AMADA Registration: MSL Practicing Certificate
This membership is for first year AMADA applications only. This application is for those who have successfully completed and received their IMSLE Certificate and IMSLE Associate Course Results. To renew your AMADA from your second year onwards please visit: https://dyslexiaassociation.org.au/ada-memberships/
Name
*
First Name
Last Name
Your title by formal qualifications (Teacher, Speech Therapist etc.)
*
Relevant Business Name (If you work in a school please name the school here)
*
Business/Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Email (this is the email address for your clients to access you if you are in private practice)
*
example@example.com
Personal Email (this is necessary so we can contact you out of office hours, holidays etc)
*
example@example.com
Business Phone Number (this is the number for your clients to access you if you are in private practice)
*
-
Area Code
Phone Number
Personal Mobile Number (this is necessary so we can contact you out of office hours, holidays etc)
*
-
Area Code
Phone Number
Please list your formal university degree/s and any other tertiary courses completed
*
Please list any relevant certifications and professional organisational memberships
*
List any relevant professional development days/training, courses and provide date/year
*
Please include teacher registration number and state if you are registered. It is not compulsory for AMADA approval to be a registered teacher.
When approved will you be an AMADA
*
In a school that has ADA School Membership
In a school that does not yet have ADA School Membership
In private practice
In a private centre/clinic working with minimum 3 other AMADA's
Other
Please advise MSL training dates and venue for your 5 day intensive
*
Date of completion (this is the date you received your MSL results)
*
Please advise on your MSL experience and settings (one to one, small group and or whole class
*
Has your MSL experience been in schools and or private practice, please explain your MSL environment and setting/s
*
Have you had any opportunities to present or advocate for MSL and or the ADA? If yes, please describe
*
Can you also offer Maths instruction? Please include formal maths teaching qualifications (B.Ed) plus any relevant additional professional training courses that you have attended.
Please attach a copy of your IMSLE results and certificate of attendance (3 documents). If you have any issues accessing your results please email: imsl.education@gmail.com
*
Browse Files
Cancel
of
Please include a letter of reference or Statutory Declaration that states that you have completed 100 hours of MSL teaching in the last 12 months. If a new graduate this will be 50 hours with your focus student + 50 additional hours.
*
Browse Files
Cancel
of
Do you require an ADA Directory listing (AMADA) for your services. Your listing is inclusive, no extra fees apply. Please note all AMADA's will be registered with the ADA. Classroom teachers please note: you need your principal's approval to teach privately so only click 'yes' if you have approval.
*
Yes
No
Other
If you requested a Directory listing, please provide a short succinct description of your services and age groups etc. ADA will include your formal qualifications and any other relevant information you have supplied in this application form.
Upload for ADA Directory listing or email to amada.applications@gmail.com
Submit
Should be Empty: