Provider Accreditation Application Form A. PROVIDER DETAILS A1. Company Registration Name: A2. Company Trading Name (if different from above): A3. Type of Company (Sole Proprietor, PTY/Ltd, cc, Ltd, other) A4. Company Registration No/CK No A5. Skills Development Levy (SDL) Number: A6. Are you ISETT SETA Levy Payer? Yes/No: A7. Are you accredited by another ETQA? If yes, indicate the name of the SETA/ BAND ETQA: A8. Number of full-time employees in your organization: A9. Number of Contract employees in your organization: A10. Size of business according to SAQA definitions (tick correct box) Survivalist ETD Small ETD provider. World Competitive small-scale ETD provider. Large ETD provider. Workplace-based provider A11. Sector identification: Information Technology Mark with a tick Electronics Telecommunication B. AVAILABILITY OF ON-SITE RESOURCES Does your organization own a computer lab? If No, do you have any contractual agreement with an institution owning a lab? How many functional computers are there in the lab you are using? Are they networked Do they have access to the internet Do they have access to the e-mail Do they have soft ware/programmes related to coursed your intend to offer? Is the software licensed? How many training sites do you have? PAAF-01 Review Date 08/10/07 Yes No Yes No Yes No Yes No Yes No Yes No Physical Address: Gallagher House, West Wing 3rd Level, Block 2, Halfway House, Midrand Postal Address: P. O. Box 5585, Halfway House, 1685 Tel: (011) 207 2600 Fax: (011) 805 6833 Call centre: 0861 1200 12 www.isett.org.za C. SITES CONTACT DETAILS(provide the following info for every site if you have more than one site) Authorized Contact Person: Title: Designation: Telephone No: Fax No. Cell No. Email Address: Physical Address: Postal Address: Province: Postal Code: Province: Postal Code: D. PROVIDER PRIMARY FOCUS Is your institution accredited by any other ETQA? If Yes, Which ETQA Are you in the process of applying to another ETQA for accreditation? Yes No Yes No Primary focus. Learning Programme If yes, by which ETQA? What is the accreditation for? E. LEARNING PROGRAMMES DETAILS (Attach a document listing learning programmes if there is more) Learning programme Qualification SAQA ID/ Title PAAF-01 Review Date 08/10/07 Unit standard(s) SAQA ID/ Title Physical Address: Gallagher House, West Wing 3rd Level, Block 2, Halfway House, Midrand Postal Address: P. O. Box 5585, Halfway House, 1685 Tel: (011) 207 2600 Fax: (011) 805 6833 Call centre: 0861 1200 12 www.isett.org.za F. PROVIDER QUALITY MANAGEMENT SYSTEM (PROVIDER QMS MUST INCLUDE BUT IS NOT LIMIT TO THE FOLLOWING POLICIES AND PROCEDURES) Do you have a clear description of your Vision, Mission, and goals as an ETD provider? Do you have an organizational structure? Do you have a Business Plan? Do you have a policy and procedure on how to manage and ensure quality? Do you have Review Mechanisms? Do you have Administrative Resources Procedures Do you have Financial Management Policy and Procedure? Do you have Occupational Health and Safety Policy and Procedures? Do you have Human Resources Policies and Procedures? Do you have policies and procedures concerning the Design, Development, Delivery, and Evaluation of Training Programme? Do you have policies and procedures relating to the management of off-site and work site education and training provision? Do you have policies and procedures for capturing and maintaining learner records? Do you have Training Committee constitution, guidelines, administration Policy and Procedures? (if applicable) Do you have policies and procedures for learner's guidance and support? Do you have Learner Information Confidentiality Procedures? Do you have Learner Feedback Post-Assessment Procedures? Do you have Learner Feedback Complaints / Grievance Procedures and cancellation? Appeals Policy and Procedure? Do you have an Assessment Policy and Procedures? Do you have an Moderation Policy and Procedures? PAAF-01 Review Date 08/10/07 Physical Address: Gallagher House, West Wing 3rd Level, Block 2, Halfway House, Midrand Postal Address: P. O. Box 5585, Halfway House, 1685 Tel: (011) 207 2600 Fax: (011) 805 6833 Call centre: 0861 1200 12 www.isett.org.za Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Signed by: Date: Please return this letter of intent to ISETT SETA ETQA for attention: Nobuhle Mdladla PO Box 5585, Halfway House, 1685 or fax it to 011 805 6833 PAAF-01 Review Date 08/10/07 Physical Address: Gallagher House, West Wing 3rd Level, Block 2, Halfway House, Midrand Postal Address: P. O. Box 5585, Halfway House, 1685 Tel: (011) 207 2600 Fax: (011) 805 6833 Call centre: 0861 1200 12 www.isett.org.za