Maternal & Child Health Clinical Placement - Expression of Interest

Privacy Collection Statement

Your personal information is being collected by Wyndham City Council to register your Expression of Interest for MCH Programs and Clinical Placement offered by Council, LaTrobe University, Federation University and/or RMIT University. Your personal information will be stored and used by Council to communicate with you and will be shared with LaTrobe, Federation and RMIT University for the purpose of assessing your enrolment into your nominated program/placement as stated in the Terms and Conditions. Further information on how Council handles your personal information is available in Council’s Privacy Policy.

I have read and understood the Privacy Statement mentioned above

To qualify for entry into the MCH programs at either La Trobe, RMIT University or Federation University, you must be a registered nurse and midwife, with at least one-year (full time equivalent) work experience in each area.

Please complete this form together with your CV and cover letter which should include your relevant experience, and why you want to be an MCH nurse.

Qualifications

AHPRA registration number

Experience

Three-year full-time equivalent nursing experience

Yes

In Progress

Three-year full-time equivalent midwifery experience

Yes

In Progress

Contact Details

Given Name

Family/Surname

Preferred Contact Number Type

Home

Work

Mobile

Preferred Contact Number

Email Address

Address

University

Applying to La Trobe University only

Applying to RMIT University only

Applying to Federation University only

Applying to all 3 Universities

Study mode

Full Time

Part time

Placement Requirements

FT = FedUni, RMIT & La Trobe in first year - 30 days
PT = FedUni & La Trobe in first year & second year - 15 days per year
PT = RMIT in second year - 30 days

Clinical Placement Availability

I am available to attend placement a min of 2 days / week

I am available to attend some placement in blocks

I understand I may have to travel outside my home municipality to secure placement

Councils applying for:

(Please apply to no more than three councils in the first instance)

Upload Application Letter

One file only.
10 MB limit.
Allowed types: pdf doc docx.

Upload Resume With Referees

One file only.
10 MB limit.
Allowed types: pdf doc docx.

I give permission for the Council, RMIT, La Trobe Universities and Federation University to share information regarding my application for a clinical place

Confirmation

I confirm that the above information is true and correct.

I understand selection of applicants is at the discretion of the MCH service provider (council) and subject to capacity.

I agree to notify the Council and the universities within 5 working days to confirm acceptance of / or no longer requiring a clinical or university place

Signature

Sign above

Date (dd/mm/yyyy)

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