Transcription of TETA Assessor Registration Application Rev 04
1 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.
2 Name of SETA to which Organisation is paying its Levy: _____ _____ 13. Education and Training Information (Attach certified copies of qualifications with detailed CV.): _____ _____ _____ _____ 14. Brief Description of Assessor Experience: _____ _____ _____ Doc No: WDA005 Rev004 3_____ _____ _____ _____ 15. Brief Description of Work Related Experience: _____ _____ _____ 16. Scope of Unit Standards to be Assessed (A separate page may be used if necessary): US Code Unit Standard (US) Title Doc No: WDA005 Rev004 4 Criteria Essential Criteria Evidence Provided Application form completed in correct format. Applicant shall have sufficient technical expertise to apply the assessment criteria outlined in the unit standards. Applicant has met the requirements of the generic Assessor standard.
3 Certified by a recognised and (accredited) provider. Applicant shall have at least three years experience in the context in which the assessment is being conducted. Meets any regulatory licensing requirements. Evidence meets requirements in terms of Validity, Authenticity, Currency and Sufficiency (VACS) Doc No: WDA005 Rev004 5 Area of Competence National Qualification or Unit Standards) for which Assessor Registration is Applied for: Evidence that candidate has a related experience/technical expertise / qualification equal to or above that of the unit standard for which Assessor Registration is applied for and sufficient experience. Registration Recommended Yes/No Doc No: WDA005 Rev004 6 _____ _____ Signature of Applicant Date FOR OFFICE USE: VERIFIED BY : _____ Date:_____ VERIFIED BY : _____ Date:_____ APPROVED BY : _____ Date:_____ Application NOT RECOMMENDED FOR THE FOLLOWING REASONS: COMPILED BY : _____ Date _____ VERIFIED BY : _____ Date _____ APPROVED BY : _____ Date _____ INFORMATION ENTERED ONTO DATABASE DATACAPTURER: Date.
