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AVERT Registration Application
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AVERT Registration Application
AVERT Registration Form
Step 1 of 5
20%
Occupation
Vet
Vet Nurse
Student Vet
Name
*
First
Last
Phone
*
Email
*
Address
*
Street Address
Address Line 2
City
State
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
State
Post Code
Vet Registration Number
*
Enter your vet registration number
State
Registration state
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
State
Licences
Please select valid licences
Drivers
Darting
Shooters
Other
Other Licences
Vaccinations (up to date)
Please select your up to date vaccinations
Tetanus
Rabies
Other
Other Vaccinations
Authorised officer (Govt.)
Biosecurity Act
Export Control Act
Training
Tell us a bit about your training
Training courses undertaken
Biosecurity – including use of personal protective equipment, entry and exit procedures, decontamination and the importance of following correct procedures
Contemporary emergency management arrangements and structures, including arrangements for management of natural disasters and emergency animal diseases
Emergency services agencies – e.g. AIIMS (Australasian Inter-service Incident Management System) training
Information management, information flow and communications in a response (including privacy/confidentiality/reporting lines, records management)
RFS, CFA, SES, Other State based emergency services training
Stress management
Other training courses not specified
Please list other training
*
Experience
Do you have experience working in disasters?
Do you have an understanding of where vets (whether volunteers or employed) fit within the response to incidents (including the concepts of lead agency and support agencies)
*
Choose an option
Yes
No
Areas of special interest or expertise
Any other information/experience you have that would be of assistance in emergency situations in Australia or Overseas
In emergency situations, where would you be available to work?
*
In the field
Off-site eg: Triage Clinic
In a control centre
Consent
*
I agree
I AUTHORISE VETS BEYOND BORDERS TO RELEASE MY INFORMATION TO EMERGENCY RESPONSE OFFICIALS IN THE EVENT OF AN AVERT EMERGENCY SITUATION
Signature
*
