Response + Recovery Leadership Development Programme Application Form Please enable JavaScript in your browser to complete this form.PLEASE NOTE: The information collected will be used to determine your acceptance to the Programme and may also be used for Programme evaluation and anonymously, in response and recovery research. Personal identification data is collected so that Programme administrators can verify your identity, a requirement for tertiary education. All information collected in this application form and during the Programme itself will remain confidential to you, course administration, course assessors associated with the Programme, and with NEMA, where required. If you have questions about how your information will be used, please contact information@rranz.org.nz. Programme Pre-Requisites Current CIMS 4 standard or higher qualification (or equivalent) Relevant experience in emergency response or recovery, or other leadership roles Employer endorsement (if relevant) You must meet the above criteria before you can apply for this Programme. If you are unsure if you meet these pre-requisites or have questions about these prerequisites, please contact us at information@rranz.org.nz. Select the RRANZ programme(s) you want to register for *Part OnePart One and Part TwoPart Two Please note that if you select Part One and Part Two you will be invoiced for both courses now.NextSelect a Part One course to register for *15 January 202418 March 202424 June 202411 September 2024Unsure/none of these dates suit (we will be in touch to discuss your options)Select a Part Two course to register for *4 - 8 March 2024 (Hamilton)June 2024 (Auckland)19 - 23 August 2024 (Wellington)18 - 22 November 2024 (Location TBC)Unsure/none of these dates suit (we will be in touch to discuss your options)Your name and detailsPlease confirm your detailsNameFirst Name *Middle Name *Last Name *Preferred name (if different from first name above)Email *LayoutMobile phone number *Office phone numberDate of birth (dd/mm/yyyy) *Gender *MaleFemaleOtherEthnicity *MāoriEuropean New ZealandPacifikaAsianEuropeanOther (please specify)Ethnicity otherHighest educational achievement *No qualificationsHigh SchoolTrade qualificationTertiary certificate or diplomaBachelor's degreeHonour's or Master's degreePhDOther (please specify)'Educational achievement otherLearning/accessibility supportDo you have any special needs/disability that the course team should be aware of? *NoYes (please provide details below)Learning disabilityDo you have any dietary restrictions (we will do our best to accomodate)? *NoYes (please provide details below)During the Part Two course, we provide a welcome dinner on the Monday evening and catering throughout the week (Tuesday through Friday) of morning tea, lunch, and afternoon tea. Dietary requirementsEmployer/host informationCurrent employer *Current role *PreviousNextBilling informationBilling informationDo you work in the public or private sector? *Public sector (e.g. council, government agency, etc)Private sector (private company or individual) Will you be using the CDEM Training Fund for your course/s? *YesNoNot applicablePlease ensure you have approval for using the CDEM fund before registering for the course. Please note: RRANZ will invoice NEMA directly for your course. We will also send a completed Course Report Form on behalf of your CDEM group. Billing detailsPayment method *Invoice my organisationPay by credit card (pleae note this will incur a 2.7% credit card fee)Organisation name *For the attention of: *Email *Purchase Order Number or Cost Code *Billing address *Address Line 1Address Line 2CityState / Province / RegionPostal CodePreviousNextRRANZ cancellation, deferment and refund policyPlease read the following then tick the box below to accept.RRANZ understands there are many reasons that can lead to participants needing to cancel or transfer their participation in our courses. Unfortunately, it may not be possible for your place on the programme to be filled by another participant at short notice, resulting in costs being incurred by RRANZ that cannot be recouped. The following administration fees and time frames for refund percentages are based upon the likelihood of your place being filled by another participant. Commitment to participate in RRANZ courses brings with it the expectation that the employing organisation has made adequate arrangements to ensure that participants will be available throughout the course. Requests for consideration of special circumstances can be made to information@rranz.org.nz. Participants who have been accepted into the RRANZ programme are subject to the following fees for cancellation. Online Courses (including RRLDP Part 1, Masterclasses, and Short Courses) 1-7 days before the course starts - 100% of the course fee 8-29 days before the course starts - 50% of the course fee 30 days or more before the course starts - $50.00 administration fee Non-attendance on the day of a course is considered a cancellation, and a 100% fee will apply. Face-to-face Courses (including RRLDP Part 2) 1-14 days before the course starts - 100% of the course fee 15-29 days before the course starts - 75% of the course fee 30 days or more before the course starts - $200 administration fee Non-attendance on the day of a course is considered a cancellation, and a 100% fee will apply. All courses are subject to a minimum enrolment number (and government alert levels for the in-person courses). If RRANZ cancels a course, participants will have the option to receive a 100% refund or they may use their credit for a future course. Fees payable Part 1 (Online): $1090.00 excl GST Part 2 (Face-to-Face): $4,390.00 excl GST Total Cost of Part 1 & Part 2: $5,480 excl GST RRANZ will invoice participants on acceptance of their application. All invoicing and payments are handled by Resilient Organisations on behalf of RRANZ. Payment of all fees is due prior to the programme of study/course start date. Checkboxes *I have read and understood the cancellation, refund, and deferment policyPreviousNextResponse / Recovery Background Experience It is important that applicants have sufficient knowledge of the Coordinated Incident Management System (CIMS) Level 4 or equivalent qualifications and/or experience to get the most out of the Programme. This information is also used for the continuous improvement of this Programme.Do you meet the current CIMS 4 unit standard or higher qualification (or equivalent)? *Yes (please indicate which standard below)NoCIMS 4 std *Please explain why you feel your experience is sufficent to enable you to complete the programme. *Number of years of response or recovery experience? *(Enter as a number)What is your primary emergency management responsibility? (Please select as many as apply) *GovernanceExecutiveManagementAnimal WelfareEmergency WelfareEngineeringFire PreventionFire SuppressionGIS/Situational AwarenessHazard ScienceHazard/Risk ManagementHealthInformation Communications TechnologyInvestigationLogistics ManagementProgramme/Project ManagementPublic Information Management/CommunicationsRecovery LeadershipResilience/Emergency ReadinessResponse LeadershipResponse/Recovery IntelligenceResponse/Recovery LogisticsResponse/Recovery PlanningRisk ManagementRMA Planning/AdviceTraining/EducationOther (please specify below)Other responsibilitiesIs there any further information you would like to tell us in support of your application?PreviousNextUpdating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to check your information. You can also go back to make changes. When you are ready click the Submit button to send your application form.PreviousSubmit