Request FormSupport service will start from $250 members/$390 non-members with additional teachers incurring additional costs. Name of Service* Address* Street Address Address Line 2 City State Postcode ELAA Membership NumberName* First Last Position* Phone*Email* Staffing Sub-committee/PanellistHas a Staffing sub-committee OR Capability Assessment sub-committee been set up to conduct the Capability Assessment?* Yes No If yes, have you completed a Terms of Reference (TOR, Tool?)* Yes No Panellist details (if known) Panellist 1 Name First Last Panellist 1 Position Panellist 2 Name First Last Panellist 2 Position Panellist 3 Name First Last Panellist 3 Position Early Childhood Teacher/s participating in Capability AssessmentNB: For all additional ECT, this is at an additional price of ELAA members: $250 per teacher Non-member: $390 per teacher How many Early Childhood Teachers are eligible to participate in Capability Assessment?*How many of these require assistance from ELAA?* If more than 5, please upload the following information: Name Position Hire date: Eligibility criteria Does your teacher: - Have a 4-year early childhood teaching qualification (or equivalent)? - Have a 3-year early childhood teaching - qualification (or equivalent) completed prior to 17 February 2006? - Employed at a level 2.5 for a minimum of 12 months at your service? - Hold full VIT registration? - Have they been the subject of any disciplinary outcome (e.g., formal written warning) that is related to their professional practice and/or conduct in the 12 months? If yes – please provide details File uploadMax. file size: 1 GB.Person 1 Name* First Last Person 1 Position* Person 1 Hire Date* MM slash DD slash YYYY Does Person 1 have a 4-year early childhood teaching qualification (or equivalent)?* Yes No N/A Does Person 1 have a 3-year early childhood teaching qualification (or equivalent) completed prior to 17 February 2006?* Yes No N/A Was Person 1 employed at a level 2.5 for a minimum of 12 months at your service?* Yes No N/A Does Person 1 hold full VIT registration?* Yes No N/A Has Person 1 been the subject of any disciplinary outcome (e.g., formal written warning) that is related to their professional practice and/or conduct in the 12 months?* Yes No N/A If yes – please provide details in the box below.Person 2 Name* First Last Person 2 Position* Person 2 Hire Date* MM slash DD slash YYYY Does Person 2 have a 4-year early childhood teaching qualification (or equivalent)?* Yes No N/A Does Person 2 have a 3-year early childhood teaching qualification (or equivalent) completed prior to 17 February 2006?* Yes No N/A Does Person 2 hold full VIT registration?* Yes No N/A Has Person 2 been the subject of any disciplinary outcome (e.g., formal written warning) that is related to their professional practice and/or conduct in the 12 months?* Yes No N/A If yes – please provide details in the box below.Person 3 Name* First Last Person 3 Position* Person 3 Hire Date* MM slash DD slash YYYY Does Person 3 have a 4-year early childhood teaching qualification (or equivalent)?* Yes No N/A Does Person 3 have a 3-year early childhood teaching qualification (or equivalent) completed prior to 17 February 2006?* Yes No N/A Was Person 3 employed at a level 2.5 for a minimum of 12 months at your service?* Yes No N/A Does Person 3 hold full VIT registration?* Yes No N/A Has Person 3 been the subject of any disciplinary outcome (e.g., formal written warning) that is related to their professional practice and/or conduct in the 12 months?* Yes No N/A If yes – please provide details in the box below.Person 4 Name* First Last Person 4 Position* Person 4 Hire Date* MM slash DD slash YYYY Does Person 4 have a 4-year early childhood teaching qualification (or equivalent)?* Yes No N/A Does Person 4 have a 3-year early childhood teaching qualification (or equivalent) completed prior to 17 February 2006?* Yes No N/A Was Person 4 employed at a level 2.5 for a minimum of 12 months at your service?* Yes No N/A Does Person 4 hold full VIT registration?* Yes No N/A Has Person 4 been the subject of any disciplinary outcome (e.g., formal written warning) that is related to their professional practice and/or conduct in the 12 months?* Yes No N/A If yes – please provide details in the box below.Person 5 Name* First Last Person 5 Position* Person 5 Hire Date* MM slash DD slash YYYY Does Person 5 have a 4-year early childhood teaching qualification (or equivalent)?* Yes No N/A Was Person 5 employed at a level 2.5 for a minimum of 12 months at your service?* Yes No N/A Does Person 5 hold full VIT registration?* Yes No N/A Has Person 5 been the subject of any disciplinary outcome (e.g., formal written warning) that is related to their professional practice and/or conduct in the 12 months?* Yes No N/A If yes – please provide details in the box below.Pre-assessment stepsPlease refer to the Capability Assessment Guide for more information on each of the steps Have you completed Step 1- Instigation?* Yes No Have you completed Step 2- Commencement?* Yes No Have you completed Step 3- Preparation?* Yes No Committee InformationTo further assist us to support your service, we would like to gain as much information as possible about your service. Approved providers for community managed services: Is your service a signatory to the VECTEA 2020, EEEA 2020 or VECTEA mirror agreements (VECA/VEEA)?* Yes No Are you familiar with the Capability Assessment process?* Yes No Are you familiar with the role of the Approved Provider in the Capability Assessment process* Yes No Are you familiar with the role of the Capability Assessment sub-committee?* Yes No Have you read the DET Capability Assessment Guide?*DET Capability Assessment Guide Yes No Committee approvalPlease attach the minutes of the meeting approving the request for a consultancy by ELAAMax. file size: 1 GB.Please provide dates of expected time frame for Capability Assessment process:*Please note that this service will be provided on a first come first serve basis and ELAA may not be able to accommodate the timeframes. However, an ELAA officer will contact you to confirm this. Preference* Onsite (Melbourne METRO only, 15km of CBD or additional travel time is charged) Offsite Further comments:
