Certificate IV in Mental Health Peer Work CHC43515 Scholarships Application Form

Mental Health Coordinating Council (MHCC) Learning & Development ABN 592 791 68647 RTO Code 91296 Certificate IV in Mental Health Peer Work CHC43515 Scholarships Application Form MHCC is offering scholarship opportunities for peer workers to complete the Certificate IV in Mental Health Peer Work CHC43515. Places are available for peer workers currently employed in public or community managed mental health service. Successful scholarship recipients will contribute $210 towards the training cost. The Scholarship will cover training fees only and do not include travel, accommodation, meals or any other study related expenses. For dates please refer to the MHCC website at www.mhcc.org.au Location Application closing date Qualification commencement date Sydney 9am Thursday 21 st July 2016 1 st - 2 nd September 2016 Am I eligible? To be eligible to study the Certificate in Mental Health Peer Work with MHCC a participant must be either a: Consumer Peer Worker currently working (paid or unpaid) in an identified peer role providing direct ongoing support to other consumers as part of their day to day work Carer Peer Worker currently working (paid or unpaid) in an peer identified role providing direct ongoing support to other carers as part of their day to day work MHCC is committed to access and equity. A number of scholarship places have been prioritised for eligible culturally and linguistically diverse and Aboriginal and/or Torres Strait Islander applicants. How do I apply? Read the Certificate IV in Mental Health Peer Work Handbook Check your eligibility for the qualification Complete an application form ensuring with all sections of the form are completed: Applicant eligibility checklist Applicant Selection criteria Manager s Endorsement and contact details of a referee provided for direct peer work experience Application is signed and dated- Electronic signatures will not be accepted Include with your application, a copy of your current job description in peer work Applications that do not address the selection criteria or have evidence missing are not able to be considered. Where do I submit my application? Scan and email: scholarships@mhcc.org.au Post: Peer Work Scholarships: MHCC LD, PO Box 668 Rozelle NSW 2039 *NOTE: Receipt of Application- MHCC will send you an email confirming that we have received your scholarship application. If you have not received this confirmation, please contact MHCC before the close date to check it has been received. Selection Process MHCC will establish an independent panel consisting of representatives of consumer peer work, carer peer work, and relevant bodies. The selection process is as follows: A selection panel will meet and assess each application against the eligibility criteria All applications that satisfactorily meet the criteria will be eligible to be awarded a scholarship Success applicants will be notified and will be required to contribute a $210 fee upon accepting their place A limited number of scholarship places will be awarded to each scheduled qualification group Scholarships will be awarded with a commitment to equity and access across metropolitan and regional NSW, consumer and carer peer work, organisations, CALD and ATSI places 1

Certificate IV in Mental Health Peer Work Scholarships Application Form Surname: Given Names: Address: Applicant s personal details State: Postcode: Male Female Other Tel (H): Tel (M): Tel (W): Fax: Email: Date of Birth: Employer: Applicant s Position title: Consumer peer work Carer peer work Length of time in position: Full Time Part Time Please tick if relevant to you: I am Aboriginal, Torres Strait Islander or Aboriginal and Torres Strait Islander I am from a culturally or linguistically diverse background where English is not my first language I am a person with a disability I am currently receiving a specified Commonwealth benefit or allowance I already hold, or am currently completing a post-school qualification If yes, please indicate: Certificate III or below Certificate IV or higher If any of the above details change, please advise us as soon as possible. Please ensure you have attached Certified Identification to your application It is a requirement that all applicants provide a certified copy of identification. This must be photo ID (i.e. drivers licence or passport). If you do not have either, please supply a certified copy of your birth certificate plus another form of photo ID. The list of approved witnesses include: JPs, pharmacists, doctors. For a full list go to: http://www.ag.gov.au/publications/pages/statutorydeclarationsignatorylist.aspx Training contribution fee A training contribution fee of $210 is payable prior to course commencement. Please provide details of payee, including name, address and email, and an invoice will be issued: Organisation Name: Contact Name: Email: Billing Address: Applicant s Eligibility Checklist 2

To be eligible to apply for a scholarship in Certificate IV in Mental Health Peer Work, applicants must meet all the selection criteria. Please confirm your eligibility before proceeding. In filling out this form I agree that (PLEASE TICK): I have read the Certificate IV in Mental Health Peer Work Handbook I am currently working in an identified consumer or carer peer work role I have my manager s endorsement to study (Manager s Endorsement is completed) I have included a copy of my current job description with my application I am able and ready to study at a Certificate IV level and complete the qualification within the timeframe of approximately 14 months I am not currently studying this qualification with another RTO I have access to support in the workplace or through relevant networks to complete the assessment requirements of the qualification I am able to pay the contribution fee of $210 if I am awarded a scholarship Signature: Date: Applicant signature required a typed name will not be accepted Study Options I would like to apply for the Certificate IV in Mental Health Peer Work CHC43515 (Tick one): Course Pathway Most suited to someone with no qualification and limited experience. This option includes training, assessment and workplace based projects. Blended Pathway (Recognition and Training) Most suited to someone with some qualifications and experience who needs to attend some training. This option requires submission of transcripts and/or workplace evidence, as well as completing some training and assessment. Full Recognition Most suited to an experienced worker who has current and extensive experience. You may have some qualification/s and may also submit a collection of evidence e.g. work documents that contribute to a portfolio. This pathway may also include completion of assessment tasks. Please confirm location you wish to attend: Will you need any study support or assistance during training or assessment? If yes please specify Unique Student Identifier (USI) From 2015 all students enrolling in VET training require an Unique Student Identifier (USI) For further information and to apply for your USI click on this link: http://www.usi.gov.au/students/pages/default.aspx If you need help setting up your USI, please contact us for assistance on 02 9555 8388 ext 106. My Unique Student Identifier is: 3

Manager s Endorsement Please ask your manager to fill out this section. This section is a part of the Selection Criteria and must be filled out. Application forms sent in without this information will not be assessed. MHCC s Certificate IV in Mental Health Peer Work CHC43515 is customised for people employed in a peer worker role. As a result, a number of assessments include workplace tasks or documentation. To ensure the applicant has the necessary support to successfully complete work-based assessments, we ask that you tick (for Yes) or cross (for No) if your organisation will provide the applicant with workplace opportunities. Before proceeding, please read the Certificate IV in Mental Health Peer Work Student Handbook (available at www.mhcc.org.au). Manager s Name (please print): Manager s Position: Applicant s Name: Applicant s Position: Organisation: Manager s Ph: Manager s Email: I confirm that I have read the Student Handbook, that I endorse the applicant applying to study the course and agree to provide the applicant workplace support to(please tick) : provide completed and de-identified workplace documentation such as recovery plans complete an activity log for an extended period while studying, to document time spent and activities carried out with consumers or carers prepare and carry out group sessions or other activities within workplace parameters and using workplace protocols research tools, networks and other resources to assist consumers or carers access workplace policies, procedures and underpinning legislation access you, as their supervisor, to seek guidance and discuss role parameters develop, carry out and analyse surveys, audits or other improvement activities provide Supervisor Reports signed off by you confirming the applicants skills and knowledge as required in different areas of their work (most subjects have a Supervisor s Report) put aside time to record stories of practice such as examples of recovery-oriented practice, trauma informed care, care relationships or assisting with self-advocacy create brochures, information sheets or use workplace communication channels following workplace protocols complete WHS activities in line with the participant s role parameters answer questions around different topics and scenarios such as working with Aboriginal or culturally diverse people in the workplace, alcohol and other drugs, assess and respond to people at risk of suicide Manager s Signature: Date: Manager s signature required a typed name will not be accepted We may contact you for verification. 4

Applicant Selection Criteria The following section is part of the selection criteria and must be filled out by the applicant. Application forms sent in without this information will not be assessed. Please list all the peer work positions you have held in the last 5 years including their year/s, duration and the name of the organisation. For example: Peer Support Worker - 2013 2014-1 year, 15 hours a week, ABC organisation. Please explain your ability and readiness to study at a Certificate IV level and to complete the qualification. Please describe any experience of past study (150 words max) Please describe your access to support in the workplace or through relevant networks to complete the assessment requirements of the qualification (100 words max) Citizenship/Residency Status Please tick the box that describes your current citizenship status. Citizen Permanent resident Not citizen/permanent resident Education What is your highest completed school level? Year 9 or lower Year 10 Year 11 Year 12 In which YEAR did you complete that school level? Have you completed any of the following recognised qualifications? Yes (please tick) No Bachelor Degree or higher degree level Advanced Diploma or Associate Degree Diploma Certificate IV Certificate III Certificate II Certificate I Miscellaneous education 5

Study Reason (Tick ONE box only) To get a better job or promotion It was a requirement of my job I wanted extra skills for my job To get a job Cultural Background To develop my existing business To start my own business For personal interest or selfdevelopment To get into another course of study To try for a different career Other reasons Are you of Aboriginal or Torres Strait Islander origin? Yes Aboriginal Yes Torres Strait Islander No Country of birth? Nationality? What is the main language spoken at home? How well do you speak English? Very Well Well Not Well Not at All Do you require any language, literacy or numeracy assistance? Yes No Disability Do you consider yourself to have a disability? Yes No Hearing/Deaf Vision Physical Acquired Brain Impairment Medical Condition Intellectual Learning Mental Illness Other Unspecified Employment Status Of the following categories, which BEST describes your current employment status? Full time Employee Part time Employee Employer (own business) Self-employed (not employing others) Employed - unpaid family worker Unemployed - seeking full time work Unemployed - seeking part time work Not employed not seeking employment 6

Previous Qualifications/Courses (for recognition or credit transfer) To assist with your enrolment please attach certified copies of the transcripts of any relevant qualifications from the Community Services Training Package you may hold e.g. Relevant Certificates, Diplomas, Statements of Attainment, Vocational Graduate Certificates or Vocational Graduate Diplomas and or higher education qualifications. As part of the national training system it is sometimes possible to gain national recognition for specific national units of competency that were completed as part of another qualification. An assessor will review the units you have already completed to see if any of them provide you with credit in CHC43515 Certificate IV in Mental Health Peer Work. Please do not send originals of qualifications/transcripts with this application. Note Some TAFEs and colleges may use their own unit names and coding and do not use the National Codes. If Certificates and/or Diplomas have TAFE codes, you will need to request a copy of your certificate from TAFE with National Codes and submit these (eg National codes look like CHCCOM3C as opposed to TAFE code 4341A). Please list the transcripts you have attached, and ensure copies of your transcripts are certified. Name of Course Payments, Costs and Funding Options Refund Amounts and Timelines all withdrawals must be in writing to receive a refund* Full refund for fee for service place Full refund for trainees and funded places Assessment Costs* Submitting assessments late without an approved extension (including resubmissions) Withdrawal in writing received within 2 weeks of the qualification start date Withdrawal in writing received within 2 weeks of the qualification start date MHCC Member Non- Member $50 $50 Re-enrolling into Assessment if withdrawn or marked Not Yet Competent $125 $135 * Please see Participant Handbook for details Payment Process An Invoice will be sent to you to complete when your eligibility to enrol has been confirmed. Disclaimer: MHCC reserves the right to discontinue/cancel or vary course and assessment arrangements without notice and at its discretion. However MHCC will try to avoid or minimise any inconvenience to participants. Please refer to the MHCC website for the latest course information: www.mhcc.org.au 7

Participant Handbook Checklist Please tick each of the following items after reading the Participant Handbook and before signing the declaration. I have read and understood the Costs, Refunds and Timelines section I have read and understood the Delivery Structure section outlining the attendance requirements of the qualification I have read the Assessment Requirements section and understand the assessment commitments of the course I am aware that workplace evidence is used for all assessments and I am able to collect evidence from and complete projects in my workplace My workplace is supporting me to collect evidence and conduct workplace projects as part of the assessment process I am aware that when I enrol into my course I can access information and resources online. (See Online Student Portal section) I have read the Contacts section of the Participant Handbook and am aware of who to contact within MHCC if I need assistance The following items are optional, please tick or cross accordingly. I am applying for Recognition (See Pathways to Completing the Qualification) I have completed studies related to the qualification and have attached certified copies of my transcripts (See Previous Study Completed) Consent This section must be read and signed in order to be eligible to study at MHCC In completing this enrolment form you: confirm that your organisation will support you in the completion of this course, including workplace supervisor s reports and workplace based assessments allow MHCC to disclose information to your employer regarding your attendance at training, completion of assessment tasks and results and additional support you may require. If you do not wish this information to be provided to your employer please advise MHCC in writing consent to the collection of this personal information for the provision of training and assessment services (please refer to the MHCC confidentiality and privacy policy) are aware that information supplied to MHCC including personal details and identification, will be used by the Department of Education and Training for audit, verification, research, statistical analysis, program evaluation, post-completion surveys and internal management processes agree that you have read the MHCC Participant Handbook (available at www.mhcc.org.au) and understand your rights and responsibilities declare that the information provided on this form is true and accurate Tick to confirm that you have attached certified photo ID to this application: Signature: Date: Student signature required a typed name will not be accepted 8