Traffic Control Application

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1 Application to deliver (RIIWHS205D) Control Traffic with Stop/Slow Bat Training Program Form No. TC-1 Thank you for your interest in delivering traffic control training on behalf of the Department of Transport and Main Roads. Please read the following pages and provide detailed responses where requested. The licence fee applicable for this approved program is $2500 plus GST (per annum). Your application will be reviewed within five business days of receipt. If you have any questions, or telephone (07) Registered Training Organisation Please provide the following information RTO name Office use RTO number ABN On scope of last ASQA audit address Web address Business address Postal address Contact name Contact number 1

2 2. Trainer/assessor qualifications and authorisations Please complete the details below for each employee/third party delivering/assessing the program. This page can be copied if required. Note: All copies of qualifications and certifications are to be certified by a Justice of the Peace. Number of staff employed to deliver/assess the program Number of third parties contracted to deliver/assess the program Name: Employee Third Party TAE40110 Certificate IV Training & Assessment RIIWHS205D Control traffic with stop/slow bat Traffic Controller Industry Authority Card (Qld) Issuing RTO RTO No Issue Card Number Attached Office use Construction White Card Name: Employee Third Party TAE40110 Certificate IV Training & Assessment RIIWHS205D Control traffic with stop/slow bat Traffic Controller Industry Authority Card (Qld) Issuing RTO RTO No Issue Card Number Attached Office use Construction White Card - 2 -

3 3. Trainer/assessor experience In support of the RIIWHS205D Control Traffic with Stop/Slow Bat unit of competency, please provide a work statement for each employee or third party contractor. Include qualifications and authorisations; experience in traffic control; evidence of industry currency and continuing professional development. Ensure each work statement addresses all criteria listed below. Mandatory criteria Included Office use 1. Two years of current industry experience 2. Demonstrate limitations of responsibility in accordance with TCASAP 3. Planning and preparing to control traffic interpret and apply site traffic plan instructions and procedures; position signage and barriers 4. Control traffic vehicle and pedestrian 5. Operate communication devices 6. Clean up 7. Access and apply safety procedures 8. Adherence and application of the TCASAP 9. Example of two current and relevant projects (word limit 300 words) - 3 -

4 4. Supporting documents Attach copies of the following documents Attached Office use only Business profile Marketing plan explaining how you will market the approved program Copy of the last ASQA audit report or letter of compliance (if applicable) Written references from two business customers within the last 12 months Memorandum of Understanding (MOU) with each third party Copy of certificate of currency for public liability insurance for a minimum amount of $10 million Copy of certificate of currency for workers compensation insurance in accordance with the Workers Compensation and Rehabilitation Act, 2003 (QLD) Training location/s Physical address/s Enrolment and completion data for the qualifications listed in your business profile A sample of student evaluations for completed qualifications Confirmation that RTO has a signed agreement with a placement company to ensure all traffic control participants have access to the mandatory 20 hours vocational placement component of this training program. Please refer to section 4.7 of Traffic Controller Accreditation Scheme Approved Procedure. For more information please read Traffic Controller Course information and FAQs - 4 -

5 5. Forward to the Department of Transport and Main Roads Check that all required questions are answered and that the form is signed and dated. Return this form and supporting documents to: June Lense Manager (Training & Development) Department of Transport and Main Roads GPO Box 1412 Brisbane Qld 4001 A team member will contact you within five business days of receipt of this application. If you have any questions, techtraining@tmr.qld.gov.au or telephone (07) Name Signature Office use only Position Desktop auditor Signature Reviewed Signature Application outcome Approved Supporting comments - 5 -

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