FP&M SETA ASSESSMENT PRACTITIONER REGISTRATION FORM. Assessor Registration No Allocated. Moderator Registration No Allocated

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FP&M SETA ASSESSMENT PRACTITIONER REGISTRATION FORM FOR NAMB USE: Assessor Registration No Allocated Moderator Registration No Allocated Please attach the following to your application Copy of Identity Document Verification not older than 3 months Copy of Qualifications Relevant Qualification certificate/s only Verification not older than 3 months Assessor and/or Moderator Qualification/s Certificate/s or statement of results Verification not older than 3 months Service letters Current employment at Assessment Center Copy of CV Signed Code of Conduct Attached herewith PLEASE DO NOT ADD OR DELETE ANYTHING ON THIS FORM Application Type Occupational Qualification Assessor Registration: Qualification Title Internal Occupational Qualification Moderator Registration: 1 1 of 7 Date revised June 2017

Constituent Occupational Qualification Moderator Registration: Assessment Area: Assessor Registration number Personal Details Surname: First Names: Signature: Race: Trade qualified in: Identity number: Residential Address: Gender: Postal Address: Telephone (Home): Cell Phone number: E-mail address: Language Proficiency Language Speak Read Write home Language: Other language 1: Y N Y N Y N Y N Y N Y N 2 2 of 7 Date revised June 2017

Other language 2: Y N Y N Y N Employment History Please ensure that this is reflected in the CV attached. Current Employment Employer Name: Accreditation No: Employer Address: Telephone number: Position: Commencement of service: Qualifications: (relative qualification, assessor and moderator training) Title Provider Date achieved 3 3 of 7 Date revised June 2017

CODE OF CONDUCT FOR PRACTICING SME Practitioner: A practicing SME Practitioner is a person qualified in a relevant qualification and practicing that Occupational Qualification in any of the following contexts: SME working on the related occupation in a production, service or maintenance environment. Line supervisor or manager to a specific occupation utilizing his occupational expertise in the fulfillment of his daily tasks Occupational Qualification training staff, mentors and coaches. Occupational Qualification assessment practitioners. OBJECTIVES The objectives of this code of conduct for learners are to: 1. Define acceptable behavior for practicing learners in the workplace. 2. Develop and maintain a high quality of learner practices and promote best practices within the occupation in the workplace and training environment. 3. Provide norms and standards for practicing for evaluating their own practices and behaviors; 4. Guide learners to practice their training with integrity, sincerity and in accordance with the accepted standards of the occupation. 5. To ensure learners respect the interests of clients and the integrity of the occupation. CODE OF CONDUCT: All practices SME assessors and moderators must conduct their occupation in line with the general rules and guidelines stipulated below: 1. Execute their job functions with professionalism, good attitudes and values, due care and diligence. 2. Must adhere to acceptable practices and high quality standards when carrying out their work 3. Continuously improve their skills within the same Occupational Qualification area and mentor and guide new entrants in the occupation. 4. Not perform their work or conduct them in any manner that will compromise the standard of the occupation or training in and for the occupation. 4 4 of 7 Date revised June 2017

5. Not engage in any act of dishonesty, corruption or bribery in the execution of their duties. 6. Must disclose to the relevant parties any interest in clients, business or stakeholders to avoid any perceived, real or potential conflict of interest at all times. 7. Not knowingly misrepresent or permit misrepresentation of their own qualification/s or competency or those of any other person involved with work 8. Must give learners workplace or training decisions, recommendations or opinions that are honest, objective and based on facts. 9. May neither personally or through another person improperly seek to obtain work, or by way of commission or otherwise, make or offer to make payment for a client or prospective client for obtaining such work 10. May not unless required by law or by these rules divulge any information of a confidential nature which they obtained in the exercise of their duties in the workplace or in the training and assessment environment. 11. Must notify FP&M SETA immediately if they become aware of any violation of these rules by any registered learner in the workplace or in the training and assessment environment 12. Must notify without delay FP&M SETA if they become aware of any assessment practitioner conducting their responsibility in any manner harmful to the occupation. 13. Actively participate in activities to develop and enhance related occupations 14. Act in a manner that will enhance and maintain a positive image towards the related occupations. 15. Must at all-time have due regard for health and safety in and around the workplace. 16. Have due regard for the environment in the execution of their work and avoid, any adverse impact there on. 17. May not willfully harm the employment, reputation or business of any other practicing learner/candidate 18. Maintain the level of confidentiality required by and in the execution of the duties in terms of his employment in the occupation. 19. Must always ensure adequate supervision of and take responsibility for work carried out by subordinates in the workplace. 20. Must submit in writing any information requested by the FP&M SETA with reference to improper conduct by themselves or any other practicing artisan. 21. Maintain registration status as prescribed by the Department of Higher Education and Training Practicing Name Id No Artisan 5 5 of 7 Date revised June 2017

Trade Date Signature FOR FP&M SETA OFFICE USE ONLY Criteria 1. All the required documentation attached? a. Copy of Identity Document b. Copy of Qualifications c. Copy of CV d. Assessor / Moderator Certificate or statement of results e. Service letters f. Signed Code of Conduct 2. Authenticity of documentation validated 3. Required evidence in place to proof subject matter or subject field expertise. 4. Proof of registration as assessor (for moderator registrations) 5. Proof of registrations as a practicing in the same Occupational Qualification Yes No N/A Administrator FP&M SETA Registration recommended Yes No Type registration Assessor Moderator Uploaded on to FP&M SETA Yes No Database Comments: Name of Administrator Signature Date / / 2017 6 6 of 7 Date revised June 2017

Quality Assurance Manager FP&M SETA: Registration approved Yes No Type registration Assessor Moderator Comments: Name Johnny Modiba Signature Date / / 2017 7 7 of 7 Date revised June 2017