22264VIC Graduate Certificate in Bereavement Counselling and Intervention. Student Application & Agreement Form

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1 Graduate Certificate in Bereavement Counselling and Intervention Student Application & Agreement Form

2 Graduate Certificate In Bereavement Student Application & Agreement Form PLEASE PRINT CLEARLY OR TYPE IN SPACES PROVIDED. ONCE COMPLETED PLEASE TO: 1. COURSE DETAILS Name of Course: Melbourne Sydney Brisbane Where did you hear about the? Mailing List Website Advertisement Word of Mouth Other 2. PERSONAL DETAILS Title: (please tick) Mr Mrs Miss Ms Dr Other Family Name: Given Names: Unique Student Identifier (USI): (please refer to Section 9) Residential Address: Postcode: State: Country: Postal Address: Postcode: State: Country: Telephone: (h) Mobile: Skype: Gender: Date of Birth:

3 STUDENT APPLICATION & AGREEMENT FORM (PAGE 2 OF 8) Emergency/Next of kin contact details Name: Relationship to Student: Telephone: 3. EMPLOYMENT Of the following categories, which best describes your current employment status? (Tick ONE box only) Full-time employee Employed unpaid worker in a family business Part-time employee Unemployed seeking full-time work Self employed not employing others Unemployed seeking part-time work Employer Not employed not seeking employment 4. CURRENT EMPLOYMENT Business Name: Position: 5. PREVIOUS EDUCATION Name of your Secondary School: What is your highest completed school level? Completed year 11 Completed year 10 Completed year 8 or lower Did not go to school Which year did you complete that school level? Are you still attending school? Yes No Have you successfully completed any of the following qualifications? Yes (please tick ANY applicable boxes) Bachelor Degree or Higher Degree Certificate III (or Trade Certificate) Advanced Diploma or Associate Degree Certificate II Diploma (or Associate Diploma) Certificate I Certificate IV (or Advanced Certificate/Technician) Certificates other than the above:

4 STUDENT APPLICATION & AGREEMENT FORM (PAGE 3 OF 8) 6. LANGUAGE AND CULTURAL DIVERSITY Are you of Aboriginal or Torres Strait Islander origin? (For persons of both Aboriginal AND Torres Strait Islander origin, mark both Yes boxes) No Yes, Aboriginal Yes, Torres Strait Islander Were you born in Australia? Yes No please specify your town/city: and country of birth: Do you speak a language other than English at home? No, English only Yes, other please specify below: 7. DISABILITIES Do you consider that you have a disability, impairment or long-term condition? (please tick ANY applicable boxes) No Vision Hearing/Deaf Physical Medical Condition Other Intellectual Mental Illness Learning Acquired Brain Impairment 8. RECOGNITION OF PRIOR LEARNING (RPL) & CREDIT TRANSFER Recognition of Prior Learning (RPL) is available where participants are able to demonstrate that they already have the competencies specified in the description of any of the units that are required for the Certificate IV in Bereavement Support qualification. Please for a RPL application form, if you wish to apply for RPL for any of the GCBCI units. Credit Transfer is the process of granting participants credit for study previously completed through another VET or Higher Education provider. Having provided your Certificate or Statement of Attainment indicating a competent level of attainment in each of the units you apply for, the ACGB will verify these with the issuing RTO or through the Unique Student Identifier Number. The participant will be granted credit for the units of competency previously completed. Alternatively, an Academic Transcript from a Higher Education Provider. This must occur prior to commencement of the unit/s.

5 STUDENT APPLICATION & AGREEMENT FORM (PAGE 4 OF 8) Please indicate if you wish to apply for RPL or Credit Transfer for this course. Unit code Unit title Recognition of Prior Learning (RPL) Credit Transfer VU21583 Apply concepts of grief and bereavement VU21584 Provide bereavement counselling and support VU21585 Provide appropriate interventions to support people experiencing complex bereavement VU21586 Access services to support clients experiencing bereavement CHCFCS806C Work within a clinical framework 9. UNIQUE STUDENT INDENTIFIER (USI) Please note: you will not be enrolled into the Counselling and Intervention course until you have provided your USI number. Introduced in January 2015, the USI will enable all of an individual s training records entered in the vocational education and training (VET) data collection, to be linked. The USI is a reference number that will stay with a student for life. Students will be able to obtain a complete record of their VET enrolments and achievements from a single online source and at no cost to them (usi.gov.au). If you do not already have a USI, you are required to get your own USI by following the instructions at usi.gov.au ( Create USI ). To obtain your USI you must have at least one form of official identification: Driver s Licence Medicare Card Australian Passport Visa (with Non-Australian Passport) Birth Certificate (Australian) Certificate of Registration by Descent Citizenship Certificate ImmiCard

6 STUDENT APPLICATION & AGREEMENT FORM (PAGE 5 OF 8) 10. COMPUTER KNOWLEDGE Student Support is extremely important to the ACGB staff. Please indicate your confidence level of the following applications: Downloading Documents Low level Intermediate level High level Saving Documents Low level Intermediate level High level Worked with PDF documents Low level Intermediate level High level Has used Acrobat Reader Low level Intermediate level High level This information indicates the level of I.T support ACGB will endeavor to provide to our students. ENROLMENT AGREEMENT TERMS AND CONDITIONS PLEASE TAKE THE TIME TO READ THE TERMS AND CONDITIONS OF THE ENROLMENT AGREEMENT The GCBCI is is the only post-graduate program in Australia solely dedicated to the vocational training of bereavement counsellors. The course is delivered in a blended format, incorporating LMS based online learning, tutor guided discussion forums and face-to-face workshops in Melbourne, Sydney and Brisbane. The following terms and conditions constitute the agreement and understanding between you (the student) and The (#22004) for the duration of your enrolment into the listed course intake. 11. DOCUMENTATION The documentation required to apply for the GCBCI are: Submitted A completed application form A cover letter outlining your motivation to undertake this course A current C.V Certified copies of your qualifications. Please all documentation to once completed. 12. COURSE DURATION The course duration of the GCBCI is approximately 11 months. Each student will receive a Training Plan outlining face-to-face training sessions, assessment due dates and the duration of each unit.

7 STUDENT APPLICATION & AGREEMENT FORM (PAGE 6 OF 8) 13. COURSE STRUCTURE The following table represents the mode of delivery and approximate duration for each unit. Unit code Unit title Mode of Delivery Approximate Duration of Study VU21583 Apply concepts of grief and bereavement LMS 4 weeks VU21584 Provide bereavement counselling and support Face-to-Face & LMS 7 weeks VU21585 Provide appropriate interventions to support people experiencing complex bereavement Face-to-Face & LMS 10 weeks VU21586 Access services to support clients experiencing bereavement Face-to-Face & LMS 10 weeks CHCFCS806C Work within a clinical framework LMS 4 weeks 14. APPLICATION FEE A $255 non refundable fee is required to process the Application into the. This $255 fee is deducted from the full fee of $6,800. This is not an addition to the course fee. In the event The cannot proceed with the commencement of the course due to the shortage of student enrolment, or other circumstances beyond our control, the $250 application fee will be refunded to students. 15. FEES The total cost of the is $6,800. Once the $255 has been paid by the student the balance of the course is $6, payments of $ will be debited from the nominated bank account or charged to a nominated credit card provided by the student on the first of each month. 16. WITHDRAWALS If a learner wishes to withdraw from the course, they should advise the Courses Coordinator in writing at The cease of payment will be applied to the student fee account in the following month installment. An opportunity may exist to defer studies and continue later.

8 STUDENT APPLICATION & AGREEMENT FORM (PAGE 7 OF 8) 17. REFUNDS Payments for the course will be direct debited following the payment details on the Student agreement. No refund of payments made, will be given in the event of a withdrawal from the course. 18. LEARNING MANAGEMENT SYSTEM (LMS) The Learning Management System used for the is Learnbook. This is a LMS derived from Moodle. Acrobat Reader is required on your computer to ensure the successful completion of these units. The Adobe application is a free download available for all PC and Mac uses. Training on how to navigate and utilize the LMS system will be provided to students during the Orientation Session prior to the commencement of unit content. Student user guides will also be provided along with consistent Student Support from The staff members. 19. ASSESSMENTS Unit code Unit title No. of Assessments Type of Assessments VU21583 Apply concepts of grief and bereavement 3 VU21584 Provide bereavement counselling and support 3 Question & Answer Case Study Short Project Case Study Role Play Role Play Analysis VU21585 Provide appropriate interventions to support people experiencing complex bereavement 2 Case Study Role Play VU21586 Access services to support clients experiencing bereavement 2 Case Study Role Play CHCFCS806C Work within a clinical framework 2 Plan For Supervision Live Role Play with Trainer (via Skype or Phone) Assessments are to be completed via the writable PDF forms provided on the Student Management System Learnbook LMS. Training on how to submit these assessments will be conducted via the Orientation Session prior to commencing the unit content. 20. RECEIVING RESULTS Results are provided to the learners within three weeks of submission. For a student to gain a competency in each unit, assessments must be assessed by the trainer as Satisfactory. Each student will be given the opportunity for 2 re-submissions, if the assessment the submit is Not Yet Satisfactory. Each assessment will be returned with detailed feedback from the trainer.

9 STUDENT APPLICATION & AGREEMENT FORM (PAGE 8 OF 8) 21. LEARNER FEEDBACK AND CONTINUOUS IMPROVEMENT As part of our commitment to learners and their professional development, ACGB is keen to hear from you about their progress in completing the course. You will be contacted during the course to provide feedback on our service and your progress. These evaluation tools include evaluation forms, AQTF learners questionnaires as well as verbal feedback. ACGB welcomes any feedback you feel is relevant, as we see this as an opportunity to review and improve our policies and practices and to gain insight into participant satisfaction levels. 22. PRIVACY No staff member of ACGB can provide information about you to a third party without your written permission. In signing this Agreement you give your consent for the ACGB to provide information about you to another organisation on those occasions as necessary as an RTO (such as the Unique Student Identifier (USI) to the Department of Education, AVETMISS data to the NCVER, etc). 23. QUALIFICATION Learners who successfully complete all the required units from their course will be issued with a Nationally Recognised Qualification Certificate and associated Statement of Results. Please note that a reissue of your Certificate will cost $50.00 (administration fee) and proof of identity is required. Where a learner does not complete the full requirements of the course, a Statement of Attainment for the successfully completed units will be issued. DECLARATION I understand that information contained in these forms may be provided to State and Commonwealth agencies and research organisations and I consent to that occurring. I certify that all details provided on these forms are correct. I acknowledge that I have read, understood and accept the policies outlined in this agreement. Name: Signature: Date:

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