Scottish Joint Industry Board for the Electrical Contracting Industry Application for the Issue of a Provisional SJIB Grade (ECS) Card

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1 Scottish Joint Industry Board for the Electrical Contracting Industry Application for the Issue of a Provisional SJIB Grade (ECS) Card Please ensure all sections are completed to the best of your ability and copies of all supporting documents are enclosed with your application. Failure to provide relevant documentation will result in a delay in your application being processed. Section 1 - Personal Details (must be completed by the applicant) National Insurance No: Once completed, please return this form along and one passport style photograph with your name and National Insurance number printed on the reverse. Full Name: Address: Postcode: Country of origin: Date Apprenticeship completed: Date of Birth: Fees: Initial Application Fees are Non Refundable All cheques and Postal Orders should be made payable to the SJIB. If you wish to make payment by card please complete the attached SJIB Payment Request form and submit with your application form. Provisional SJIB Grade (ECS) Cards are valid for 18 months only and will not be renewed. Section 2 - Qualifications Please Note: Any operative requesting a Provisional SJIB Grade (ECS) Card must provide proof they have successfully completed CEC Registration form, SELECT s ECS Health and Safety course and Assessment and either the City & Guilds IET Wiring Regulations BS 7671 (full course only) or EAL Level 3 Diploma in Requirements for Electrical Installations (code 500/3484/4) before a card can be issued. Mandatory Requirements (Please provide photocopies of qualifications) CEC Registration Form City & Guilds IET Wiring Regulations (BS 7671) ECS Health and Safety certificate EAL Level 3 Diploma in Requirements for Electrical Installations (BS 7671) Code: 500/3484/4 For office use only Apprenticeship Adult Training Country CEC UK Naric Report? Yes No C & G 2381/2382 C & G 2391/2392 C & G 2400 /01 C & G 2394 C & G 2395 C & G 2396 EAL BS 7671 EAL BS 7671(update) EAL BS 7671 (2011) Select 218 Select 209 Select 208 Code:500/3484/4 Code:500/3483/2 QCF Code:600/3719/2 Select 214 CompEx ECS APL Missing Paperwork:

2 Section 2a - Qualifications In addition to the mandatory training, the following assessed qualifications can be added to your card (Please provide photocopies of qualifications) SELECT IET Wiring Regulations (BS 7671) C & G Inspection & Testing (BS 7671) SELECT Inspection & Testing (BS 7671) C & G Design & Verification (BS 7671) SELECT Periodic Inspection & Testing (BS 7671) C & G Design, Erection & Verification (2396) (BS 7671) SELECT Design & Verification (BS 7671) C & G Initial & Fundamental Inspection & Testing EAL Level 3 Diploma in Requirements for Electrical Installations (BS 7671) Update Code: 500/3483/2 EAL Level 3 Award in Requirements for Electrical Installations (BS 7671)June 2008 (2011) (QCF) Code: 600/3719/2 (2394) (BS 7671) C & G Periodic Inspection, Testing and Certification (2395) (BS 7671) CompEx (Ex01 Ex11) (only valid if obtained within the last five years) Section 3 Apprenticeship Details Course Title Qualification Start Date End Date Section 4 - Employment History Name and Address of Company Grade or Job Title Employment Dates From To

3 Section 5 - Employer s Declaration - This section must be completed by the Employer If unemployed please tick here Name and Address or Company stamp of Employer supporting this application. We support this application and the applicant is able to carry out electrical installation work efficiently in accordance with the National Working Rules for the Electrical Contracting Industry, BS 7671 (IET Wiring Regulations), the Building (Scotland) Regulations 2004 and the Electricity at Work Regulations Name: (in print) Position in Company: Signed: Date: The SJIB have seen a significant increase in the number of fraudulent certificates and cards circulating over the last few months and treat this matter very seriously. In 2000 the SJIB National Board introduced the following rules: Any operative who submits forged certificates to the SJIB when applying for their card will have their existing card removed and no further applications will be considered for a period of 6 years, i.e. the lifetime of two cards. An operative with a genuine SJIB Grade card who submits a false application for re-grading will be allowed to retain their existing grade, however no further applications for re-grading will be considered for a period of 6 years. These rules will be applied if, after a thorough investigation an individual is found to be in breach of either rule. Completed applications should be returned to: The SJIB The Walled Garden Telephone: Bush Estate Fax: Midlothian Website: EH26 0SB grading@sjib.org.uk Please note that your application may take three to four weeks to process. The SJIB is not an open office; people will only be seen by prior appointment. Anyone visiting the SJIB without an appointment will be turned away..

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5 Payment Request Form Please complete in BLOCK CAPITALS and return this Payment Request Form to the SJIB with all corresponding paperwork. Full Name: National Insurance No. Payment For: (SJIB Grade (ECS) Card, ECS Health & Safety or Replacement Craftsman Certificate) Card Type: (Visa Debit, Credit, Mastercard, Maestro & Switch) Card Number: Valid From: Security Code: (Last 3 digits on signature strip) Expiry Date: Issue Number: (if applicable) Name on Card: Contact No: Billing Address: Amount Payable: SJIB use only Authorisation Number: Date:

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