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Also known as
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Work employer
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Preferred Email
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Preferred Phone
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Gender
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Male
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Secondary Email
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Work role
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Work address
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Work suburb
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Work state
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Work postcode
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Work country
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Secondary phone
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Personal address
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Personal suburb
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Personal State
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Western Australia
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Northern Territory
Personal postcode
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COMS number
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ROMSA number
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O&M qualifications
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Other qualifications
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Advanced practice
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all of selected
none of selected
GDMI
Children
Adult neuro
Assistive technology
Access
Echolocation
CVI
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Wheeled mobility
Profile
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Service to the industry and professional service
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Publications
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Awards
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Conferences and presentations
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Mandatory declaration - comply with Constitution rules and code of ethics
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Yes
No
Mandatory declaration - worked 3 months FTE in past 5 years
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is not
Yes
No
Mandatory declaration - have professional indemnity insurance
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is not
Yes
No
Mandatory declaration - comply with local laws
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No
Mandatory declaration - not under investigation for conduct/health
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is not
Yes
No
Mandatory declaration - completed 80 hours LV/blind experience
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is not
Yes
No
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