DISCRETIONARY GRANTS: EMPLOYERS HOSTING LEARNERS TO APPLY Type of programme applying under: Tick the relevant programme with an X Stipend Per Learner (R) per month CANDIDACY INTERNSHIP TVET Placement Closing date for submission
Guidelines: Applying for DG funding by Institutions of Higher Learning Any Employer under the auspices of SASSETA may apply The Employer must attach the mandatory documents as specified in the advertisement Each application should respond to the advertisement. The Institution must ensure that ensure that they are familiar with the NSDS111 document of the Department of Higher Education; the SASSETA Sector Skills Plan and SASSETA Discretionary Grants Policy. Completing the DG Application A separate application must be completed for each project being applied for. A detailed project plan must be attached to this application. An implementation plan must be attached to this application A training plan/schedule in terms of practical training to be offered to the learners must be attached Details of the key team who will be responsible for managing and implementing the learning must be supplied A detailed line item budget must be attached to this application Accompanying supporting documents All copies must be certified by a commissioner of oaths and not be older than three months. Proof of banking details in the form of a letter from the bank or a cancelled cheque. Ensure that each relevant field in the application is completed. Each application to be signed off by a designated person Incomplete applications will be disqualified. All submissions must either : - be hand delivered to the mailroom at the SASSETA Office: Riverview Office Park, Janadel Avenue (off Bekker Road) Midrand; or - Posted to SASSETA at PO Box 7612, Halfway House, 1685 Page 2
Please indicate on the outside of the envelope,as indicated in the DG Advert, the following: - Funding Window - Project Applied for Institution Registered Name: Trading as: Skills Development Levy (SDL) Number: (Where applicable) Page 3
PART A: ADMINISTRATIVE DETAILS A1 Details of the Applicant (The Employer) Institution: Accreditation Number: Quality Assurance Body Postal Address: Postal Code: Page 4
A1 Details of the Applicant (The Employer) Telephone Number: Fax Number: Email Address: Bank: Account Holder: Bank Branch: Branch Code:.. Page 5
Please note that each application covers ONE project only No Discretionary Grants Project as advertised Candidacy /Internship /TVET Placement No of learners 18.1 18.2 Total Amount Requested
Company Details of the Employer Full Name of Employer Trading as BEE Yes No Company Owned exclusively by Management includes Company Contact Details Youth Women People With Disability Youth Women People With Disability Physical Address (including Postal Code) Postal Address (including Postal Code) Company Registration No. Phone E-mail Levy No Fax Company Tax No Location of company Rural Urban Province Contact Person Name & Surname Phone Cell E-mail Page 7
Please complete the following tables to indicate the equity spread of the learners across provinces Provincial Distribution Equity Black Coloured Indian White Disability M F M F M F M F M F -35 + 35-35 + 35-35 + 35-35 + 35-35 + 35-35 + 35-35 + 35-35 + 35 WC Gauteng NWP Limpopo KZN Mpumalanga FS EC NC Page 8
Please complete the following tables to indicate the Urban / Rural provincial spread of the learners EC FS GP KZN LP MP NC NWP WC R U R U R U R U R U R U R U R U R U Please complete the following tables to indicate the spread provincial of People With Disabilities (PWD s). EC FS GP KZN LP MP NC NWP WC Page 9
YES/NO Discretionary Grants 2 nd Funding Window Application Forms for Candidacies, Internships and WIL Programmes 2016 APPLICANT S DECLARATION I/We the undersigned hereby declare and certify that: The information provided in this application is factually correct in all material respects I/We are duly authorized to submit this application on behalf of Capacity of Employer to deliver the programme Capacity to deliver Qualified and experienced Mentors Project Cost First time Applicant Suitable workstations to host the learners Aligned to the SASSETA Discretionary Grants Policy Had not previously been awarded a SASSETA Discretionary Grant training project? DO you have sufficient workstations in line with the numbers being applied for? Provide details hereof: Project plan Well structured Project / Implementation plan Confirm that Levy-Paying Organizations are up-to-date with levy payments to the Commissioner of the South African Revenue Services (if applicable) and that the application is supported by management and employees. Representative/Organization Page 10
Full Name: Designation: Signature: Date: Page 11
CHECKLIST BEFORE SENDING YOUR APPLICATION 1. We requested assistance from SASSETA where clarity was needed 2. The Discretionary Grant Guidelines were considered in completing this application. 3. Each relevant and required section of the application form has been duly completed. 4. Each supporting document is in line with the application requirements 5. The accreditation details requirements are in order. 6. The capacity requirements (assessors / moderator) requirements are in order. 7. Each of the legal compliance (Tax clearance / CIPRO/PSIRA) requirements is in order. 8. The certified documents are not older than three months. 9. The application is an original (not a copy of a copy) 10. Each relevant organisational party endorsed this application? 11. The applicable and authorised company representative signed-off the application form. 12. The application is a product of consultation with the relevant stakeholder parties? 13. The application is signed and dated (where appropriate) by each relevant party 14. The coversheet template is pasted on the back of the envelope. 15. An independent person checked this application for compliance with each requirement. 16. The application is posted / hand delivered to reach SASSETA by the due date and time. Yes N/A No Page 12