Course Application Form
Comments
Participant Name
First Name Surname
* *
Organisation
Please provide details on the Facility/Organisation where you work
Organisation Name Address
* *
Phone Fax
*
Participant Email
*
Occupation What is the title of your current position?
*
Confirmation
Contact Email for Confirmation
*
Please re-enter your email
*
Eligibility

Please check your Eligibility prior to making a booking. According to the eligibility criteria, are you eligible to complete units CHCAC319A and/or CHCAC416A?

Dates
CHCAC319A (from Certificate III in Aged Care Work)
“Provide support for people living with dementia”
From the training schedule, please select your preferred course dates
Dates
CHCAC416A (from Certificate IV in Aged Care Work)
“Facilitate support responsive to the specific nature of dementia”
* Whilst there are no pre-requisites for this unit, it is understood that each participant's experience,
skills + achievements are taken into account prior to applying for registration. Please indicate below that you have considered your suitability to attend this course.
From the training calendar, please select your preferred course date (if applicable)
Cancellations/
Changes
Please notify as soon as possible of any cancellations, changes of name(s) or booking difficulties
Other
How did you find out about Dementia Care Essentials? *
Other (please describe)
Do you require disability access?
Do you require assistance with hearing?
Do you require assistance with vision?
Do you have special dietary needs?
If so please specify.
Is English the main language you speak?
If not, please specify.
 
For Booking enquiries or assistance please contact our Training & Events Officer on 1800 672 500 or email training@dce.asn.au

Dementia Care Essentials has been developed in conjunction with the following partners:



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