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www.fsaus.com.au www.nsca.org.au Course Parcipant Handbook WHS Qualificaons Students

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Page 1: Course Participant Handbook WHS Qualifications Students · Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed) Face to Face 12 months

www.fsaus.com.auwww.nsca.org.au

Course Participant Handbook WHS Qualifications Students

Page 2: Course Participant Handbook WHS Qualifications Students · Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed) Face to Face 12 months

Fire and Safety Australia Pty Ltd

Course Participant Handbook - WHS Qualifications – Annexure

Authorised: NSCA File: Course Participant Handbook – WHS Qualifications - Annexure

Date: October 2017 Version 1 Page 1

UNCONTROLLED WHEN PRINTED RTO22250

Course Participant Handbook – WHS Qualifications Students

In support of Fire and Safety Australia’s Course Participant Handbook V6, the following information relates specifically to learners undertaking WHS qualifications.

Learning Modes

In accordance with our philosophy to provide quality, flexible WHS learning, we offers learners the opportunity to study WHS qualifications via various delivery methods.

Distance Education. Units are accessible on the NSCA website via the student portal with Learning & Development Trainer/Assessor available to offer support.

Face to Face Interactive Learning. Face to face workshops scheduled in venues Australia wide. Course assessments are completed self-paced, post workshop.

System Requirements

Learners must have access to the following in order to complete their studies:

Personal Computer, with Internet Explorer 9 or Google Chrome. If you have IE 10 or 11 you may experience issues with the student portal. We strongly recommend using Google Chrome.

Microsoft Office with Word, Excel, PowerPoint programs. Microsoft Publisher is recommended but not essential.

Adobe Acrobat Reader

Email

Learners are required to submit their assessment responses via the student portal using an

appropriate software program, for example, Microsoft Word, Microsoft Excel, Microsoft PowerPoint.

Page 3: Course Participant Handbook WHS Qualifications Students · Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed) Face to Face 12 months

Fire and Safety Australia Pty Ltd

Course Participant Handbook - WHS Qualifications – Annexure

Authorised: NSCA File: Course Participant Handbook – WHS Qualifications - Annexure

Date: October 2017 Version 1 Page 2

UNCONTROLLED WHEN PRINTED RTO22250

Qualification Levels

A qualification is designed based on the Australian Qualifications Framework (AQF) specifications and provides the requirements for the construction of the qualification. These specifications cover all levels of qualifications from Certificate I through to Doctoral Degrees. AQF was developed to ensure national recognition and consistency between Training Providers, as well as a common understanding of what defines each qualification.

Each specification includes details regarding the broad range knowledge, skills and application required at each qualification level. See table below for AQF specifications for a Certificate III, Certificate IV, Diploma and Advanced Diploma qualifications. (Reference AQF 2nd Edition January 2013).

Skill Certificate IV Diploma

Cognitive Skills Identify, analyse, compare, and act. Identify, analyse, amalgamate and act.

Cognitive, Technical and Communication Skills

Apply and communicate technical solutions for non-routine tasks to a defined range of predictable and unpredictable problems.

Analyse, plan, design and evaluate approaches to unpredictable problems and/or management requirements.

Specialist Technical Skills

Complete routine and non-routine tasks and functions.

Express ideas and perspectives.

Communication Skills

Guide activities and provide technical advice in the workplace.

Transfer knowledge and specialised skills to others, and demonstrate understanding of knowledge.

Application Specialised tasks or functions in known or changing situations and environments.

In depth knowledge in some areas of specialisation, in known or changing contexts. Able to transfer and apply theoretical/technical/creative skills in a range of situations.

Management Responsible for own functions and outputs, may have limited responsibility for others.

Personal responsibility and autonomy in performing complex technical operations with responsibility for own outputs in relation to broad parameters for quality and quantity.

With initiative and judgement to organise the work of self and others and plan, coordinate and evaluate the work of teams within broad but generally well defines parameters.

Page 4: Course Participant Handbook WHS Qualifications Students · Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed) Face to Face 12 months

Fire and Safety Australia Pty Ltd

Course Participant Handbook - WHS Qualifications – Annexure

Authorised: NSCA File: Course Participant Handbook – WHS Qualifications - Annexure

Date: October 2017 Version 1 Page 3

UNCONTROLLED WHEN PRINTED RTO22250

Assessment Requirements

Each unit of your qualification consists of an assessment.

Assessments are written assessments and consist of a combination of short response questions, scenarios/case studies and workplace projects. Learners will need to be able to access a workplace in order to complete the workplace projects.

For face-to-face delivery, the assessments are completed post workshop. This is to ensure that the learning from the workshop is assessed in a workplace environment. Assessments are not completed during the face to face contact time.

For distance education and face-to-face delivery, Microsoft Word templates of the assessments are provided via your student portal.

Refer to Due Dates for further information on assessment timeframes.

Due Dates Learners have the following time frames to complete their enrolled course. If a learner has not completed by the relevant due date, their enrolment will be deactivated.

Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed)

Face to Face 12 months from Day 1 of the nominated workshop date.

Dip WHS Distance Education 12 months from Enrolment Date (the date the registration is processed)

Face to Face 12 months from Day 1 of the nominated workshop date.

Bridging Courses Distance Education 6 months from Enrolment Date (the date the registration is processed)

Individual Units Distance Education 1 month from Enrolment Date (the date the registration is processed)

Face to Face 1 month from nominated workshop date

Statement of Attainment Core Units (Diploma Entry Requirement)

Distance Education 6 months from Enrolment Date (the date the registration is processed)

Page 5: Course Participant Handbook WHS Qualifications Students · Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed) Face to Face 12 months

Fire and Safety Australia Pty Ltd

Course Participant Handbook - WHS Qualifications – Annexure

Authorised: NSCA File: Course Participant Handbook – WHS Qualifications - Annexure

Date: October 2017 Version 1 Page 4

UNCONTROLLED WHEN PRINTED RTO22250

Extensions

It is the learner’s responsibility to meet their course due date.

A ONCE ONLY extension of 6 months is available for a fee of $180.

Learners must submit the extension application form at least 1 week prior to the due date to allow processing. If the extension application is not received and processed prior to the course expiry, the learner’s enrolment will expire and deactivate. The NSCA reserve the right to cancel an enrolment without notice, if after the enrolment period, the learner has not completed or achieved their qualification. If requested, a statement of attainment will be issued for any units that have been successfully completed.

Learners may request an extension on their course due date within the following conditions:

At least 50% of the learners enrolled units have been submitted for assessment; AND

The request for extension by completing an Extension Request Form (Appendix 1) and sending to [email protected] BEFORE the current due date.

Extensions may be denied if:

No assessments have been submitted and/or the request for the extension is received AFTER the current due date.

Upon approval of the extension, the amended due date will be provided to the learner.

Expired enrolments will be deactivated. Once an enrolment has been deactivated, reenrolment will

be required in order to recommence studies and a full new enrolment fee is payable.

Extenuating Circumstances

Requests for extenuating circumstances WILL NOT be granted on the basis of work commitments. It is the learner’s responsibility to meet their course due date.

A request for an extension of time on the grounds of extenuating circumstances may be applied for in the following instances only:

Extreme hardship

Debilitating medical condition

In all instances, supporting documentation MUST be provided upon application and the provision of additional time is at the discretion of NSCA. In the case of a medical condition, an extension of time will generally be awarded for the period of time covered by the supplied medical documentation.

Learners may apply for extenuating circumstances by completing the Extension Request Form (Appendix 1) and sending to [email protected] with supporting documentation BEFORE the current due date. All documentation is held in the strictest of confidence. To ensure confidentiality please mark the subject of your email as PRIVATE AND CONFIDENTIAL - EXTENUATING CIRCUMSTANCES APPLICTION.

Page 6: Course Participant Handbook WHS Qualifications Students · Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed) Face to Face 12 months

Fire and Safety Australia Pty Ltd

Course Participant Handbook - WHS Qualifications – Annexure

Authorised: NSCA File: Course Participant Handbook – WHS Qualifications - Annexure

Date: October 2017 Version 1 Page 5

UNCONTROLLED WHEN PRINTED RTO22250

Course Fees

Course Method Course Fees

Certificate IV in Work Health and Safety Face to Face $1850

Distance Education $1550

Distance Education (Monthly Payment) $1600

Certificate IV in Work Health and Safety Bridging

Face to Face $700

Distance Education $590

Diploma of Work Health and Safety Face to Face $2600

Distance Education $1990

Distance Education (Monthly Payment) $2144

Diploma of Work Health and Safety Bridging Distance Education $800

Diploma of Work Health and Safety

Entry Requirement - Cert IV WHS 5 Core Units

Distance Education $590

Other Relevant Fees/Services

Service Fee

Extension Fee $180 for ONCE ONLY 6 month extension.

Certificate Reissue $30 + GST

Fees/Services are payable upon processing. Member rates are not available on other Fees/Services.

Page 7: Course Participant Handbook WHS Qualifications Students · Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed) Face to Face 12 months

Fire and Safety Australia Pty Ltd

Course Participant Handbook - WHS Qualifications – Annexure

Authorised: NSCA File: Course Participant Handbook – WHS Qualifications - Annexure

Date: October 2017 Version 1 Page 6

UNCONTROLLED WHEN PRINTED RTO22250

Certificate IV in Work Health and Safety BSB41415

This course is designed to give learners practical knowledge and skills to enable the provision of valid and timely WHS advice and assist with improving safety in the workplace. Individuals are in either a WHS role, or wanting to secure a WHS role, working under limited supervision and may provide leadership and guidance to others relating to WHS matters. The course covers a broad range of health and safety functions and responsibilities in the workplace including identifying hazards, assessing WHS risks, implementing strategies to control WHS risks and evaluating an organisation’s WHS performance.

This course provides learners with the knowledge and skills to:

Implement and support the workplace WHS management system

Prepare and advise workplace personnel for dealing with WHS issues

Understand WHS legislative requirements and assist with monitoring workplace compliance

Implement WHS initiatives and processes that support organisational WHS goals

Apply knowledge of risk assessment to contribute to the selection of risk assessment techniques, tools and processes for common hazards

Contribute to setting up and running WHS consultation and participation processes

Who Should Attend

Safety Officers, safety supervisors and managers, safety advisors, supervisors, health and safety representatives and workers that have WHS responsibilities.

Entry Requirements

There are no formal entry requirements however, it is highly recommended that learners have access to a workplace in order to complete the assessment tasks.

Page 8: Course Participant Handbook WHS Qualifications Students · Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed) Face to Face 12 months

Fire and Safety Australia Pty Ltd

Course Participant Handbook - WHS Qualifications – Annexure

Authorised: NSCA File: Course Participant Handbook – WHS Qualifications - Annexure

Date: October 2017 Version 1 Page 7

UNCONTROLLED WHEN PRINTED RTO22250

Certificate IV WHS Face to Face Course Structure

Day 1 BSBWHS402 Assist with compliance with WHS laws

This unit describes the performance outcomes, skills and knowledge required to assist with providing advice about the legislative duties, rights and obligations of individuals and parties prescribed in WHS laws. It includes identification of WHS legislation, duties, rights and obligations and the necessary actions to ensure compliance in the workplace.

Day 1 BSBWHS404 Contribute to WHS hazard identification, risk assessment and risk control activities

This unit describes the performance outcomes, skills and knowledge required to contribute to identifying WHS hazards; assessing WHS risks; and developing, implementing and evaluating risk controls appropriate to own job role and work area.

Day 2 BSBRES401 Analyse and present research information

This unit describes the performance outcomes, skills and knowledge required to gather, organise and present workplace information using available systems.

Day 2 BSBWRT401 Write complex documents This unit describes the performance outcomes, skills and knowledge required to plan documents, draft text, prepare final text and produce documents of some complexity.

Day 3 BSBWHS403 Contribute to the implementation and maintenance of WHS consultation and participation process

This unit describes the performance outcomes, skills and knowledge required to contribute to the implementation and maintenance of WHS consultation and participation processes in the workplace as part of a systematic approach to managing WHS.

Day 3 BSBWHS410 Contribute to work-related health and safety measures and initiatives

This unit describes the performance outcomes, skills and knowledge required to contribute to a range of work-related health and safety measures and initiatives.

Day 4 BSBWHS405 Contribute to the implementation and maintenance of a WHS management system

This unit describes the performance outcomes, skills and knowledge required to contribute to the implementation and maintenance of a WHS management system.

Day 4 BSBWHS408 Assist with effective WHS management of contractors

This unit describes the performance outcomes, skills and knowledge required to assist with the WHS management of contractors, and has a strong focus on compliance with WHS organisational and legislative requirements.

Day 5 BSBWHS406 Assist with responding to incidents This unit describes the performance outcomes, skills and knowledge required to assist with actions and activities performed in response to incidents.

Day 5 BSBWHS510 Contribute to the implementation of emergency procedures

This unit describes the performance outcomes, skills and knowledge required to contribute to the implementation of planning and response procedures for emergencies.

Page 9: Course Participant Handbook WHS Qualifications Students · Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed) Face to Face 12 months

Fire and Safety Australia Pty Ltd

Course Participant Handbook - WHS Qualifications – Annexure

Authorised: NSCA File: Course Participant Handbook – WHS Qualifications - Annexure

Date: October 2017 Version 1 Page 8

UNCONTROLLED WHEN PRINTED RTO22250

Certificate IV WHS Distance Education Course Structure

Unit 1 BSBWHS402 Assist with compliance with WHS laws

This unit describes the performance outcomes, skills and knowledge required to assist with providing advice about the legislative duties, rights and obligations of individuals and parties prescribed in WHS laws. It includes identification of WHS legislation, duties, rights and obligations and the necessary actions to ensure compliance in the workplace.

Unit 2 BSBWHS404 Contribute to WHS hazard identification, risk assessment and risk control activities

This unit describes the performance outcomes, skills and knowledge required to contribute to identifying WHS hazards; assessing WHS risks; and developing, implementing and evaluating risk controls appropriate to own job role and work area.

Unit 3 BSBRES401 Analyse and present research information

This unit describes the performance outcomes, skills and knowledge required to gather, organise and present workplace information using available systems.

Unit 4 BSBWRT401 Write complex documents This unit describes the performance outcomes, skills and knowledge required to plan documents, draft text, prepare final text and produce documents of some complexity.

Unit 5 BSBWHS403 Contribute to the implementation and maintenance of WHS consultation and participation process

This unit describes the performance outcomes, skills and knowledge required to contribute to the implementation and maintenance of WHS consultation and participation processes in the workplace as part of a systematic approach to managing WHS.

Unit 6 BSBWHS410 Contribute to work-related health and safety measures and initiatives

This unit describes the performance outcomes, skills and knowledge required to contribute to a range of work-related health and safety measures and initiatives.

Unit 7 BSBWHS405 Contribute to the implementation and maintenance of a WHS management system

This unit describes the performance outcomes, skills and knowledge required to contribute to the implementation and maintenance of a WHS management system.

Unit 8 BSBWHS408 Assist with effective WHS management of contractors

This unit describes the performance outcomes, skills and knowledge required to assist with the WHS management of contractors, and has a strong focus on compliance with WHS organisational and legislative requirements.

Unit 9 BSBWHS406 Assist with responding to incidents This unit describes the performance outcomes, skills and knowledge required to assist with actions and activities performed in response to incidents.

Unit 10 BSBWHS510 Contribute to the implementation of emergency procedures

This unit describes the performance outcomes, skills and knowledge required to contribute to the implementation of planning and response procedures for emergencies.

Page 10: Course Participant Handbook WHS Qualifications Students · Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed) Face to Face 12 months

Fire and Safety Australia Pty Ltd

Course Participant Handbook - WHS Qualifications – Annexure

Authorised: NSCA File: Course Participant Handbook – WHS Qualifications - Annexure

Date: October 2017 Version 1 Page 9

UNCONTROLLED WHEN PRINTED RTO22250

Diploma of Work Health and Safety BSB51315

This course is designed for learners who coordinate and maintain the work health and safety (WHS) program/system within an organisation. It will provide learners with the opportunity to grow their practical knowledge and skills in the development, implementation and management of these programs/systems.

The course provides learners with the knowledge and skills to

Recognise, evaluate and manage health and safety hazards in the workplace

Administer various work health and safety functions, planning and policy and process development in the workplace

Communicate effectively with personnel at all levels of the organisation

Developing actions, interventions and measures to prevent re-occurrence of incidents

Achieving change in WHS matters

Gather and analyse relevant WHS information and data

Contribute to the implementation, review and improvement of the WHS plan and WHS management system

Who Should Attend

Safety practitioners and managers with WHS responsibilities.

Entry Requirements

Learners must hold a Qualification/Statement of Attainment with the five (5) core units from the Certificate IV in Work Health and Safety BSB41415 or equivalent, being:

BSBWHS402 Assist with compliance with WHS laws

BSBWHS403 Contribute to the implementation and maintenance of WHS consultation and participation process

BSBWHS405 Contribute to the implementation and maintenance of a WHS management system

BSBWHS404 Contribute to the WHS hazard identification, risk assessment and risk control activities

BSBWHS406 Assist with responding to incidents

Face to Face Pre Course Assessment Requirements

A pre course workbook is issued upon confirmation of enrolment. This pre course workbook is due for submission of Day 1 of the workshop. If it is not completed and submitted on Day 1 it must be submitted as per the learners due date.

Page 11: Course Participant Handbook WHS Qualifications Students · Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed) Face to Face 12 months

Fire and Safety Australia Pty Ltd

Course Participant Handbook - WHS Qualifications – Annexure

Authorised: NSCA File: Course Participant Handbook – WHS Qualifications - Annexure

Date: October 2017 Version 1 Page 10

UNCONTROLLED WHEN PRINTED RTO22250

Diploma WHS Face to Face Course Structure

Day 1 BSBWHS506 Contribute to the development, implementation and maintenance of a WHS management system

This unit describes the performance outcomes, skills and knowledge required to contribute to the development and implementation of elements of a WHS management system.

Day 1 BSBWHS502 Manage effective WHS consultation and participation processes

This unit describes the performance outcomes, skills and knowledge required to manage the identification, review, development, implementation and evaluation of effective participation and consultation processes as an integral part of managing WHS.

Day 2 BSSWHS503 Contribute to the systematic management of WHS risks

This unit describes the performance outcomes, skills and knowledge required to contribute to the systematic management of WHS risk. It addresses the processes and techniques necessary to contribute to the systematic management of WHS risk.

Day 2 BSBWHS504 Manage WHS hazards and risks This unit describes the performance outcomes, skills and knowledge required to manage WHS hazards and risks.

Day 3 BSBWHS505 Investigate WHS incidents This unit describes the performance outcomes, skills and knowledge required to plan, conduct and report on investigations of WHS incidents that have resulted in, or have the potential to result in, injury or damage. It covers conducting an initial assessment of the situation; establishing the scope and legal parameters of the investigation; conducting a systematic analysis to identify underlying causes and actions for prevention; and reporting on the outcomes of the investigation appropriate to the potential severity of the incident, which may include accessing specialist expertise.

Day 3 BSBWHS510 Contribute to the implementation of emergency procedures

This unit describes the performance outcomes, skills and knowledge required to contribute to the implementation of planning and response procedures for emergencies.

Day 4 BSBHRM509 Manage rehabilitation or return to work programs

This unit describes the performance outcomes, skills and knowledge required to process and analyse both workers compensation and sick leave claims. It also covers the establishment of rehabilitation needs and return to work programs, and their monitoring, ongoing review and evaluation.

Day 4 BSBWHS410 Contribute to worker health and wellbeing measure and initiatives

This unit describes the performance outcomes, skills and knowledge required to contribute to a range of work-related health and safety measures and initiatives.

Day 5 BSBWHS507 Contribute to managing WHS information systems

This unit describes the performance outcomes, skills and knowledge required to contribute to managing work health and safety information systems (WHSIS) to support work health and safety (WHS) management.

Page 12: Course Participant Handbook WHS Qualifications Students · Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed) Face to Face 12 months

Fire and Safety Australia Pty Ltd

Course Participant Handbook - WHS Qualifications – Annexure

Authorised: NSCA File: Course Participant Handbook – WHS Qualifications - Annexure

Date: October 2017 Version 1 Page 11

UNCONTROLLED WHEN PRINTED RTO22250

Diploma WHS Distance Education Course Structure

Unit 1 BSBWHS506 Contribute to the development, implementation and maintenance of a WHS management system

This unit describes the performance outcomes, skills and knowledge required to contribute to the development and implementation of elements of a WHS management system.

Unit 2 BSBWHS502 Manage effective WHS consultation and participation processes

This unit describes the performance outcomes, skills and knowledge required to manage the identification, review, development, implementation and evaluation of effective participation and consultation processes as an integral part of managing WHS.

Unit 3 BSSWHS503 Contribute to the systematic management of WHS risks

This unit describes the performance outcomes, skills and knowledge required to contribute to the systematic management of WHS risk. It addresses the processes and techniques necessary to contribute to the systematic management of WHS risk.

Unit 4 BSBWHS504 Manage WHS hazards and risks This unit describes the performance outcomes, skills and knowledge required to manage WHS hazards and risks.

Unit 5 BSBWHS505 Investigate WHS incidents This unit describes the performance outcomes, skills and knowledge required to plan, conduct and report on investigations of WHS incidents that have resulted in, or have the potential to result in, injury or damage. It covers conducting an initial assessment of the situation; establishing the scope and legal parameters of the investigation; conducting a systematic analysis to identify underlying causes and actions for prevention; and reporting on the outcomes of the investigation appropriate to the potential severity of the incident, which may include accessing specialist expertise.

Unit 6 BSBWHS510 Contribute to the implementation of emergency procedures

This unit describes the performance outcomes, skills and knowledge required to contribute to the implementation of planning and response procedures for emergencies.

Unit 7 BSBHRM509 Manage rehabilitation or return to work programs

This unit describes the performance outcomes, skills and knowledge required to process and analyse both workers compensation and sick leave claims. It also covers the establishment of rehabilitation needs and return to work programs, and their monitoring, ongoing review and evaluation.

Unit 8 BSBWHS410 Contribute to worker health and wellbeing measure and initiatives

This unit describes the performance outcomes, skills and knowledge required to contribute to a range of work-related health and safety measures and initiatives.

Unit 9 BSBWHS507 Contribute to managing WHS information systems

This unit describes the performance outcomes, skills and knowledge required to contribute to managing work health and safety information systems (WHSIS) to support work health and safety (WHS) management.

Page 13: Course Participant Handbook WHS Qualifications Students · Cert IV WHS Distance Education 12 months from Enrolment Date (the date the registration is processed) Face to Face 12 months

Fire and Safety Australia Pty Ltd

Course Participant Handbook - WHS Qualifications – Annexure

Authorised: NSCA File: Course Participant Handbook – WHS Qualifications - Annexure

Date: October 2017 Version 1 Page 12

UNCONTROLLED WHEN PRINTED RTO22250

Extension Request Form Applies to NSCA qualifications only. To be submitted in conjunction with the Extension Policy outlined in this Handbook. This form must be completed and returned BEFORE your Due Date. Requests received AFTER your Due Date may be refused. Complete and return to [email protected]

REQUEST TYPE

6 Month Extension ($180) (Once Only Extension)

Complete Sections A, C, D, E

Extenuating Circumstances

Complete Sections A, B, C, E

SECTION A – PARTICIPANT DETAILS

NAME

MOBILE NO.

ADDRESS

EMAIL ADDRESS

SECTION B – EXTENUATING CIRCUMSTANCES EVIDENCE (ATTACHED)

MEDICAL EVIDENCE ☐

OTHER EVIDENCE (SPECIFY)

☐ ________________________________________________________________

SECTION C –COURE DETAILS

COURSE CURRENTLY ENROLLED

☐ CERTIFICATE IV IN WORK HEALTH AND SAFETY

☐ DIPLOMA OF WORK HEALTH AND SAFETY (EXTENSIONS ARE NOT AVAILABLE FOR BRIDGING COURSES OR WHS STATEMENT OF ATTAINMENT)

SECTION D –PAYMENT METHOD

¨ CREDIT CARD Please charge my: ¦MasterCard ¦Visa ¦Amex

Card No: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Expiry Date: ______/_________ CVV: _______

Cardholders Name:

Cardholder’s Signature

SECTION E –PARTICIPANT DECLARATION

FULL NAME

DATE

☐ I declare that the information and supporting documentation provided is true and correct.

☐ I have read, understand and agree to the application of the Extension and Extenuating Circumstances Policy contained within the Pre-Enrolment Handbook as well as Fire and Safety Australia’s Terms and Conditions

OFFICE USE ONLY

APPROVAL ¨ ☐ 6 MONTH EXTENSION ¨ ☐ EXTENUATING CIRCUMSTANCES

SIGNATURE DATE