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Director Certification Application Form for Provider Approval, Qualification Recognition and CPD programme evaluation This form is completed as per the Guidelines on approval of activities contributing toward the Career Path or CPD for Director Certification. There are 2 sections to this form: Section 1: This section is only completed once and applies to the applicant institution or organisation. Section 2: This section is completed for each activity or intervention for which approval is sought. The applicant simply needs to copy and paste this section for each activity or intervention. Both parts of this section need to be completed for each activity or intervention. Additional information can accompany the application as separate documents. Section 1: Institution or Organisation This section needs to be completed by every institution or organisation applying for approval. Please ensure that all relevant information is provided. Name of Institution / Organisation Website address (of programme applying for) Postal Address Company registration no (if applicable) VAT number (if applicable) Status of Institution Accredited HEI or training Yes / No or Organisation provider? Reg number: Registered with DHET? Yes / No SETA / QCTO / CHE SETA / QCTO / CHE accreditation? Recognized professional Yes / No body? SAQA number: Other Please describe Reason for Recognised Qualification application Approved CPD Programme Name of contact Title person Name Surname Designation / Job Title Contact details Office no.: Mobile: Email: Section 2: Activity or Intervention 2.1 Description of Activity or Intervention Complete a separate table for each activity or intervention included in this application. The application may be supported with detailed content, presentations, learning material etc to facilitate an accurate CPD point allocation. Name of activity or intervention Date and programme of activity or intervention Full qualification SAQA ID Type of activity or Short learning programme (SLP) intervention Workshop, seminar, conference 2 days or 3 days Full Duration or (please tick) less qual. more Mode of delivery Face to Online Hybrid face Outline of activity or intervention (attach brochure or webpage printout) For full qualification approval, provide comprehensive list of outcomes and content Name(s) of facilitators or lecturers (attach CVs) Target audience Assessment (Y/N) Type of assessment (describe)
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