Accreditation Application form - Sasseta

1 Accreditation Application formFor further information please contact us on: Call Centre 0861 102 477 SERVES THE FOLLOWING INDUSTRIES:Legal Investigation and Private Security Policing Correctional Services Justice National Intelligence Agency South African Secret Services Department of DefenceInstructions on completing the Application form1. All education and training providers seeking Accreditation with the Sasseta must complete this AnAccreditation Manualhas been compiled to assist you with the completion of this Application and toprovide you with other critical information on the Accreditation process.

2 It is essential that you review themanual before completing this Application , and refer to it while youfill in the Please submit all the relevant documentation requested (see the last paragraph of each section) with theapplication applications must be complete to enable the SETA to proceed with the Accreditation process. To assist withthis, if you have queries regarding the Application , please refer to the Accreditation manual, and if you needadditional information or clarity on any aspect of the Application form , contact the Please use a black pen and print clearly when completing the Please note if you are applying to become accredited as anassessment onlyinstitution you arenot requiredto complete sections c or Sector Education and Training Authority for.

3 Legal Investigation and Private Security Policing Correctional Services Justice National Intelligence Agency South African Secret Service Department of DefenceBackground informationIMPORTANTIf the training provider is located in one physical location only: Complete sections 1, 2, and 3If the training provider is located in more than one physical location, hasbranches: Complete section 1 once Complete sections 2 and 3 forevery physical locationSECTION 1 SINGLE ESTABLISHMENT/HEAD OFFICE DETAILSREFERENCE NUMBERSPAYE, SDL or UIF Number:Provide any one of these referencesSASSETA ETQA ReferenceNumber:Provide 12 digitAccreditation Number,or APR or PAA Summary DetailsRegistered Name:For CIPRO registered organisations, these details will be verifiedwith CIPRO.

4 Sole proprietors should provide personal Name:Complete even if same as aboveType of Organisation:Close Corporation, Section 21 Company, Trust, Sole Proprietor, :SETA to which organisation is Chamber:Where Registration Number:Provide CIPRO number or National ID in case of sole Income Tax Number:Either company or personal income tax number,notthe VAT Number:Where Commencement Date:Either date of incorporation (CIPRO) or date on which businessstarted trading (sole proprietor)Physical Address:Physical AddressPostal Code:Details will be verified with CIPRO and/or Address:Postal AddressPostal Code:NOTE: Branchis defined as a permanent training site with afixed address.

5 There is another responsible, dedicated person other than the responsible person of themain branch (head office/as applied for in the original Accreditation ). This branch is to be fully operational and has applied for their own Accreditation withSASSETA (and SAPS if applicable).The particulars of the branch need to be given to Sasseta by the accredited training provider (Main branch/Head office) and be site visited by Sasseta accordingly. The branch needs to comply with all the necessary processes and procedures as stipulated in the Accreditation Official Contact PersonInitials:Surname:This should be the single official contact person for theSASSETA Number:(0 )Fax Number:(0 )At least the office phone and fax numbers must be Number:(0 )e-mail:@Ensure that the e-mail address is legible and clear2 The Sector Education and Training Authority for.

6 Legal Investigation and Private Security Policing Correctional Services Justice National Intelligence Agency South African Secret Service Department of Chief Financial Officer/Accounting OfficerInitials:Surname:Position/Capacit y:Telephone Number: (0)Fax Number:(0)Must be reflected on an official letterhead,Cell Number:(0)which must be attached to this Address:Postal AddressPostalCode:Staff NumbersTotal number of full-timestaffNumber of staff who areETD PractitionersTotal number of part-time ETD staffTotal number of ETDstaff regularly con-tractedProvince/s in whichprovideroperates(Note: a provider maybebasedin oneprovince butoperatingin otherprovinces)GPWCECKZNLPNWMPFSNCA reas in which provideroperates(Note.)

7 A providermay bebasedin an urbanor rural area butoperatingin rural areas or both urbanand rural areas)Urban Areas onlyRural Areas OnlyBoth Urban and RuralAreasApplication to become accredited asan assessment only provider or adelivery and assessment provider(please tick the relevant box)Assessment onlyDelivery and assessmentDo you hereby declare that theprovider organisation is notaccredited by any other ETQA?YesNoSignatureName of signatoryPosition in organisationDate3 The Sector Education and Training Authority for: Legal Investigation and Private Security Policing Correctional Services Justice National Intelligence Agency South African Secret Service Department of DefenceHead Office Sasseta ETQAR eference Number.

8 ProvideAccreditation Number, or APR or PAA COMPLETE THIS PAGE FOR A SINGLE ESTABLISHMENT/EVERY BRANCH*SECTION 2 DETAILS OF PREMISES(Complete even if same as details in Section 1)This is public information and will be published on the Sasseta Web Numbers: Sasseta ETQA ReferenceNumber:ProvideAccreditation Number, or APR or PAA Numberif different from the Head Office DetailsProvide the name under which business is conducted. If more than onebranch trade under the same name, a distinguishing characteristic of theTrading Name:branch ( suburb, town, city or province) must be specified after thetrade , UIF, or PAYE Number:Provide if this number differs from that of the Head the Head Office at these premises?

9 YesorNoPrimary ETQA:SASSETAETQAO ther:Please specify the ETQA with which this establishment/branch isaccredited. IfOtherplease attach documentary Code:If the establishment/branch is accredited by an ETQA other thanSASSETA ETQA, please specify the code allocated by that Date:CCYYMMDDP lease specify the date of Accreditation by the accrediting Expiry Date:CCYYMMDDP lease specify the expiry date of Type:HDelivery OnlyHDelivery & AssessmentHAssessment Only Please indicate which functions the branch is accredited Number:(0)Fax Number:(0)Cell Number:(0)e-mail:@Contact Person.

10 These details must be different from the Head Office unless thePhysical Address:establishment/branch is physically at the same place as the Head AddressPostal Code:Postal Address:Physical AddressPostal Code:HGautengHWestern CapeHMpumalangaProvinceHEastern CapeHLimpopoHNorthern Cape Indicate the province where the branch is StateHNorth WestHKwaZulu-NatalSECTION 3 ASSESSORS AND MODERATORS(provide details of all assessors and moderators used by THIS ESTABLISHMENT/BRANCH)National ID NumberSASSETA Registration Number*A/MName and Surname*Please indicate only one per line: A Assessor or M Moderator.