or Torres Strait Islander person. Yes	I am an Aboriginal and/or Torres Strait Islander person. No
I have completed an undergraduate degree.	I have completed an undergraduate degree. Yes	I have completed an undergraduate degree. No
I have completed a post-graduate degree in a relevant health field.	I have completed a post-graduate degree in a relevant health field. Yes	I have completed a post-graduate degree in a relevant health field. No
I acknowledge to obtain a Management Intern position, I may need to meet certain requirements which include, but may not be limited to, the Working with Children Check, the Aged Care Check and the National Criminal Record Check.	I acknowledge to obtain a Management Intern position, I may need to meet certain requirements which include, but may not be limited to, the Working with Children Check, the Aged Care Check and the National Criminal Record Check. Yes	I acknowledge to obtain a Management Intern position, I may need to meet certain requirements which include, but may not be limited to, the Working with Children Check, the Aged Care Check and the National Criminal Record Check. No
I am willing to obtain Health clearances including vaccinations The Victorian Government has recently announced that it will soon be mandatory for all Victorian health care workers to be vaccinated for COVID-19. Evidence of vaccination will be required by a placement organisation before commencing. If you are unvaccinated, a work placement in a relevant organisation may be unavailable. In this instance you may not be able to complete the program.	I am willing to obtain Health clearances including vaccinations The Victorian Government has recently announced that it will soon be mandatory for all Victorian health care workers to be vaccinated for COVID-19. Evidence of vaccination will be required by a placement organisation before commencing. If you are unvaccinated, a work placement in a relevant organisation may be unavailable. In this instance you may not be able to complete the program. Yes	I am willing to obtain Health clearances including vaccinations The Victorian Government has recently announced that it will soon be mandatory for all Victorian health care workers to be vaccinated for COVID-19. Evidence of vaccination will be required by a placement organisation before commencing. If you are unvaccinated, a work placement in a relevant organisation may be unavailable. In this instance you may not be able to complete the program. No

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* 3.
IELTS
IELTS is the international standardised test of English language proficiency for non-native English language speakers.

	Yes	Not applicable
I have obtained a minimum band score of 7 in the IELTS (proof will be required)	I have obtained a minimum band score of 7 in the IELTS (proof will be required) Yes	I have obtained a minimum band score of 7 in the IELTS (proof will be required) Not applicable

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* 4. How did you hear of the internship program ?

Seek

Current Employer

HMIP Intern (Current or Past)

University

ACHSM Website

ACHSM Social Media (LinkedIn, Twitter, Facebook)

Word of Mouth

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* 5. I have read the 2022 Candidate Guidelines

Yes

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* 6. Employment History
Please list your employment history, starting with your current or most recent role.

Employer 1

Dates From

Dates To

Job Title

Description of role, responsibilities and tasks undertaken (no more than 150 words)

Employer 2

Dates From

Dates To

Job Title

Description of role, responsibilities and tasks undertaken (no more than 150 words)

Employer 3

Dates From

Dates To

Job Title

Description of role, responsibilities and tasks undertaken (no more than 150 words)

Employer 4

Dates From

Dates To

Job Title

Description of role, responsibilities and tasks undertaken (no more than 150 words)

Question Title

* 7. Education History
To be eligible for a Management Internship applicants must hold a relevant undergraduate qualification at the time of completing this application.
Applicants with a post-graduate qualification in a relevant health field need to stipulate the degree (ie. health science, health service management, health management, health administration or international health management).
State all the relevant qualifications which render you eligible to apply for a Management Internship position.

Qualification 1

Institution

Year completed

Qualification 2

Institution

Year completed

Qualification 3

Institution

Year completed

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* 8. Explain how these qualifications have enabled you to develop a strong foundation of knowledge, skills, competencies and abilities which are relevant to your chosen career in health services management.

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* 9. Selection Criteria.
Each criterion must be addressed for your application to be considered. Where possible, include examples.
Answers should be professionally written and concise (no more than 250 words per criterion)

Demonstrated interest and desire in working towards a career in health service management.

Demonstrated high level interpersonal, written and verbal communication and leadership skills.

Ability to exercise a high degree of professional independence and willingness to work with supervision.

Demonstrated analytical thinking and problem solving skills to undertake complex tasks.

Demonstrated competency in the use of computers (including Microsoft Excel, Outlook, Word, and Power Point) and the proven ability to learn and adapt to new systems and new technologies.

Please provide an explanation as to why you are applying for the Vic HMIP.

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* 10. Please nominate two professional referees who are able to discuss your knowledge, skills and experience.
Referees include direct line managers, or direct supervisors and one of these should be your current line manager. If you are not employed, referees can include a previous employer, mentor, professional coach or teacher, so long as the individual has observed you utilising your capabilities and skills first-hand. In nominating your referees, please consider this person must consent to giving a verbal report to support your application for this position if requested.
Referees will only be contacted if an applicant makes it to the final interview stage.

Name 1:

Role:

Employer/Organisation:

Relation to applicant (eg line manager, mentor etc)

Contact Phone Numbers:

Email:

Name 2:

Role:

Employer/Organisation:

Relation to applicant (eg line manager, mentor etc)

Contact Phone Numbers:

Email:

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* 11. By ticking the box below, you acknowledge the Vic HMIP includes both rural and metropolitan placements, and as such, you understand and agree that you will be placed across both sectors.

I agree

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* 12. Declaration

I declare all information is accurate and true

I declare I have read all relevant documentation prior to submitting my application

I declare I will make payable to ACHSM a one-off Program Fee of $1,100+GST if offered a Placement

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50% of survey complete.

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* 1. Personal Information:

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* 2. Mandatory Declarations

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* 3. IELTSIELTS is the international standardised test of English language proficiency for non-native English language speakers.

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* 4. How did you hear of the internship program ?

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* 5. I have read the 2022 Candidate Guidelines

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* 6. Employment HistoryPlease list your employment history, starting with your current or most recent role.

Question Title

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* 8. Explain how these qualifications have enabled you to develop a strong foundation of knowledge, skills, competencies and abilities which are relevant to your chosen career in health services management.

Question Title

* 9. Selection Criteria.Each criterion must be addressed for your application to be considered. Where possible, include examples.Answers should be professionally written and concise (no more than 250 words per criterion)

Question Title

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* 11. By ticking the box below, you acknowledge the Vic HMIP includes both rural and metropolitan placements, and as such, you understand and agree that you will be placed across both sectors.

Question Title

* 12. Declaration

* 3.
IELTS
IELTS is the international standardised test of English language proficiency for non-native English language speakers.

* 6. Employment History
Please list your employment history, starting with your current or most recent role.

* 9. Selection Criteria.
Each criterion must be addressed for your application to be considered. Where possible, include examples.
Answers should be professionally written and concise (no more than 250 words per criterion)