© Certification Application Guidelines

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Contains details of the professional activities the Certified Case Manager™ has undertaken, since their previous Certified Case Manager™ endorsement (i.e. registration date), as part of their continuing professional education and practice development as a case management practitioner or professional.

THE CCM™ RE-ENDORSEMENT CHECKLIST

PREREQUISITES FOR CCM™ RE-ENDORSEMENT One (1) year FTE (1824 hrs) vocational case management practice experience in the past 3 years Twenty four (24) hours of Professional Training and Development (PTD) in the past three (3) years

DOCUMENT NAME

FILE TYPE

CERTIFIED COPY REQUIRED?

Re-endorsed Certified Case Manager™ - Employment Verification Form or Statutory Declaration ¹ Re-endorsed Certified Case Manager™ - Professional Training and Development (PTD) Form

PDF (scanned copy)

Yes*

PDF (scanned copy)

Yes*

EXPLANATORY NOTES

These documents are submitted as evidence (proof) of your stated level of skills, knowledge, experience and/or qualifications and to substantiate your eligibility to apply for re-endorsement as a Certified Case Manager™. These documents are essential for the CMSA to authenticate your application and are attached/uploaded to the online form. As you complete the online form you will be prompted to do so.

¹The Statutory Declaration form may be used in lieu of the Re-endorsed Certified Case Manager™ Employment Verification

Form should an applicant be self-employed and/or need to reference multiple employers/appointments for the required one (1) year FTE (1824 hrs) of vocational case management experience.

Please note: if you choose to provide a Statutory Declaration form it must include:

1. the total hours of your vocational case management experience - this must be equal to or greater than the hours as stated for Re-endorsement (i.e. >1824 hrs) 2. your vocational case management experience in chronological order commencing with your current/most recent position including: the dates you commenced and ceased employment in each position (in month and year format MM /YY), your position title, your employers name (company name) and location (suburb, city/town, state).

IMPORTANT ~ PLEASE READ:

(i) All information must be typed into each CCM form (not handwritten).

(II) Each CCM form must be printed off and signed by the individual completing the form.

(ii) Each CCM form must be certified by a Justice of the Peace (JP).

(iv) Each CCM form must be scanned into a PDF file.

*Obtaining a “certified copy” requires you to (i) make a photocopy of the original form or document - this is the copy that is to be certified as “a copy of the original document” by a JP (ii) Provide the JP with the original form or document and a photocopy of the original form or document (iii) ask the JP to certify the photocopy “as a copy of the original document”.

COPYRIGHT © 2017 Case Management Society of Australia and New Zealand and Affiliates (CMSA)

C E R T I F I E D C A S E M A N A G E R A U S T R A L I A & N E W Z E A L A N D

C A S E M A N A G E M E N T S O C I E T Y O F A U S T R A L I A & N E W Z E A L A N D 1 9 9 6

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.