Mental Health Coordinating Council (MHCC)
Learning & Development
ABN 592 791 68647
Advanced Diploma of Community Sector Management CHC60312
Leadership in Action ENROLMENT FORM
Please write clearly in CAPITAL LETTERS and attach your certified ID.
Please forward your completed form to:
Email: training@mhcc.org.au
Fax: 02 9810 8145
Post: PO Box 668 Rozelle, 2039
For further information phone 02 9555 8388 ext 106
Applicant’s Details
Surname:
Given
Names:
Home
Address:
State:
Postcode:
Date of
Birth:
Gender:
Tel (H):
Tel (W):
Tel (M):
Fax:
☐Male
☐Female
☐Other
Your email address is required for all communication including emails that are cc’d to your employer
Email:
Organisation/
Employer:
Position
Title:
If any of the above details change, please advise us as soon as possible.
Please ensure you have attached Certified Identification to your application
It is a requirement that all applicants provide a certified copy of identification. This must be photo ID (i.e. drivers’ licence or
passport). If you do not have either, please supply a certified copy of your birth certificate plus another form of photo ID. The list
of approved witnesses include: JPs, pharmacists, doctors. For a full list go to:
http://www.ag.gov.au/Publications/Pages/Statutorydeclarationsignatorylist.aspx
STUDY OPTIONS:
I would like to apply for the Advanced Diploma of Community Sector Management CHC60312:
For Member Organisations
For Non-member Organisations
Course Pathway
☐ $3,200
☐ $3,520
Full Recognition
☐ $2,100
☐ $2,300
Please confirm location you wish
to attend:
☐Sydney
Adv Dip CSM Qualification Enrolment Form V13
☐ Other
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Will you need any study support or assistance during training or assessment? If yes please specify
Unique Student Identifier (USI)
From 2015 all students enrolling in VET training require an Unique Student Identifier (USI)
For further information and to apply for your USI click on this link: http://www.usi.gov.au/Students/Pages/default.aspx
If you need help setting up your USI, please contact us for assistance on 02 9555 8388 ext 106.
My Unique Student Identifier is:
Citizenship/Residency Status
Please tick the box that describes your current citizenship status.
☐Citizen
☐Permanent resident
☐Not citizen/permanent resident
Employment Status
Of the following categories, which BEST describes your current employment status?
☐Full time Employee
☐Part time Employee
☐Employer (own
business)
☐Self-employed (not employing
others)
☐Unemployed - seeking part time work
☐Not employed – not seeking employment
☐Employed - unpaid family worker
☐Unemployed - seeking full time
work
Education
What is your highest completed school level?
☐Year 9 or lower
☐Year 10
☐Year 11
☐Year 12
In which YEAR did you complete that school level?
Have you completed any of the following recognised qualifications?
☐ Yes (please tick) ☐ No
☐Bachelor Degree or higher degree level
☐Diploma
☐Certificate II
☐Advanced Diploma or Associate Degree
☐Certificate IV
☐Certificate I
☐Certificate III
☐Miscellaneous education
☐To develop my existing
business
☐To get into another course of
study
☐To start my own business
☐To try for a different career
☐For personal interest or selfdevelopment
☐Other reasons
Study Reason (Tick ONE box only)
☐To get a better job or promotion
☐It was a requirement of my job
☐I wanted extra skills for my job
☐To get a job
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Cultural Background
Are you of Aboriginal or Torres Strait Islander
origin?
☐Yes –
Torres Strait
Islander
☐Yes –
Aboriginal
☐No
Country of birth?
Nationality?
What is the main language spoken at home?
How well do you speak English?
☐Very Well
☐Well
Do you require any language, literacy or numeracy
assistance?
☐Yes
☐No
☐Not
Well
☐Not at All
Disability
Do you consider yourself to have a disability?
☐Hearing/Deaf
☐Vision
☐Physical
☐Yes
☐No
☐Acquired Brain
Impairment
☐Medical Condition
☐Mental Illness
☐Other
☐Unspecified
☐Intellectual Learning
How many years’ experience do you have
in leadership or management?
You need to currently be in a leadership or
management role where you are directly
supervising staff?
Please confirm if you meet this criteria:
☐ Yes . How long have you been in this role?
☐ No
Please briefly explain what your role entails and how many staff you directly supervise
Before you proceed with your application, you must read the Leadership In Action Philosophy
Statement on page 6 of this application form and make a commitment to the following:
I have read the Leadership In Action Philosophy Statement on Page 6 of this
application form and I am prepared to commit to the training program based on the
information provided
Adv Dip CSM Qualification Enrolment Form V13
☐ Yes
☐ No
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Previous Qualifications/Courses (for recognition or credit transfer)
To assist with your enrolment please attach certified copies of the transcripts of any relevant
qualifications from the Community Services Training Package you may hold e.g. Relevant Certificates,
Diplomas, Statements of Attainment, Vocational Graduate Certificates or Vocational Graduate Diplomas and or
higher education qualifications.
As part of the national training system it is sometimes possible to gain national recognition for specific national
units of competency that were completed as part of another qualification. An assessor will review the units you
have already completed to see if any of them provide you with credit in CHC60312 Advanced Diploma of
Community Sector Management.
Please do not send originals of qualifications/transcripts with this application.
Note Some TAFEs and colleges may use their own unit names and coding and do not use the National Codes.
If Certificates and/or Diplomas have TAFE codes, you will need to request a copy of your certificate from TAFE
with National Codes and submit these (eg National codes look like CHCCOM3C as opposed to TAFE code
4341A).
Please list the transcripts you have attached, and ensure copies of your transcripts are certified.
Name of Course
1.
2.
3.
4.
Payments, Costs and Funding Options
Refund Amounts and Timelines – all withdrawals must be in writing to receive a refund*
Refund minus 25% administration fee – Full fee
paying
Within 1 month of starting
Assessment Costs*
Submitting assessments late without an
approved extension (including resubmissions)
$50
$50
Re-enrolling into Assessment if withdrawn or
marked Not Yet Competent
MHCC Member
$125
Non-Member
$135
* Please see Participant Handbook for details
Payment Process
An Invoice Request Form will be provided to you to complete when your eligibility to enrol has been confirmed.
Disclaimer: MHCC reserves the right to discontinue/cancel or vary course and assessment arrangements
without notice and at its discretion. However MHCC will try to avoid or minimise any inconvenience to
participants. Please refer to the MHCC website for the latest course information: www.mhcc.org.au
Adv Dip CSM Qualification Enrolment Form V13
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How you heard about this training?
Please tick the appropriate box below, to show how you heard about this course/qualification
☐MHCC “Meet Your Neighbour” event (please state location)
☐Conference (please state which conference)
☐MHCC flyer (if flyer was obtained from a particular conference, please state which conference above)
☐MHCC website
☐FYI e-newsletter
☐LDU News (e-newsletter)
☐Through my workplace
☐Word of mouth
☐Other (please state)
Participant Handbook Checklist
You must read the Participant Handbook and tick each of the following items before signing the
declaration.
☐ I have read the section on Costs, Refunds and Timelines and understand the financial commitment
involved.
☐ I have read the Delivery Structure section and understand the attendance requirements of the
qualification.
☐ I understand that I must attend all 10 training days.
☐ I have read the Assessment Requirements section and understand the assessment commitments of the
course.
☐ I have a minimum of 1 year management experience and am currently in a management position where I
am supervising staff. I am aware that workplace evidence is used for all assessments and I am able to
collect evidence from and complete projects in the workplace
☐ My workplace is supporting me to collect evidence and conduct workplace projects as part of the
assessment process
☐ I am aware that when I enrol into my course I can access information and resources online (See Online
Student Portal)
☐ I am aware of who to contact within MHCC if I need assistance (See Contacts)
The following items are optional, please tick or cross accordingly.
☐ I am applying for Recognition (See Pathways to Completing the Qualification). If you answer Yes to
this question you must apply for Recognition when enrolling. Applications for Recognition are assessed
prior to commencement of classes.
☐ I am applying for credit transfer (See Previous Study Completed). If you answer Yes to this question
you must apply for Credit Transfer when enrolling. Applications for Credit Transfer are assessed prior to
commencement of classes.
Adv Dip CSM Qualification Enrolment Form V13
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Consent
This section must be read and signed in order to be eligible to study at MHCC
In completing this enrolment form you:
 confirm that your organisation will support you in the completion of this course, including workplace
supervisor’s reports and workplace based assessments
 allow MHCC to disclose information to your employer regarding your attendance at training, completion
of assessment tasks and results and additional support you may require. If you do not wish this
information to be provided to your employer please advise MHCC in writing
 consent to the collection of this personal information for the provision of training and assessment
services (please refer to the MHCC confidentiality and privacy policy)
 are aware that information supplied to MHCC including personal details and identification, will be used
by the Department of Education and Training for audit, verification, research, statistical analysis,
program evaluation, post-completion surveys and internal management processes
 agree that you have read the MHCC Participant Handbook (available at www.mhcc.org.au) and
understand your rights and responsibilities
 declare that the information provided on this form is true and accurate

☐ Tick to confirm that you have attached certified identification to this application
Signature:

Date:
Student signature required – a typed name will not be accepted
Adv Dip CSM Qualification Enrolment Form V13
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Leadership in Action: A program for experienced managers
Advanced Diploma of Community Sector Management (CHC60312)
What’s it all about?
The Advanced Diploma of Community Sector Management Leadership in Action (ADCSM LIA) is a
nationally recognised qualification from the Community Services Training Package (CHC12). ADCSM
LIA is delivered to experienced individuals already in management and/or leadership roles, which is why
we are able to roll the program out over ten workshops (Aboriginal LIA is 12 days). In this respect, we
have built-in a degree of recognition of existing skills and knowledge, therefore reducing the delivery time
and format.
So what is so unique about LIA?
Traditional leadership training programs often have a strong focus upon hard skills; the technical
and rational capabilities required of managers and leaders such as budgeting, risk management
and reporting. However, contemporary research and literature suggest these types of skills are
capabilities best learnt “on the job”. The same research indicates that a more pressing
component of skill development for leaders and managers is in the area of soft skills.
Soft skills are about managing self, individual and teams in a changing and challenging world.
ADCSM LIA utilises the concept of emotional intelligence to explore interpersonal skills,
developing the ability to identify, assess and manage the emotions of one’s self, of others and of
groups.
Utilising the method of reflective practice, participants are supported in developing the five
emotional intelligence competencies: self-awareness, empathy, motivation, self-regulation and
social skills.
During the program participants will have the opportunity to:





Identify their leadership style and discover how they can adjust their behaviour to
work most effectively with diverse colleagues and managers. This assists leaders
to increase their capacity to lead and develop others, a key characteristic of
successful managers.
Mentor a colleague for the duration of the program- a satisfying and rewarding
role.
Explore the balance between influence and control, and consider ways of dealing
with interpersonal conflicts and HR issues.
Investigate strategies to address a range of management dilemmas
Explore Action Learning as a creative problem-solving methodology
Places are limited and selection criteria will be assessed as part of the application process.
The Advanced Diploma of Community Sector Management is an initiative of the Mental Health
Coordinating Council Learning and Development.
Adv Dip CSM Qualification Enrolment Form V13
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