Sample Form - AusTAB

"*" indicates required fields

Training and Accreditation Policies (TAPs):

It is a requirement of the Australian Training and Accreditation Board that the applicant for accreditation accepts the Training and Accreditation Policies (TAPs) controlling the training of Feldenkrais Practitioners.

Your Organisation*

Your Email*

Postal Address*

Street Address Address Line 2 City State Postcode Country

Mobile*

Business Phone

Other Phone

Relevant Country Business Registration Number (If applicable)

Are you registered for VAT/ GST/Consumption Tax/GBRT?*

Yes

Section 2A – Program Details

Name of Program*

Location*

Town and Country

Start date*

Completion date*

Planned Program Schedule - Year 1

(add cells as needed)

Segments

Dates

Days/Hrs per segment

Name of Trainer

Hrs In person/Hrs Online

Guild Member (Yes/No)

Planned Program Schedule - Year 2

(add cells as needed)

Segments

Dates

Days/Hrs per segment

Name of Trainer

Hrs In person/Hrs Online

Guild Member (Yes/No)

Planned Program Schedule - Year 3

(add cells as needed)

Segments

Dates

Days/Hrs per segment

Name of Trainer

Hrs In person/Hrs Online

Guild Member (Yes/No)

Planned Program Schedule - Year 4

(add cells as needed)

Segments

Dates

Days/Hrs per segment

Name of Trainer

Hrs In person/Hrs Online

Guild Member (Yes/No)

Section 2B – Program Administrator Details

Your Name*

First Last

Postal Address*

Street Address Address Line 2 City State Postcode Country

Email*

Mobile*

Business Phone

Qualifications and Duties*

Section 2C – Educational Director Details

Your Name

First Last

Postal Address*

Street Address Address Line 2 City State Postcode Country

Email*

Mobile*

Business Phone

Professional Qualifications*

Qualifications and Training Experience since Certification and Duties*

Section 3A - Attachments

Please attach each of the following documents to the application as required by TAPs.

1.Statement and signature from each intended Trainer confirming their acceptance of Training contract as per Schedule in Part 2, Section A (TAP 8).

Drop files here or

Accepted file types: jpg, pdf, png, svg, ai, eps, doc, docx, rtf, Max. file size: 512 MB, Max. files: 6.

2.An educational plan concisely describing, among other things, the general and specific skills and functional capabilities that will be fostered and the strategies to be used to provide learning experiences and ongoing feedback and evaluation as the program progresses. (TAPs 8,18,22,23,24)

Drop files here or

Accepted file types: jpg, pdf, png, svg, ai, eps, doc, docx, rtf, Max. file size: 512 MB, Max. files: 6.

3.A copy of the contract that will be entered into between the training organisation and trainees. (TAP 8 & 20). Student Contract Guidelines are included in the FPTP Application Toolkit.

Drop files here or

Accepted file types: jpg, pdf, png, svg, ai, eps, doc, docx, rtf, Max. file size: 512 MB, Max. files: 6.

Section 3B – Payment

On receipt of the completed and signed application form an invoice will be sent to you by the National Secretariat of the Australian Feldenkrais Guild with payment details. Assessment of the application commences on receipt of the payment.

Consent

Tick box to certify that you have read and accept the Training and Accreditation Policies (TAPs) and agree to contract with AusTAB to deliver the program described in this application.

Name

This field is for validation purposes and should be left unchanged.