Screening Questionnaire

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1 RPL Options (1) RPL for Access: If you have a grade 12 National Senior Certificate but do not meet the minimum admission requirements = complete the screening questionnaire + submit detailed Curriculum Vitae with certified certificates and letter from employer confirming job position. If you do not have grade 12 = complete the screening questionnaire + compile detailed portfolio of evidence (POE). (2) RPL for Subject Credits: Complete the screening questionnaire and detailed POE. Depending on the evidence, additional interviews and assessments may be required. Title A. PERSONAL INFORMATION Surname Name(s) ID number Postal Address Screening Questionnaire Cell phone number Work telephone Fax number Work address Alternative *** For biographical and statistical reporting *** Please indicate X next to your answer Gender Female Male Population group African Coloured Indian / Asian White Disability Hearing Mental Physical Sight Not applicable Nationality South African Other, please specify: B. RPL APPLICATION Please indicate X next to your answer on the left side. Type of RPL application: Access only Access & Subject Credits Qualification for RPL: National Diploma: Human Resource Management Baccalareus Technologiae: Human Resource Management Baccalareus Technologiae: Human Resource Development Magister Technologiae: Human Resource Management Page 1

2 C. MOTIVATION FOR RPL APPLICATION C.1. Explain why you are applying for RPL. (500 words) C.2. Describe how your career has developed from beginning to date. (500 words) Page 2

3 C.3. Where do you see yourself in 5 years from now? (500 words) D. EMPLOYMENT HISTORY Name of company Job title Key performance areas (duties) Employment dates: e.g. 1 Jan Dec 2007 *** Please attach detailed CV, including letter from employer confirming current job position. E. SPECIFIC HR WORKPLACE EXPERIENCE Page 3

4 HR Function(s) X if relevant to you How many years did you do this? Strategic HRM Talent Management HR Risk Management Workforce Planning (recruitment & selection) Learning & Development Performance Management Reward & Remuneration Employee Relations Employee Wellness (including EAP) Safety, health and environment Organisational Development HR Information Systems / Technology HR Administration HR Generalist In which company did you do this? F. ADDITIONAL TRAINING & DEVELOPMENT Course Provider / Institution Course dates: e.g. 1 Feb 31 March 2010 Certificate / qualification date issued Major Subjects passed ***Please attach certified copies of all certificates / qualifications with academic records. G. PROFESSIONAL BODY REGISTRATION Page 4

5 Are you registered as an HR practitioner with a professional body? Yes No Are you registered with the South African Board for People Practices? Yes No If not, what other professional body are you registered with? Indicate your professional level of registration: Master HR Professional (MHRP) Chartered HR Professional (CHRP) HR Professional (HRP) HR Associate (HRA) HR Technician (HRT) HR Candidate (HRC) ***Please attach a certified copy of your registration certificate. Make an X in the box H. RECOMMENDATION This section will be completed by the RPL facilitator in the Department of Human Resources Management. HOD recommendation: RPL for Access The candidate may proceeds with the RPL process Insufficient information to make an initial assessment Not recommended RPL for Access & Subject Credits The candidate may proceeds with the RPL process Insufficient information to make an initial assessment Not recommended Page 5

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