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Health.-.Covid Vaccination Status - Exempt Form
  • Must be NCIG's COVID-19 Vaccination Declaration or Exemption Request form
  • Applicants name to be displayed on uploaded evidence and to match applicants registered name (however shortened versions of names such as 'Chris' for 'Christopher' is accepted)
  • Date of Birth (DOB) for applicant to be listed and match applicants registered DOB
  • Date of

    Competency

    Competency Requirements

    Upload Requirements

    Examples

    • Must be NCIG's COVID-19 Vaccination Declaration or Exemption Request form
    • Applicants name to be displayed on uploaded evidence and to match applicants registered name (however shortened versions of names such as 'Chris' for 'Christopher' is accepted)
    • Date of Birth (DOB) for applicant to be listed and match applicants registered DOB
    • Either the vaccination section or the exemption section to be filled out
      • If the vaccination section is filled out: At least, Date of Second Vaccination to be completed
    • Verification Officer Declaration section to be completed in full by a company representative
    • Issue Date = Date of latest vaccination
    • Expiry Date = None
      • If the exemption section is filled out: Date of Exemption to be completed
    • Verification Officer Declaration section to be completed in full by a company representative
    • Electronic signatures such as a signature signed with a stylus, or a timestamped digital signature, or a signature in a "fancy font" can be accepted
    • Issue Date = Date of latest vaccination.

    If exemption supplied, issue date to be document was signed.

    • Expiry Date = Date of exemption expiry (if listed), otherwise none