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4

Associate Fellow Members (AFCMSA) of the Case Management Society of Australia & New Zealand (CMSA)

adhere to the CMSA National Standards & National Code of Ethics for Case Management in all their day-to-

day professional interactions with colleagues, the community, clients & /or representatives, key stakeholders &

employer thus contributing to the veracity, integrity & fidelity of the profession of case management.

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Please attach a scanned copy of all PTD Form A as a record of

your PTD activities (each copy must be signed and Certified).

Note you must scan a copy of Form A into one (1) PDF

document only. Multiple uploads are not available.

Please attach a scanned copy of PTD Form B as a summary

of all 72 hrs of PTD activities (copy must be signed and

Certified).

Please attach Referee Form 1 (copy must be signed and

Certified).

Please attach Referee Form 2 (copy must be signed and

Certified).

I have submitted the following evidence as a mandatory

requirement of my application and acknowledge that failure

to do so will render my application incomplete for the

purpose of assessment by the CMSA.

1. Qualifications (listed only)

2. Employment Verification Form OR Statutory Declaration

3. Curriculum Vitae (CV)

4. Professional Training and Development (PTD) Forms (Form A

& Form B)

6. Referee 1

7. Referee 2

I solemnly and sincerely commit to read, understand, utilise

and apply the CMSA National Code of Ethics within all my

professional interactions as a member of the CMSA.

I hereby agree

I solemnly and sincerely commit to read, understand, utilise

and apply the CMSA National Standards within all my

professional interactions as a member of the CMSA.

I hereby agree

I declare the above to be true and correct.

I have read and consent to the CMSA Privacy Policy (see

www.cmsa.org.au

) and understand how it relates to the use

of my personal information.

1. Yes

2. No

I have read, acknowledge and agree to abide by the CMSA

Constitution and By-laws.

I hereby agree

Please attach your Certificate of Attainment

CMCT01 Case

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5. Certificate of Attainment

CMCT01 Case Management

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