Download Living with Cancer Education Program LWCEP

Living with Cancer Education Program LWCEP
2015 Facilitator Training Course - Information Sheet & Registration Form.
The Living With Cancer Education Program – LWCEP.
The Living with Cancer Education Program provides people with cancer, their families and friends
with information and strategies to help make sense of cancer and treatment. It is a group based
program that covers a series of topics delivered by health professionals in a relaxed environment
which encourages participation, questions and group interaction.
Facilitator Training Overview.
The training aims to equip health professionals to deliver the LWCEP in their organisation through:

Facilitation skills

Adult learning principles, managing small groups and presentation skills practice.

LWCEP program content and delivery

Resources, power-point presentations and DVD

Networking and peer support with other health professionals and CCV staff

Recruitment, marketing skills, development of a promotion and program plan

Access to the LWCEP Facilitator portal on the website
Participant Selection Criteria.
1. Current knowledge and experience in working with people with a cancer diagnosis
2. Completion of professional training or relevant work experience in a field such as social work,
nursing, occupational therapy or other allied health
3. Applicability of the training and program to current workplace practice/duties/role
4. Ability to facilitate at least one LWCEP across 1 – 2 years
5. Capacity to facilitate the program with a co-facilitator - CCV may be able to assist if requested
LWCEP Facilitator Requirements.
1. Attend the two day training course
2. Have a proposed date to deliver a program within 12 months of completing the training
3. Submit an evaluation after each program.
4. Participate in a professional development session every two years (VC or face to face)
5. Is supported by their organisation in the delivery of the LWCEP.
Registration Cost:
$250.00
2015 Training Dates @ CCV:
14 / 15 May;
2015 Training Regional
Bendigo – June 23 / 24; Hume region – August 4th / 5th
20 / 21 August;
“I became a facilitator because as a social worker in oncology, I had heard good feedback on how helpful the
program was from patients who had participated in the past. I am a big believer in peer support so apart from
the fabulous information people get, they have an opportunity to talk to people in the same boat.” Julie P. 2014
The Living With Cancer Education Program is a confidential program which complies with current Federal and State Privacy Legislation. Non-identifying information may be used for
statistical purposes.
LWCEP Facilitator Training Registration /2015
Living with Cancer Education Program LWCEP
2015 Facilitator Training Course - Information Sheet & Registration Form.
REGISTRATION Form
Name:
Qualifications:
__________________________________________________________
Current role:
Years spent working in
oncology:
Organisation:
Street address:
Postal address:
Postcode: _________________________________________
Work telephone:
Email Address:
Are you willing to present LWCEP in any language other than English?
Yes
/
No
Language: _______________________________________________________________________
How did you find out about the LWCEP facilitator training?
 Colleague
 Training flyer
 Cancer News Publication
 Other
 Cancer Council Victoria website
 Cancer Council Victoria staff
Group Work Experience / Training
Please list experience you have in running group programs and any training you have undertaken in
group facilitation.
Please list what your expectations are of the Living with Cancer Education Program Facilitator training
The Living With Cancer Education Program is a confidential program which complies with current Federal and State Privacy Legislation. Non-identifying information may be used for
statistical purposes.
LWCEP Facilitator Training Registration /2015
Living with Cancer Education Program LWCEP
2015 Facilitator Training Course - Information Sheet & Registration Form.
Agreement between Cancer Council Victoria,
Auspicing Organisations and LWCEP Facilitators.
 The facilitator has the agreement of their workplace to conduct the Living with Cancer
Education Program as collaboration between themselves and Cancer Council Victoria.
 The facilitator agrees to facilitate a Living with Cancer Education Program within 12 months of
the training. If this is not possible they will contact the LWCEP Coordinator.
 That the name "The Living With Cancer Education Program" is not altered in any way and that
the contents and name of the Living With Cancer Education Program including the manual,
brochures, posters, etc. are the intellectual property of Cancer Council of Victoria.
 Cancer Council Victoria is to be acknowledged in all publicity of the Program. The Living With
Cancer Education Program Coordinator will be advised in writing if the Living with Cancer or
Cancer Council Victoria logo is to be used.
 Facilitators will have (where possible) a proposed date for their first program prior to attending
the training and will discuss any proposed changes to the program with the LWCEP
coordinator.
 Facilitators will register their program with Cancer Council Victoria at least three weeks prior
to conducting a Living with Cancer Education Program and will notify the coordinator of any
cancellations.
 Cancer Council Victoria will support LWCEP delivery with resources, information and catering.
Facilitator’s Name:
Signature:
Date:
Managers Name:
Job Title:
Organisation:
Phone number:
Email:
Signature:
Date:
The Living With Cancer Education Program is a confidential program which complies with current Federal and State Privacy Legislation. Non-identifying information may be used for
statistical purposes.
LWCEP Facilitator Training Registration /2015
Living with Cancer Education Program LWCEP
2015 Facilitator Training Course - Information Sheet & Registration Form.
Payment Form
Cancer Council Victoria ABN 61 426 486 715
A receipt will be mailed to you within four weeks of payment. Registration is GST free. Cancer Council
Victoria is a charity and is permitted by GST legislation to treat this course as a GST free supply.
Name of applicant: ____________________________
Organisation ______________________
Payment options please complete:
 Please debit my/Organisation
credit card for $___________ Name on Card: __________________________________________
Type (please circle): Visa
MasterCard
Amex
Bankcard
Number on Card: ___ ___ ___ ___
___ ___ ___ ___
Expiry Date: _____ _____ / ____ ____
Diners
Other: ________________________
___ ___ ___ ___
___ ___ ___ ___
CCV: ___ ___ ___
Signature: _____________________________________
 Please tick if your organisation is to be invoiced for your training fee
Name of organisation _____________________________________________________________
Attention (contact person) __________________________________________________________
Email address ___________________________________________________________________
Phone number ___________________________________________________________________
____________________________________________________________________________
 Please find cheque enclosed made out to Cancer Council Victoria
Please sign the Application Form and Agreement and return with Payment to:
Jane Auchettl LWCEP Program Coordinator CISS
Cancer Council Victoria, 615 St Kilda Road Melbourne 3004
Phone: 9514 6348 Fax: 9514 6750 Email: [email protected]
.
The Living With Cancer Education Program is a confidential program which complies with current Federal and State Privacy Legislation. Non-identifying information may be used for
statistical purposes.
LWCEP Facilitator Training Registration /2015