This form asks you to provide information about yourself and your request for recognition of previous education, learning and experience.

The form contains four sections:

Section 1: General information about yourself and your experiences. (Provision of a resume should suffice for these purposes).

Section 2: Information about the Areas of Knowledge for which you are seeking recognition. (Refer to Core Body of Knowledge Guidelines (CBOK)).

Section 3: The relation between the Areas of Knowledge and your experiences including work, community, education, training and professional development, presentation and publication of papers etc.

Section 4: Brief Summary of Conclusions to be stated by applicant.

After completing the application form you should forward it to the Director, Membership Board. The assessment will be based on the questions that are included in this application and will be made by a panel formed by the Director, Membership Board. The purpose of the panel review will be to confirm and clarify your request for recognition and to make sure that all relevant learning experiences have been identified.

Please provide the following documentation, if not previously supplied:

• A detailed resume
• Copies of any presented papers, public addresses, published articles, or statements, case studies, etc.
• Copies of testamurs, transcripts, professional development course outlines
• Work samples if available
• Any other information which you feel might aid the assessment of your request.

You should read the RPL Guidelines before completing this form.

1. APPLICATION AND ASSESSMENT FEE

Council has approved a fee of $300 which will not be implemented until 1 January 1998.

SECTION 1: GENERAL INFORMATION

(a) Personal Details:

Surname: __________________________________________________

Given Name: __________________________________________________

Address: __________________________________________________

___________________________ Post Code _____________

Tel. No. Day: ___________________ Evening ____________________

I certify that, to the best of my belief, the information provided in this application is true and correct.

Signature: ___________________________ Date: _________________

(b) Work Experience (Summary):

Indicate in the space below work experience in IT which relates specifically to Areas of Knowledge involved.

	Employer	Type of Work	Dates Employed
1			From: To:
2			From: To:
3			From: To:
4			From: To:
5			From: To:
6			From: To:
7			From: To:
8			From: To:
9			From: To:

Add any additional experience, etc. that you think might be relevant:

(c) Qualifications, Professional Development, Training, Presented Papers, Published Articles, etc..

Title/Award	Brief Details	Date

(d) Community Involvement in IT: (d) Detail below any involvement in the community with respect to IT.

SECTION 2: Information about the Areas of Knowledge.

After studying the CBOK document tick the Areas of Knowledge your believe what you have learned from your experience provides a fit.

1	Computer Organisation and Architecture
2	Conceptual Modeling
3	Database Management
4	Data Communications and Networks
5	Data Structures and Algorithms
6	Discrete Mathematics
7	Ethical/Social Implications/Professional Practice
8	Interpersonal Communications
9	Program Design and Implementation
10	Project Management
11	Security
12	Software Engineering and Methodologies
13	Systems Analysis and Design
14	Systems Software

SECTION 3: Please detail relation between selected Areas of Knowledge and what learned from Type of Work and Qualifications

SECTION 4: BRIEF SUMMARY OF CONCLUSIONS  

 

 

 

 

 

 

Area Of Knowledge	Relevant Prior Qualifications And Experience Related To What Learned from Type of work (From Section 1(b) (c) and (d))