nomination for the 2020 defence & industry study course (disc) · non-exclusive licence to use,...

2020 Defence & Industry Study Course | 1

Nomination for the

2020 Defence & Industry Study Course (DISC)

DIVERSITY AND INCLUSION

Answering the following questions is optional. They are used to ensure the program factors in all requirements. Any answers provided below are held in strict confidence by the DISC Management Team.

The Department of Defence has a workplace diversity program which aims to create an inclusive environment that recognises individual and cultural differences and is free from discrimination and harassment. By answering these questions you will help our office develop effective workplace diversity programs and maximise the benefits that diversity brings to the organisation.

Gender Female Male

I choose not to disclose this information

Are you an Australian Aboriginal and/or Torres Strait Islander? Yes No


Are you from a culturally and/or linguistically diverse background? Yes No


Do you have a disability?Yes No



APPLICANT DETAILS

Surname First name

Preferred name Rank/Title

Date of birth Place of birth

Employement type

Industry: Prime SME Defence Public Sector

Employer

Current position

Work address

Work phone Work mobile

Work email addressEmployment postal address

PERSONAL DETAILS

Home address

Home phone Personal mobile

Personal email addressDriver’s licence number

State issued

Jacket size Shirt size

Next of kin name Relationship

Next of kin contact number

Alternate

Emergency contact name

Emergency contact number

Doctor’s name Contact number

Medicare number

Do you have private health insurance? Yes No

Name of insurer Fund number


NATIONALITY AND SECURITY DETAILS

Are you an Australian citizen? Yes No

Do you hold dual citizenship? Yes No

Do you hold a current Australian Government security clearance? Yes No

Security clearance level

Expiry date

Do you hold a Defence Common Access Card (DCAC)? Yes No

DCAC Number Expiry date

DCAC Colour Purple Blue Green Yellow Red

MEDICAL DETAILS Details — please complete if you select the Yes box.

Dietary requirementsYes No

Allergies (includes medication/s)Yes No

Recent injuriesYes No

Recent surgeryYes No

Medical limitationsYes No

MedicationYes No

DiabetesYes No

Respiratory problemsYes No

Heart issuesYes No


MEDICAL DETAILS Details — please complete if you select the Yes box.

Hypertension Yes No Do you suffer from vertigo Yes No

Current tetanus shot Yes No Do you suffer from epilepsy Yes No

Hypotension Yes No

Epipen type Epipen expiry date

Directions on how to assist with epipen

Physical limitations

Any other medical details that have not been identified previously

TRANSPORTATION

Nearest commercial airport

Qantas Frequent Flyer Number

Lounge Status

Virgin Frequent Flyer Number

Lounge Status

Do you have any special requirements for air travel


ABOUT THE NOMINEE

Biography (no more than 500 words)

Please note: If your application is successful your biography may be disseminated to other course participants and presenters.


ABOUT THE NOMINEE

Why do you want to attend DISC? (no more than 200 words)


ABOUT THE NOMINEE

What skills and experience can you bring to DISC ? (no more than 200 words)

How did you hear about the DISC?

Other


ACKNOWLEDGEMENTS

Please note: All Applicants must acknowledge each of the following course requirements in order to be able to submit their application for a position on the 2020 Defence & Industry Study Course.

Fee paying acknowledgementI am aware that participation on the Defence & Industry Study Course is on a fee paying basis. Fees for 2020 have been set at $9000 (exclusive of GST). Payment will be required within 30 days of a correctly rendered invoice being provided to my organisation if I am successful in my application.

Physical activity acknowledgementI am aware that the Defence & Industry Study Course may involve a level of physical activity and may include camping, touring naval ships involving the climbing of steep stairs and standing without shade for extended periods.

Attendance acknowledgementI am aware that successful completion of the Defence & Industry Study Course requires attendance at and participation in all modules of the course. I am further aware that the course is a residential based programme.

Privacy notice acknowledgementPrivacy notice. I acknowledge that the information I have provided will only be used for the explicit purpose of administering my application for the Defence & Industry Study Course and my student administration if I am successful. My biography and photograph may be issued to other course participants and speakers. This information will not be disclosed for any other purpose without my consent. Photos of participants may be used for Defence marketing purposes to promote the Defence & Industry Study Course.

Conditions of participation acknowledgementI acknowledge that I have read the [Conditions of Participation] and, should I be selected to participate on the 2020 Defence & Industry Study Course, agree to be bound by them during my participation.

Please note: All Applicants must make one of the following two declarations in order to be able to submit their application.

Declaration of Approval To Submit Application (Employee)I declare that my Manager/Supervisor has seen this application and read the Conditions of Participation. I further declare that my Manager/Supervisor approves submission of my application and has acknowledged the requirement to pay the course fee.

Manager/Supervisor’s Name

Contact number

Declaration of Recognition of Commitment to the Course (Employer)I declare that as the Owner/Chief Executive, I acknowledge the requirements of the course and the financial commitment should I be successful in my nomination.

Note: Please attach passport photo with your application


Conditions of ParticipationBy submitting your application for the Defence & Industry Study Course (DISC) you acknowledge that you have read these Conditions of Participation (the Conditions) and should you be selected to attend the course, agree to comply with the Conditions.

1. The course

1.1. DISC is run by the Commonwealth of Australia, represented by the Department of Defence’s Capability Acquisition and Sustainment Group (the Commonwealth).

2. Payment of course fees

2.1. Participation in the DISC is on a fee paying basis. Fees for 2020 have been set at $9000 (exclusive of GST) (the Fees). Payment to the nominated account will be required within 30 calendar days of a correctly rendered invoice being provided to your organisation. If the Fees are not paid by the due date, the Commonwealth reserves the right to cancel your application and offer your place to another individual.

3. Physical activity and waiver

3.1. The DISC may involve a level of physical activity. Physical activity may include extended periods of standing and walking, the climbing of steep stairs, the need to be outside without shade for extended periods and an overnight camping stay.

3.2. You agree that you are physically capable of undertaking such activities and agree to undertake the DISC at your own risk. To the extent permitted by law, you agree to waive any claim you may have against the Commonwealth for any injuries you sustain during your participation in the DISC.

3.3. You agree to advise the DISC facilitator if you believe you are unable to undertake a particular activity. You acknowledge that in the event you are unable to undertake an activity, the Commonwealth is not obligated to provide you with an alternative activity and that you may not receive the same level of information as other participants.

4. Attendance acknowledgement

4.1. Successful completion of the DISC requires attendance at, and participation in all modules. Failure to attend all modules may result in you being ineligible to graduate from the course. Further, you acknowledge that the course is a residential based programme.

5. Privacy notice acknowledgement

5.1. You agree that the information you have provided in your DISC application will be used for the purpose of administering your application and, if you are successful in your application, your facilitation as a student in the DISC. This may involve disclosing your information to a third party for purposes including, but not limited to, booking flights and accommodation for the purposes of undertaking the modules, organising catering and organising access to various facilities.

5.2. Additionally, you agree to allow the Commonwealth to disseminate your biography and photograph to other course participants and to speakers.

6. Personal equipment

6.1. You agree to be responsible for your personal equipment and belongings, ensuring adequate physical security as required.

7. Compliance with laws

7.1. You agree to comply with all relevant Commonwealth, State and Territory laws while participating in the course. In addition, agree to comply with the following requirements:

a. You must behave honestly and with integrity, and act with care and diligence while participating in the DISC.

b. You must treat everyone associated with the DISC, including but not limited to other participants, speakers, Commonwealth personnel and employees of any facilities visited with respect and courtesy, and without harassment.

c. You must comply with any lawful and reasonable direction given by the DISC Facilitators.

d. You must use any resources or materials provided to you in connection with the DISC in a proper manner and for a proper purpose.


7.2. You agree that failure to comply with the conditions in 7.1 may result in your participation in the DISC being suspended or terminated. Any such suspension or termination will be at the sole discretion of the Commonwealth. Where the Commonwealth determines that your participation will be suspended or terminated, you agree to waive any claim for compensation from the Commonwealth for not being permitted to attend the DISC including, but not limited to, the course fees you or your organisation has paid.

8. Intellectual Property

8.1. For the purposes of this clause Intellectual Property means all copyright and all rights in relation to inventions (including patent rights), registered and unregistered trademarks (including service marks), registered and unregistered designs, and circuit layouts, and any other rights resulting from intellectual activity in the industrial, scientific, literary and artistic fields recognised in domestic law anywhere in the world.

8.2. The ownership of any Intellectual Property you create as part of your participation on the DISC (DISC Material) will vest in you.

8.3. You agree to grant the Commonwealth a royalty-free, irrevocable, world-wide, perpetual and non-exclusive licence to use, copy, display and publish the DISC Material you create during your participation on the Course.

8.4. You agree to grant the Defence Industry Courses Alumni royalty-free, worldwide, perpetual non-exclusive licences to use, copy, display and publish the DISC Material you create during your participation on the course.

8.5. You agree to acknowledge all third party Intellectual Property rights in any DISC Material you create in accordance with standard academic practice.

9. Chatham House Rule

9.1. The Chatham House Rule is that any information disclosed during a meeting or presentation may be reported by those present, but the source of that information may not be explicitly or implicitly identified. In the case of the DISC there is an enhanced Chatham House Rule which is designed to allowed frank and fearless discussion during the course.You therefore agree that no information disclosed by a speaker to the course will be disseminated outside those present without the express permission of the speaker.

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nomination for the 2020 defence & industry study course (disc) · non-exclusive licence to use,...

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