Membership Information You have selected the CPE Applicant membership level. The price for membership is $300.00 now (including GST). Do you have a discount code? Click here to enter your discount code Discount Code Account Information Username Password Show Password Confirm Password First Name Last Name Email Address Confirm Email Address Position Title Website Receive Newsletter and related Society information Peer Support and Consultant Mentors / Offers Peer Support Consults Address for Correspondence(Include Company name if work address) Company Name Address Line 1 Address Line 2 Suburb Country State NONE ACT NSW NT QLD SA TAS VIC WA Other International Postcode Home Phone Work Phone Mobile Fax Areas of Specialisation Industry Sectors Transport Manufacturing Health Care & social assistance Energy & mining Defence Agriculture, forestry & fishing Construction Office and mobile work environments Government Research UX HCI User testing & usability Controls and displays Affective ergonomics Human Centred Design Inclusive design Good work design Product design Built environment Neuro ergonomics Safety Science Work systems Injury prevention Injury management Psycho-social factors Training Human Performance & Analysis Human factors engineering Task analysis & heuristics Organisational psychology Error analysis Human capacity Search Profile Summary Examples of Relevant Society Affiliation I have been an active member of the HFESA (or other IEA affiliated society) for the past four years. This is demonstrated through the following (please include dates and examples): Qualifications I have completed an education programme that provides a comprehensive set of Ergonomics competencies (physical, cognitive and organisational domains). Qualification 1 Qualification Year granted Granting body Qualification 2 Qualification Year granted Granting body Qualification 3 Qualification Year granted Granting body Please tick to confirm Summary of the major work sample which will be provided in the full application, including date of completion; and/or commentary on how mentoring can assist me achieve this criteria**: Summary of supporting work sample/s & date/s completed; and/or commentary on how mentoring can assist me achieve this criteria**: The checklist for major and minor work samples can be downloaded here. Upload file 1 Upload file 2 I have completed and attached the “Checklist for major & minor work samples” I can provide evidence of a minimum of four years full-time practice (or part-time equivalent) in Human Factors and Ergonomics, and confirm that I am currently working in the field, working as an ergonomics practitioner, educating others about ergonomics. I can nominate 2 referees (one of whom is an HFESA Member) to support my application with written reports, utilising the HFESA referee form. (Note: their names and details to be provided in Stage 2, the formal CPE application). You can download a copy of the referee form here. Full Name LEAVE THIS BLANK Already have an account? Log in here Choose Your Payment Method Pay by Credit Card Pay by Check Processing…
