© UAE Certification Guidelines 2017

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VOCATIONAL CASE MANAGEMENT EXPERIENCE EMPLOYMENT VERIFICATION FORM

All applicants must complete and submit a certified copy of the Employment Verification Form as evidence of their vocational case management experience (practical or theoretical). This form is available online at www.cmsa.org.au on the Certification page of the website. Please download and save a copy to your personal computer. Please note all information must be typed into the form, saved and then printed prior to being signed and certified. You must then scan the certified copy and save a copy to your personal computer in readiness to attach to your online application. Hand written copies will not be accepted by the CMSA. Inclusive of the equivalent FTE total hours of vocational case management experience as stipulated within your nominated Pathway to Certification you must demonstrate that 12 months (1824 hours) Full Time Equivalent (FTE) practice (practical or theoretical) of your total hours has occurred in the past 3 years. This compulsory FTE is based on 38 hours per week over 48 weeks. • Download and provide a copy of the form in Microsoft Office Word to the individual completing the form. • Provide the individual with the CMSA contact details should they have any questions related to completing the form. • Check the completed form for any errors or omissions prior to having it certified. A CMSA UAE Statutory Declaration form may be used in lieu of the Employment Verification Form should an applicant be self-employed and/or need to reference multiple employers/appointments for the FTE (hrs) of vocational case management experience pursuant to the nominated pathway. Please refer to STATUTORY DECLARATIONS for further information. PROFESSIONAL TRAINING AND DEVELOPMENT (PTD) ACTIVITIES PROFESSIONAL TRAINING AND DEVELOPMENT (PTD) FORM A A separate form is completed for each PTD activity until the applicant has accrued the minimum total of seventy two (72) hours of PTD in the past three (3) years. The hours should be backdated from the date of your impending CCM application and may include the CMCT01 Case Management (National Certification) Competency Training. The CMSA recognises this training as 6.5 hours of PTD activities for both the face-to-face and e-learning training. Should an applicant have undertaken an undergraduate or post graduate course e.g. Diploma or Certificate/Graduate Certificate (either in full or part thereof) in the past three (3) years they should use this qualification (either full or part thereof) to demonstrate the required minimum seventy two (72) hours of PTD. This means that the applicant will only be required to complete one (1) PTD Form A rather than multiple copies of the PTD Form A. As an applicant will be completing numerous copies of Form A as a record of each PTD activity they are required to collate and scan all completed, signed and certified copies of Form A into one (1) PDF document. Depending on the number of PTD activities the applicant has undertaken this will result in one (1) large scanned file to be attached to the online CCM application. Please do not scan forms separately as multiple uploads will not be available to the applicant when they complete the online CCM application. Form A must be saved into one (1) PDF file only. A PTD Form A consists of the following information that is typed electronically into the form, then printed and signed by the applicant. All content must be typed into this form. Handwritten versions of the form will not be accepted by the CMSA. IMPORTANT: You are not required to submit copies of the evidence of each activity (e.g. certificates etc) along with your PTD Form A. The evidence (e.g. certificates etc) should be kept on file in the event the CMSA may request this from you pursuant to an audit of your application. If you are submitting an Employment Verification Form it is your responsibility to: • Provide a copy of the Certification Application Guidelines to the individual completing the form.

PROFESSIONAL TRAINING AND DEVELOPMENT (PTD) FORM A APPLICANT DETAILS:

Please provide your title (Dr, Prof, Mr, Mrs, Ms),Surname and Given/First name. Please insert a number for each time you complete this form. For example if this is the first PTD activity you are claiming please insert “1”. The next time you complete Form A you should insert “2” then “3” etc in numerical order for each Form A you complete.

PTD NUMBER:

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The Case Management Society of Australia and New Zealand and Affiliates (CMSA) Certification sets the benchmark of excellence in case management. Certified Practising Case Managers™ (CPCM) and Certified Case Managers (Non Practising)™ (CCMNP) adhere to the CMSA National Standards and National Code of Ethics for Case Management and are recognised for their advanced education, experience, knowledge and skills by their colleagues, consumers and employers. The Case Management Society of Australia and New Zealand and Affiliates (CMSA) Certification sets the benchmark of excellence in case management. Certified Practising Case Managers™ (CPCM) and Certified Case Managers (Non Practising)™ (CCMNP) adhere to the CMSA National Standards and National Code of Ethics for Case Management and are recognised for their advanced education, experience, knowledge and skills by their colleagues, consumers and employers.