Applications are to be lodged to the SRSA Program Management Unit.

Closing date to submit applications: 5:00PM EST 28 February 2018. Proposed CPD activity must take place between: 1 April 2018 and 28 February 2019.

Late application will not be accepted.

Support for Rural Specialists in Australia (SRSA) Program
CPD Support for Rural and Remote Specialists

Important information to note when completing the application form

  1. Before completing this application form, please read the Individual Application Guidelines.
  2. Where the applicant is not affiliated with a College (i.e. area of need practitioner, staff specialist), the applicant is also required to submit a letter from the employer confirming their status as a specialist.
  3. Applications will be considered on a case by case basis with priority given to more remote applications. Information on the remoteness classification is available online (click here).
  4. The applicant must have been living and working in the rural and remote area for no less than 12 months.
  5. Backfill for individual funding support may also be considered where, without such support a medical specialist may not be otherwise able to participate in approved CPD activities.
  6. Applications must be submitted using the SRSA Individual Support Funding Application Form.
  7. All applications must be typed.
  8. Annual Scientific Meetings are considered lower priority than practical skills workshops.
  9. The total maximum grant amount an applicant can apply for is $10,000 for a maximum of five days at a maximum rate of $2,000 per day i.e. workshop registration, travel costs and accommodation.
  10. Please supply a URL or flyer providing more information on the nominated CPD event.
  11. The proposed CPD event must take place in Australia, between the 1 April 2018 and 28 February 2019. No retrospective funding will be considered.
  12. If the applicant attends the CPD event before being informed of the outcomes of the Assessment Panel, they do so at their own risk. Please ensure you keep your receipts so that if your application is successful you can be reimbursed.
  13. Applications will be assessed by an Assessment Panel, appointed by the SRSA Sub-Committee.
  14. Applications will be assessed according to the Eligibility and Selection Criteria outlined in the Individual Application Guidelines.
  15. Post assessment feedback will be provided to both successful and unsuccessful applications.
  16. Successful applicants must provide all relevant original receipts for full reimbursement.
  17. Statutory Declarations will not be considered.
  18. If you require further information on the application process please contact the SRSA PMU at admin@ruralspecialist.org.au or 02 9256 5419.

Privacy Statement: The information provided by you in this application form will be used to assess your eligibility to receive funding under the Support for Rural Specialists (SRSA) Program and for reporting and research purposes. Any information you have supplied in connection with your application will be dealt with in accordance with the National Privacy Principles of the Privacy Act 1988.

Support for Rural Specialists in Australia (SRSA) CPD – Individual Application Form

Please refer to the Individual Application Guidelines when completing this application.

1. Applicant details

2. Needs Assessment

Please list the last 3 CPD activities you have participated in, including date and location (i.e. local activities such as audit or formal CPD activities)
1.
2.
3.

3. Learning and Evaluation

4. Details of CPD activity

5. Budget

6. DECLARATION

I declare that:
The information in Section 1 is true and correct.
The information in Section 2 – 3 provides an accurate reflection of my current CPD and peer support needs.
The information above outlines a CPD activity which will support my capacity to practice as a specialist in a remote area.
The CPD proposal outlined above will be implemented as per the information above, and any variations will be discussed with the SRSA Program Management Unit and the relevant College.
I understand that I am required to complete an evaluation of my involvement with this SRSA funding support.
Full Name:
Date:

Applications are to be submitted by the closing date: 5:00PM EST 28 February 2018.