PSETA ACCREDITATION APPLICATION FORM
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1 RECEIVED BY DATE FOR OFFICE USE PSETA ACCREDITATION APPLICATION FORM PUBLIC SERVICE SECTOR EDUCATION AND TRAINING AUTHORITY This compulsory form is to be completed by organisations when applying for primary accreditation with the PSETA. All sections must be completed. The applicants completing this form can contact the PSETA ETQA department if uncertain of some requirements as stipulated herein. It is recommended that anyone completing this form is familiar with the PSETA accreditation policy which is available on the website. To avoid any unnecessary delays in the processing of the application, applicants are requested to ensure that all supporting documents are submitted as per the instructions contained in this form. INSTRUCTIONS This form must be completed in full. All supporting documents must be submitted as required. Use a black pen and print clearly when completing the form. Ensure that the programme you re applying for resides within the PSETA scope. Ensure that the Assessors and Moderators are properly registered or qualified to be registered with the PSETA. Sign the provider code of conduct and/or terms and conditions Annexure A. 1
2 SECTION A: PROVIDER DETAILS ORGANISATIONAL INFORMATION Name of the Provider Trading Name Type of Organisation Application Reference Organisation Registration Number Postal Address Province and City Physical Address Telephone Number Fax Number /Website Contact Person Position in the Organisation Mobile Number Address Note: Company registration documents; valid tax clearance certificate; audited financial statements or valid insolvency letter; proof of payment of skills development levy (only if applicable); proof of availability of the facilities and evidence of access to other organisations facilities through valid agreement. 2
3 SECTION B: SCOPE OF ACCREDITATION List Unit Standards and/or Qualification applying for SAQA ID Title Level Credits Note: If scope applying for is more than the space provided above, please insert more lines to accommodate all learning programmes. 3
4 SECTION C: ETD PRACTITIONERS Capture the details of the Assessors and Moderators submitted by the provider, ensure that registrations are still valid and relate to the scope of provision applying for ID Number Last Name First Names Registration No Status Please submit the documentary proof of registration with the PSETA, including the scope of registration. I f external ETD Practitioners will be used, sound and properly signed MOU s must be submitted as proof of valid agreement. If the details submitted are incorrect, they will not be recorded. The Assessors and Moderators will only be allowed to assess or moderate the unit standard(s) or qualification(s) which they are registered against. Staff Complement Indicate the total numbers of staff members (full-time and contract) employees in the organisation Full-time Contract Note: Please submit the organogram of the organisation. 4
5 SECTION D: QUALITY MANAGEMENT SYSTEM For the PSETA to award accreditation, the organisation applying for accreditation must provide proof that it has a quality management system that addresses all critical ETD policies and procedures as well as their working documents. Does your organisation have the following policies and procedures, please indicate by ticking the applicable answer (Yes/No) on the far right: Human Resources Physical Resources Administration Finance Learner Entry Guidance and Support Learning Material Development and Review Assessment Moderation Appeal Certification Recognition of prior Learning Impact Assessment Policy and Procedures Yes No 5
6 Workplace Learning Health and Safety NOTE: The policies and procedures must be submitted with their applicable working documents and/or forms. SECTION E: ADDITIONAL ORGANISATION INFORMATION All organisations are expected to have basic business and/or organisation information that explains the specific nature of their business, approach, strategies and etc. Does your organisation have the documentary proof of the following aspects of business, please indicate by ticking the applicable answer: Vision Mission Values Strategic Objectives Organogram Business Profile NOTE: The proof of the existence of the above information must be submitted with the application pack. Policy and Procedures Yes No 6
7 SECTION F: SUBMISSION CHECKLIST To ensure that the submission complies with the requirements, you are requested to complete the checklist below: Yes No Duly completed PSETA accreditation application form Organisation registration documents Valid tax clearance certificate Audited financial statements or valid insolvency letter Proof of availability of facilities Quality Management System Letter of appointment of QMS representative Business profile ETD Practitioners Any sort of MOU Training Material Letter of appointment of OHS representative Assessor and/or Moderator registration application documents fully completed with supporting documents Letter of appointment of learner support person 7
8 SECTION G: DECLARATION BY APPLICANT I... (Full names) declares to the best of knowledge that all information provided is complete and correct. Signed at... on this, the... day of Applicant Signature Date Completed Application Forms must be forwarded to: PSETA ETQA - Accreditation 420 Festival Street Hatfield Pretoria 0028 Or P.O. Box Hatfield
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