About the Application Process

• Who can help me to fill in the application form?
• Who are the relevant professionals that can sign my application form?
• Relevant Service Providers
• Relevant Health Professionals
• Why has my application form been returned to me?
• How do I get photographs for the card?
• What sort of photograph do I need?
• Why do I have to provide my date of birth?

Who can help me to fill in the application form?

There are no restrictions as to who can fill in the application form. The applicant may seek assistance from a friend, a family member or a service provider, etc.

Only the applicant, their legal guardian or their agent can sign the applicant statement in the form.

An AGENT is any person requested, or given permission, by the applicant to sign the application form on the applicant's behalf. The applicant may request an agent to sign their application form for them if they are unable to sign the form themselves (for example; the applicant is unable to hold a pen).

Your application will also need to be signed by a relevant professional.

Who are the relevant professionals that can sign my application form?

A relevant professional must sign your application form. The list of professionals that can sign your form depends on the information you have provided in your application.

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Relevant Service Providers

If you indicated in your application form that you that you receive one of the nine specific services or supports that are listed (Cardholder Application Form - Item 6), you could have the program manager of that service/support sign your form. Alternatively, you may prefer to complete the section about why you require a companion (Cardholder Application Form - Item 8) and have a Relevant Health Professional sign your form. The nine specific services/supports are;

• Victorian Department of Human Services, Disability Services funded,Shared Supported Accomodation Service
• Victorian Department of Human Services, Disability Services funded, Home First Program
• Victorian Department of Human Services, Disability Services funded, Family Options Program (caregiver payment level 3 or 4)
• Victorian Transport Accident Commission (TAC) funded support in a Supported Accommodation Service
• A Victorian Aged Person's Mental Health Residential Service
• A Commonwealth funded Residential Aged Care Service
• A Commonwealth funded Extended Aged Care at Home Package
• A Commonwealth funded Community Aged Care Package
• Attendant Allowance from the Commonwealth Department of Veterans Affairs

You must not alter the service or support that has been listed or your application may be returned to you. If the service or support that you currently receive is not on this list, you will need to complete Item 8 of the Cardholder Application Form.

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Relevant Health Professionals

If you do not receive one of the specific services or supports listed, you will need to complete a section about why you require a companion (Cardholder Application Form - Item 8) and have a health professional sign your form. (You can choose this option even if you do receive one of the listed services/supports).

You should ask a health professional who knows you well so that they are able to verify the information in your application. The health professionals that can sign your form are restricted to;

• Registered Medical Practitioner
• Registered Nurse (Division 1, 3 or 4)
• Registered Physiotherapist
• Registered Psychologist
• Qualified Occupational therapist eligible for membership of Occupational Therapy Australia
• Qualified Social Worker eligible for membership of the Australian Association of Social Workers
• Qualified Speech Pathologisteligible for practising membership of Speech Pathology Australia

Why has my application form been returned to me?

Applications may be returned to people for a variety of reasons;

• If your application is missing required information, photographs or signatures, it cannot be processed and will be returned to you to be completed.
• If we are not able to determine your need for a Companion Card from the information that you have provided, the program may request additional information from you.If your application is returned to you, there will be accompanying information indicating what the applicant needs to do for the application to progress.

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How do I get photographs for the card?

Many chemists and photo shops will take passport photographs for approximately $10 for 4 photographs (you will need to check these prices with the shop).

There are also many photo booths in shopping centres and train stations, which can be cheaper (approximately $6).

The two photographs must be submitted in hard copy and must be passport sized, colour, clear and of a good print quality (see what sort of photograph do I need ).

What sort of photograph do I need?

The two photographs should be:

• From a passport-photo outlet or booth
• Clear & current
• Identical
• Colour
• Passport sized (45mm X 35mm)
• Of your head and shoulders only

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Your photograph will be printed on the Companion Card, it is therefore important that the photographs are of a good print quality. If the photograph on the Companion Card does not adequately represent the cardholder, venues and activities may refuse the cardholder a Companion Ticket. Photographs that do not fit the criteria above may result in the application being returned.

Photographs cannot be returned to applicants under any circumstances.

Why do I have to provide my date of birth?

We ask for a person's date of birth, or their approximate age in years (for people who do not know their date of birth) for 3 reasons:

1. A person's name and address can change. A date of birth is one of the non-altering pieces of personal identifying information requested.
2. Providing a date of birth helps to distinguish applicants from each other on our database i.e.) 2 people living in a Residential Aged Care Service who have the same name.
3. Signing the application form has legal implications. People below 18 years of age cannot sign the application form for this reason. Providing a date of birth helps us to check that people below 18 years of age have had a guardian sign the application form.

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