Counselling Psychology Student Handbook.pdf - Health Sciences ...

CHECKLISTBefore you forward this Consent Form to the Criminal Records Screening Unit for processingplease initial the boxes provided below to ensure all relevant documentation is attached. Anincomplete Consent Form will be returned YOUConsent Form completed and signed;Photocopies of Documentary evidence that has been signed by the person who has sightedthe originals;Correct Cheque / Money Order made payable to The Department of Health;Name and contact number of the person signing the photocopies of the documentaryevidence as sighting the originals.Name: _________________________________________ (of the person who has sighted theoriginal documentation, which can be anyone who has known you for at least 12 monthsexcluding family members)Contact Number: ______________________Page 64 of 88Curtin University is a trademark of Curtin University of Technology.CRICOS Provider Code 00301J (WA), 02637B (NSW)