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TETA Assessor Registration Application Rev 04

Doc No: WDA005 Rev004 1 1. Last Name: _____ 2. First Names: _____ 3. ID Number: 4. Gender: _____ 5. Race / Equity: 6. Disability Status: 7. Home Language: 8. Internal Contracted 9. Industry / Chamber: 10. Personal Contact Details: Physical Address: Postal Address: Postal Code: Postal Code: Telephone No: Fax No: Cell No: E-mail: TETA Assessor Registration Application Doc No: WDA005 Rev004 2 11. Organisation/Training Provider Contact Details: Company Name: Physical Address: Postal Address: Postal Code: Postal Code: Telephone No: Fax No: Cell No: E-mail: 12.

Doc No: WDA005 Rev004 4 Criteria Essential Criteria Evidence Provided Application form completed in correct format. Applicant shall have sufficient technical

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