Appendix 2: Proposed Reaccreditation Form

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Office use only:
AStat - Application for Re-Accreditation
Name:
Title
Surname
Given name
Country
Postcode
Address:
Street name and number
Suburb/locality
State
Email:
Telephone:
Are you a member
of SSA?:
YES
NO
SSAI Branch:
Accredited Statisticians shall provide to the Accreditation Committee every five years including any years of
cessation of membership of the Society or accredited membership, a summary of their activities in that five
years to demonstrate at least continuing contact/involvement with Statistics and the practice of Statistics
appropriate to them, plus the name of a referee to be contacted if desired. As stated in the Accreditation
Rules and Regulations, the Committee will discount temporary interruptions to employment, and parental
leave. Provision of comprehensive information requested below will ensure that your application is
processed in a timely manner.
Continuing role as a Statistician
Employment in the five years prior to this application
Please provide in the table below specific details of your employment in the last 5 years relevant to this
application. Indicate the nature of the work and the level of responsibility taken for the statistical
content of your own work and of those you are supervising. Provide an indication of numbers of reports to
clients and published papers during that period (continue on separate sheet if necessary). Any temporary
interruptions to employment, and parental leave should be indicated.
Employer/Position/Duration
(please provide start and end
dates eg April 2011 - July 2013)
Details of responsibilities and activities
Publications, reports or other materials
Please provide details of ‘up to five’ (at least three) publications, reports or other materials that were
produced during the five years prior to this application. These documents should be chosen to best
demonstrate your level of competence in the application of statistical methods. Applicants must have taken
responsibility for the statistical content of their work, so it is important that you summarise your statistical
contribution to those publications or reports that are jointly authored. You may wish to attach one or two
documents with this application; however, this is optional.
If some of these documents are so confidential that it would be ABSOLUTELY impossible for you to
provide them upon request, then you must provide a paragraph for each document which will tell a
knowledgeable statistician what statistical techniques you used in the paper. A fictitious example is as
follows: "I was attempting to model two variables (one continuous, and one binary) in terms of
several predictor variables (some continuous and some categorical). After performing the appropriate
tests of assumptions, I concluded that the continuous variable could be modelled by a general linear
model after the variable had had a log transformation. The binary variable was successfully modelled
by a logistic regression."
This example does not breach confidentiality, but provides information by which the assessors of your
application may judge the nature of the analyses that you have performed. If your work was
supervisory in nature, we would still expect a description that would allow knowledgeable statisticians
to assess the nature of your statistical work.
Statistical services provided outside your employment
Please specify in the table below any statistical services that you have provided outside your employment
in the five years prior to this application. (Examples: editor or reviewer for a journal, reviewer for a grant
application).
Professional Development Activities
Please provide specific details of (up to 10) activities, and the frequency of undertaking these activities, in
the 5 years prior to this application to demonstrate your personal professional development as a
statistician. (Examples: attendance at conferences, courses, workshops, seminars, Branch meetings,
reading the literature, structured discussion meetings).
Professional development activities
Frequency
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Referee
Please nominate one referee who can comment on your professional competence from first hand
knowledge of your statistical work. Where considered necessary, the Accreditation Committee may
contact your referee for a report on your application for re-accreditation.
Name:
Address:
Email:
Telephone:
Declaration

I certify that the information provided in this application form is true and correct.
Accredited Statisticians are listed on the SSAI’s web site unless they decline.

I agree / disagree (delete one) to have my name included on the web site.
Signature: ___________________________________________
The completed form should be returned to:
Chair, Accreditation Committee
Statistical Society of Australia Inc
PO Box 213
BELCONNEN ACT 2616
Date: ____/____/____
Email: [email protected]
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