RCSA Australia & New Zealand
PO Box 18028
Collins Street East VIC 8003 Australia
ABN 41 078 606 416
P: +61 3 9663 0555
F: +61 3 9663 5099
E: info@rcsa.com.au
www.rcsa.com.au
Corporate Membership Application
Only a corporation (or a Crown agency) that is substantially engaged in the supply of labour onhire, recruitment, contracting or consulting services may be eligible for RCSA Corporate
membership.
Acceptance as a Corporate member is not automatic and the application process may take some
weeks to complete. Please note as per the RCSA Constitution, Corporate membership is not
available to sole traders and partnerships.
RCSA Code Training must be completed by your Nominated Corporate Delegate
and a certificate of completion submitted with the application (see page 8 for
details) Commence online Code training
PLEASE PRINT CLEARLY IN BLOCK LETTERS
Nominated Corporate Delegate and Company Details
Nominated corporate delegate full legal name:
Preferred full name:
Designation (if any) APRCSA, MRCSA, FRCSA:
Position title:
Email address:
Company name:
Company trading name:
Does the business have any other brands?
Yes
No
(please see page 3 for further details)
Postal address:
Physical address:
Work phone:
Work facsimile:
Toll free:
Mobile:
Website address:
Essential Contacts
Director(s) name:
Director:
Director(s) name:
Ethics contact name:
Position:
Email address:
Please note that all formal communications regarding membership,
renewals, will be addressed to the Nominated Corporate Delegate.
including
It is the responsibility of the member to advise the RCSA of any changes in writing.
Page 1 of 9
Corporate Membership Application
Other Company Details
Total number of FTE staff within the business (or within the recruitment division):
(Include consultants, administration, and management. Do not include on-hired)
Date company established:
Company ABN/ACN:
New Zealand Business Number:
Type of legal entity:
Ltd/Private company
Publicly listed company
Trust
Other __________________
Please list other associations and industry groups your company maintains membership with:
Company Survey
1. What does your company wish to achieve by participating as an RCSA Corporate Member?
2. Why do you believe it is important to have an industry body such as RCSA?
3. How did you learn about RCSA Corporate Membership?
At an RCSA event
Newshub email
RCSA website
Referred by colleague/ friend
RCSA Journal
Other ____________________________
Industry publication
4. Please provide detailed background information about your Nominated Corporate Delegate’s (from page
1) qualifications, skills and experience in the recruitment industry:
Page 2 of 9
Corporate Membership Application
Classification of Membership Categories
As outlined in the RCSA By Laws, it is the policy of the RCSA that Corporate membership is for
the applying organisation as a whole. Membership of a single office of a multi-office organisation
cannot be accepted. The application is to be submitted by the Head Office of the organisation,
along with a detailed list of all other offices across Australia and New Zealand.
NB. Staff members are considered to be your direct employees for the purposes of Membership.
Are you a franchisee or franchisor?
Yes
No
SINGLE OFFICE:
1-3 staff
Single office (within 70km of
nearest capital city):
4-10 staff
11+ staff
Single office regional (more than
70 km from nearest capital city):
4-10 staff
11+ staff
OR
Member with MULTIPLE OFFICES in one state*
OR
If you have multiple offices across multiple states, please indicate the location and quantity below*:
Regions
Offices
VIC/TAS
1
2
3
4
5
6
7
8
9
10
11+
NSW/ACT
1
2
3
4
5
6
7
8
9
10
11+
QLD/NT
1
2
3
4
5
6
7
8
9
10
11+
WA
1
2
3
4
5
6
7
8
9
10
11+
SA
1
2
3
4
5
6
7
8
9
10
11+
NZ
1
2
3
4
5
6
7
8
9
10
11+
*Please attach a list of your multiple office locations including full details of nominated
representative for each location (name, position title, postal and email address, fax
and phone number).
International offices:
Do you have offices in countries other than Australia & New Zealand? If so, please indicate the
country/countries:
Page 3 of 9
Corporate Membership Application
Member Groups
The Association of Medical Recruiters of Australia and New Zealand (AMRANZ) and the Association of
Nursing Recruitment Agencies (ANRA) are Member Groups within RCSA. AMRANZ Membership is
available to those organisations who are currently engaged in the recruitment of medical
practitioners including overseas trained doctors. ANRA Membership is available only to those
organisations who are currently engaged in the recruitment of nursing staff.
Please tick the box if you would like to join either or both of these
groups.
AMRANZ
ANRA
Specialisations (tick only your top 7):
Accounting
Engineering/Technical/Mining
Logistics
Admin/Office support
Executive search
Maintenance contracting
Aged/Disability care
Finance/ Banking
Manufacturing
Agriculture
Finance/ Banking/ Accounting/
Superannuation
Occupational rehabilitation/
Return to work management
Allied health
Food production
Online job board
Animal health / Veterinary
Generalist
Payroll outsourcing
Automation/Electronic/Technology
Government
Publishing/Printing
Automotive/ Auto parts
Graduate positions
PR/Promotions
Beauty/Hair care
Health & safety
Real estate/Property
Business support
Health/Medical/Pharmaceutical
Recruitment to recruitment
Call centre/Customer service
Hospitality/Catering
Retail/Fashion
Childcare/ Nannies
HR/Recruitment services
Sales/Marketing
Cleaning
Immigration
Science/Technology
Communications/Media/Advertising
Indigenous recruitment
Security
Construction/Trade services
Industrial
Shipping/Transport
Defence force
Insurance
Sport/Entertainment
IT/Telecommunications
Storage/Distribution
Education
Legal services/Compliance
Supply chain services
Electrical contracting
Library/Records management/Information
management
Travel/Tourism
Disability/ Disadvantaged
employment
Page 4 of 9
Corporate Membership Application
Business Functions
457 Labour Agreement Services
Employment Consulting Services
Permanent Recruitment
Services
Contracted Services
On-hired Employment Services
Recruitment Process
Outsourcing
Contractor Management
Services
Overseas Recruitment Services
Workforce Consulting
Services
Insurances and Policies
Recruitment Agent’s Licence
Yes
No
Not applicable
Payroll Tax Number
Yes
No
Not applicable
The following insurances and policies are in place:
AUS Workers Compensation
Insurance
Yes
No
Not applicable
Professional Indemnity
Yes
No
Not applicable
Public Liability
Yes
No
Not applicable
WHS Policy
Yes
No
In development
Collection Statement & Privacy
Policy
Yes
No
In development
Equal Employment Opportunity
Policy
Yes
No
In development
Quality standard
Yes
Specify:
RCSA Code for Professional Conduct
Following the Code for Professional Conduct means that RCSA Member practices are always of
the highest standard. The Code and its supporting materials can be accessed via these links:
RCSA
RCSA
RCSA
RCSA
Code for Professional Conduct
Disciplinary & Dispute Resolution Procedures
Constitution
By Laws
Page 5 of 9
Corporate Membership Application
Declaration
For the purposes of the questions below "Associated Entity" means any entity or person with
whom you are or have been associated by virtue of any office holding, management position,
consultancy or employment.
To the best of your knowledge, information and belief, and so far as you may lawfully be required
and permitted to disclose:
1. Are you or any Associated Entity presently, or have you or any Associated Entity within the
last [five years] been the subject of any:
(a) prosecution under any law regulating employment agencies either in Australia, New
Zealand or another country?
Yes
No
(b)
sanctions imposed by any body with lawful authority to impose sanctions under a
responsibility to regulate or moderate professional or ethical conduct in the employment services
industry either in Australia, New Zealand or another country?
Yes
No
(c)
complaint of unsatisfactory, unprofessional or
hearing or determination under the procedures
association code for the regulation or moderation
services industry either in Australia, New Zealand or
Yes
unethical conduct accepted for investigation,
of any mandatory, voluntary, industry or
of professional conduct in the employment
another country?
No
2. Are you aware of any circumstance that may give rise to any such prosecution, sanctions or
complaint?
Yes
No
3. Within the last 3 years have you, or has any company with which you have been associated,
been declared insolvent or taken advantage of any law relating to insolvency?
Yes
No
Would like to discuss
Declaration continued on next page.
Page 6 of 9
Corporate Membership Application
Declaration
4.
Except to the extent to which spent convictions or clean slate laws provide relief from
disclosure, within the last 3 years have you, or have any of your current directors or managers,
been or are you or they currently being prosecuted for a breach of any law relating to:
 Employment protection, Industrial obligations or
industrial action

Work health and safety
 Taxation or other revenue obligations (whether Federal,
State, Territory or National)

Consumer protection or fair
trading
 Human rights, discrimination, freedom of association,
harassment or vilification

Competition
 Human trafficking, exploitation of prostitution or forced
labour of any kind

Immigration
 Directors and officers’ duties under corporations of
company law

Fraud, dishonesty, theft or
corruption
 Telecommunications, spam or privacy

Sexual offences
Yes
No
Would like to discuss
I declare and confirm that, as the Nominated Corporate Delegate on behalf of the Company, that
the Company will not engage any officer, employee or contractor in or about the performance of
any employment service (as that term is outlined in the RCSA Code for Professional Conduct,
Disciplinary & Dispute Resolution Procedures, Constitution and By-Laws) unless reasonably
satisfied that such person has first read and understood the RCSA Code for Professional Conduct
and has agreed not to act in any manner that may cause the Company to breach these obligations
under them.
I declare that I have read and understand the RCSA’s Constitution and By-Laws, RCSA Code for
Professional Conduct and Disciplinary & Dispute Resolution Procedures (links provided on page 5).
I declare that all information provided is true and correct.
Both signature boxes MUST be signed.
Nominated Corporate Delegate (block letters):
Ethics Contact (block letters):
Signature:
Signature:
Date:
Date:
Privacy Statement
This information is for internal use by the Corporate Membership Assessment Panel and will not be
disclosed to any third party.
Page 7 of 9
Corporate Membership Application
Please note:
1. Corporate Members may wish to satisfy themselves that their staff members have read and
understood the Code, and that staff members have completed the Code online training and selfassessment. A certificate will be automatically generated to those staff that complete the RCSA
online Code training and self-assessment, and Corporate members may wish to place a copy of
this on the staff member’s personnel file.
2. The Company named in this application assumes responsibility for all independent contractors
and licensees associated with the Company, to abide by the RCSA Code for Professional
Conduct. The named Company will therefore be subject to RCSA Disciplinary & Dispute
Resolution Procedures should the behaviour of the independent contractor or licensee come into
disrepute. It is recommended that independent contractors and licensees become Individual
Members of the RCSA, and also read the RCSA Code and complete the online Code training.
3. It is a condition of RSCA membership that the Corporate Member at all times maintains an
effective subscription to RCSA’s corporate communications, including its electronic
communications. Members are reminded that Principle 7 of the RCSA Code, states that:
a) Members must work diligently to develop and maintain a satisfactory and up to date level
of relevant professional knowledge.
b) Members must ensure that their staff members are adequately trained and skilled to
undertake their responsibilities.
Code for Professional Conduct Training
The RCSA requires the Nominated Corporate Delegate for all new Corporate Members to
complete and pass the RCSA Code for Professional Conduct online training to become a
member. Online Code training must be completed and evidence of completion submitted with the
Corporate Membership application.
Once Corporate membership has been approved, the Nominated Corporate Delegate must ensure
that staff read and understand the RCSA Code and complete online Code training within six weeks
of RCSA approving Corporate membership, or a new staff member joining the organisation.
Please contact the Membership Manager, on +61 3 9663 0555 or info@rcsa.com.au for
information to access the online training.
OFFICE USE ONLY
Approved
Signature
ASIC register
ABN Lookup
Date
Category
NZ Companies Office
Website
Page 8 of 9
Ethics
Code training
FTE/Office/Brand conf.
Corporate Membership Application
Payment Section
Payments for annual or pro-rata Membership investment may be made using this form.
Please indicate payment method:
Cheque
Direct Deposit
MasterCard
Diners Club
Visa
American Express
Amount $ ___________ (Correct payment amount may be obtained from info@rcsa.com.au or
+61 3 9663 0555)
Card Number
Name (as on card)__________________________________
Expiry Date
Signature ________________________________________
Date
____/____
____/____/____
EFT payments can be made to:
Australian payments
Account Name
Bank
BSB
Account No
Reference
New Zealand payments
Account Name
Bank
Account No
Reference
Recruitment & Consulting Services Association
Westpac
033 002
723561
Please include “MAPP” and your company name on your
deposit and include your banking receipt with your payment
RCSA Ltd
BNZ Christchurch
02 0800 0681 385 00
Please include “MAPP” and your company name on your
deposit and include your banking receipt with your payment
Completion by the Nominated Corporate Delegate of RCSA
Code for Professional Conduct online training submitted with
application? Yes
Please email, fax or post your application to the contact details listed on page 1 of this form.
Page 9 of 9