Section 3
Declaration of Health and Fitness to Undertake Education
Renewal
The Declaration of Health and Fitness to Undertake Education Renewal is a compulsory requirement. Candidates must complete the Declaration in full.
Please ensure you disclose all health issues and provide any relevant documentary evidence. Please complete, sign and submit the Declaration of Health together with medical documents, if applicable.
Please note that until we receive the completed Declaration we cannot proceed to the interview and the admission process will be delayed. Some applicants may be asked to provide further information
from a medical doctor and we would appreciate prompt responses to any requests for further information.
Please read the following instructions:
1. Section A requests general information about candidates.
2. Section B relates to specific health matters. Please answer the questions by circling ‘Yes’ or ‘No’. If you answer yes, please give further details, including any relevant dates.
3. Section C requests the candidate’s consent to share information about their health and medical history with relevant staff of Abiding Heart Education and with appropriate medical and therapeutic professionals when necessary.
4. Failure to disclose any information which is subsequently discovered to be relevant for your fitness to attend the course may lead to your dismissal from the course without refund of tuition fees already paid.
5. Relevant supporting medical documentation and/or diagnosis should be enclosed with your Declaration.
6. Signature of Declaration
Section A: Personal Details and GP/Family Doctor Details
General Practitioner / Family Doctor Details
Section B: Medical Questionnaire
Teacher Training Applicants: Please answer all questions by circling Yes or No. If you answer Yes, please give further details and attach relevant documentation from your healthcare professional if available.
Foundation Studies Applicants: Please answer all questions by circling Yes or No, except those specific to Teacher Training. If you answer Yes, please give further details and attach relevant documentation from your healthcare professional.
Section C: Statements of Consent and Declaration
You are asked to consent to sharing information about your health or medical history with relevant staff of Abiding Heart Education and with appropriate medical and therapeutic professionals when necessary. We
may request further information from your GP, healthcare professional, medical adviser or hospital specialists and we may also request you to attend a medical examination.
I understand that by typing my name in the signature line below, I understand that this electronically
signed signature of Section 3, 'Declaration of Health and Fitness to Undertake AHE Teacher Education Course', my Application Form is valid. I honestly and accurately completed this section (3) of the Abiding
Heart’s Teacher Education Application Form and I declare that:
1. The information contained in Section 3 of my Application Form and in the enclosed documents is true and I undertake to provide documentary evidence, if required
2. All the copies enclosed are true to the original documents.
3. I am aware that the lack of veracity of the information or the distortion of the documents will affect my admissions process resulting in me not being accepted to the Course and that I may be liable for legal responsibility.
Section 4
Education Renewal Course Terms and Conditions
This section covers the Applicant’s responsibility to read, understand and agree to the Education Renewal Course Terms and Conditions Policies, Procedures and Legal Notification.
At Abiding Heart Education (AHE) we look for highly motivated and committed candidates for our Education Renewal Course. All applicants are personally responsible for reading and understanding AHE
Terms and Conditions, requirements, policies, procedures and information in this section. Once you read the Education Renewal Course Terms and Conditions, Policies, Procedures and Legal Notification (Section 4), please sign the declaration and agreement in section 5.
I HAVE CAREFULLY READ, UNDERSTAND, AND VOLUNTARILY SIGN SECTION 4 AND THE ACKNOWLEDGMENT AND ASSUMPTION OF RISKS, INDEMNITY AND GENERAL WAIVER AND RELEASE AGREEMENT (ARTICLE 31 OF SECTION 4). I AM AGREEING TO BE BOUND BY THE CONTENTS OF ALL PAGES OF THIS DOCUMENT THAT INCLUDES ARTICLES 1-31 AND ANNEX I OF THIS DOCUMENT. I ACKNOWLEDGE THAT IT SHALL BE EFFECTIVE AND LEGALLY BINDING UPON ME, MY SPOUSE, CHILDREN, AND OTHER FAMILY MEMBERS, HEIRS, EXECUTORS, REPRESENTATIVES, SUBROGEES, ASSIGNS, AND ESTATE.
Once signed, this Agreement is legally held while engaging with AHE, going through the admissions process, and during and after the course has ended.
I understand that by typing my name on the signature line below and electronically submitting Section 4 (which includes Articles 1-31 and Annex I) of my Application Form, I am agreeing to be bound by the
contents of this section of this document - visa my electronic signature, and having it be legally binding upon me.
Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.