© Certification Application Guidelines

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Pathway 3 – Certified Practising Case Manager™ Application

Title First Name Last Name Gender

Business Address Line 1 Business Address Line 2 Business Address Line 3 Suburb State Postcode

Postal Address Line 1 Postal Address Line 2 Postal Address Line 3 Suburb State Postcode Business Phone Mobile Primary Email Address Secondary Email Address Date of Birth Employer Name (Agency) Position Title Department Name I am applying via the following Vocational Pathway to Certification.

3. Pathway 3

I have read the Certification Application Guidelines.

1. Yes 2. No - Please ensure you have read these guidelines prior to continuing with your application 3. Pathway 3 - Diploma OR Certificate OR no formal qualification

Please select and attach evidence of your minimum level of qualification. Copy must be certified. I have attained the minimum vocational case management experience. Please note you must have practised for 12 months (1824 hrs) in the last 3 years?

3. Pathway 3. 5 years FTE (9120 hrs)

The Case Management Society of Australia (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.