Public cohort:Application form

Maximum participants: 24

Please complete in full and submit to:

Course Title:Partnership Brokers Training: Level 1

Coursedates:12-13-14-15 May 2015

Venue:University College, Melbourne

Closing Date for Applications & Fees:24 April 2014

Closing date for EARLY BIRD payment:24 March 2014

Title (Mr/Mrs/Ms/Dr)
First name
Last name
Contact address: home or work
Street
City
Zip/Post code
Country
Email
Contact telephone number
Profession
Job title
Organisation
Professional Sector
Background
Nationality
Gender
Is English your first language Y / N

Relevant Higher Education and/or Professional Qualifications

Key skills

What are your reasons for applying for this course?

Please state in the box below why you would like to take part in Level 1, describe your current engagement in partnerships and how you would apply the skills developed during the course to your work

Additional Information

Please indicate whether you can demonstrate any (or all) of the following:

past or present engagement in multi-sector partnerships, as either a convenor, advisor, negotiator, partner or third-party facilitator;

preparation of detailed case-studies or impact evaluations of partnerships for sustainable development; and

professional training and field experience in ‘interest based negotiation’, be that in relation to partnering, facilitation of multi-stakeholder dialogue, or dispute resolution.

Please indicate if you have any dietary restrictions which we need to be aware of for catering purposes:

How did you find out about the course?

☐ Via TDI

☐via PBA website

☐via Trainer: Julie Mundy

☐via Trainer: Michelle Halse

☐via previous participant - Name:

☐via Dixon Partnership Solutions (DPS – Ian Dixon)

☐Other (please specify):

Invoicing & organisational agreement

PBTFee payable AUD$2,200 plus GST- Payment and registration must be received by 24April 2015, in order to secure your place. A discounted fee of AUD$2,100 plus GST is available for early bird (PAYMENT AND REGISTRATION received by 24 March 2015), not for profit, community sector, or multiple registrations (up to a maximum of 4) from one organisation.)

Please indicate who will pay the training fee, and provide details for the invoice

EmployerYourself

Name:

Address:

ABN:

GST payable? Yes/No

Please note that you will not be invoiced until you have been accepted onto the program.

I confirm that the information which I have given in this application is complete and true.

SignatureDate

ANNEXE 1: Financial Details

The fee for the training is:Level 1: AUD$2,200 plus GST (total AUD2,420)

The Level 1 fee covers:

  • all tuition fees
  • background reading materials and course handouts
  • Level 1 Handbook
  • Morning and afternoon tea and lunch

The Level 1 fee does NOT include:

  • travel costs involved in attending the course
  • accommodation costs
  • parking at venue
  • per diems for participants during the course
  • chargeable telephone calls
  • bank or credit card charges

Once an applicant has been formally accepted and offered a place on Level 1, the nominated organisation or person (as stated in the invoicing section of the application form) will be issued with an invoice for fees. This must be paid before the Fee Deadline Date stated in Annexe 1. The applicant is responsible for the payment of this invoice, regardless of the donor. If the fee is not honoured before the start date of Level 1, the candidate may not be allowed to participate. Fee payment and invoicing is handled on the cohort on behalf of PBA by our associate organisation, The Difference Incubator (TDI).

Cancellation policy

Cancellation by candidate:
Once accepted on the training and an invoice for payment of fees has been issued, a cancellation fee will be immediately due should the candidate withdraw, irrespective of whether or not payment has been made. The cancellation fee is as follows:

50% of course fees – For withdrawals made up to three weeks before the course start date

100% of course fees - For withdrawals made within three weeks of the course start date

In exceptional circumstances, and at the discretion of the Partnership Brokers Association (PBA), cancellation fees may be put towards attending a later cohort or accepting a substitute candidate (subject to the meeting of applicant criteria).

Cancellation by organisers:
If, for whatever reason, this cohort is postponed or cancelled by the organisers, applicants will be notified at least one week before the program of any such changes. Neither PBAnor TDI can accept liability for any expenses incurred.

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