Register of Activity Providers Application

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The Duke of Edinburgh's International Award - Australia

All questions are mandatory, and must be answered before submission of the application. Before filling out this application, please make sure you have read all information regarding being included on the Register of Activity Providers on our website.

This form must be submitted with supporting documentation, as detailed below:

Signed Volunteer Code of Conduct
Insurance Certificate(s) of Currency
Minimum 2 Working With Children Checks of staff members/volunteers
Evidence of Award training i.e training certificates
Minimum 2 written references from Award Centres who have used your services for the Award

Organisation/Company Details

Organisation/Company Name

Physical Address

State

Postal Address

State/Territory

Website

Telephone

Principal Contact Person:
This will be the primary person the National Office will contact.

First Name

Last Name

Telephone

Email

Owner/Chair of Board:

First Name

Last Name

Telephone

Email Address

Type of Organisation
Please list your legal entity type

ABN

State of Registration

Year established (min. 2 years ago preferred)

Is the Organisation financially solvent?

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Activity Details

Activity/Activities Provided:

Is there access to public transport?

Location of Activity:

Please advise of any access restrictions

Age restrictions:

What is the typical cost/fee?

Is there any Duke of Ed discount?

How much?

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Training Requirements

Completing at least Award Leader Level 1 Training is required to be included on the Register of Activity Providers.
At least one person in your organisation must be trained to this minimum standard, though it is preferable more than one person is trained. Training is offered in person through the Division Offices in each State/Territory, but otherwise available online for free.
Please remember to attach certificate or other transcript as proof of training completion upon completion of this form.

Below also enables you to detail the technical expertise of your staff/volunteers below who will be working with Award Participants.

Trained Personnel 1

Staff/Volunteer Name

Level Trained

Training Completed Date

If selected other, please describe:

Where Trained? i.e online, or WA Office etc

Subject/Technical Qualifications

Trained Personnel 2 (optional)

Staff/Volunteer Name

Level Trained

Training Completed Date

If selected other, please describe:

Where Trained? i.e online, or WA Office etc

Subject/Technical Qualifications

Trained Personnel 3 (optional)

Staff/Volunteer Name

Level Trained

Training Completed Date

If selected other, please describe:

Where Trained? i.e online, or WA Office etc

Subject/Technical Qualifications of Staff

Working With Children Check Information

Do all Staff working with children have a Working With Children Check?

We request the DOB for this part of the application so we can verfiy the WWCC status

Provide details for at least two members of staff

WWCC 1

First Name

Last Name

Date of Birth

WWCC Number

WWCC 2

First Name

Last Name

Date of Birth

WWCC Number

Will all staff working with Award Participants be over 18 years of age?

Award Experience - History with the Award

What is your history working with Duke of Ed Award Centres? Please describe in detail. Guideline: at least 250 words

In order to verify your experience with the Award and working with Award Centres, please supply TWO written references. Please provide the details of 2 Referees below. Remember to attach the written references as part of this application.

An Award Centre Referee should be an Award Leader from an Award Centre that has used your Organisation's Activity in the past.

Award Centre Referee 1

Contact Name

Email

Phone

Award Centre Referee 2

Contact Name

Email

Phone

Insurance

What Insurance policies are currently held by the organisation? Min. generally expected Public Liability and Accident Insurance. Please attach certificates of currency to this application at the end of the form.

Any record of adverse media, fines or non-compliant activity?

Please Explain:

Supporting Documentation

Signed Volunteer Code of Conduct

Insurance Certificate of Currency

Award Training Certificate, please submit as a single/combined PDF

Written Reference Award Centre

Written Reference Award Centre 2

Register Conditions

By submitting this application, you agree to the following:

We recognise that the National Board may at any time and at its sole discretion remove an Activity Provider from the Register due to non-compliance with Award requirements, unsafe practices, matters of unethical activity, reputational damage and/or complaints made and upheld.
We agree to pay the application fee and an annual fee for our inclusion on the Register of Activity Providers.
The use of the Award logo on any documentation including digitally is subject to prior approval by the CEO of The Duke of Edinburgh’s International Award - Australia. With approval, Activity Providers may use the Award logo with the words “Proudly Supporting”, as per the Award’s branding guidelines.
As an Activity Provider and, where relevant, as Assessors, we will ensure the Participant is supported to complete the relevant Section of the Award in accordance with the Award Handbook, and recorded in the Online Record Book.
We will abide by The Duke of Edinburgh’s International Award – Australia Volunteer Code of Conduct as published in The Award Handbook. A signed copy is required.

We confirm that the information provided above is accurate. Should there be any changes, we will immediately inform in writing The Duke of Edinburgh’s International Award – Australia.