Application form for New/Renewal Registration as Trainer

Transcription

1 MQA/QAF/TR/Ver 1.0 TRAINER 01 July 2018 Please read carefully the General Notes on Page 4 before filling this form Application form for New/Renewal Registration as Trainer A. Applicant s Details MNIC No: Title Passport No:.. (Applicable for foreign nationals only) Surname: Other Name/s: Maiden Name (if applicable) Residential Address: Name and Address of Training Institution:.. Nationality: Date of Birth:.. Phone No.- Office: Home :.. Mobile : Fax No: address :... This application is for: (see general notes) A first time application for Registration as Trainer (Rs 1,500 per field of competence) An application for additional Field of Competence (Rs 1,500 per field of competence) An application for upgrade of National QualificationsFramework level (Rs 1,500) (Please tick as appropriate) Fill in all Section except Section G An application for Renewal of Registration as Trainer (Rs 1,500 per field of competence) Page 1

2 B. Field of Competence (Specific area of expertise in which training will be delivered) Proposed Field/s of Competence (FOC) (Rs 1500/- per FOC) FOC 1:.... FOC 2:.... FOC 3:.... FOC 4:.... FOC 5:.... FOC 6:.... C. Basic Qualifications (For renewal of Registration, please provide only updates) SC / GCE O Level Alternative Qualification/Equivalent Qualification (specify:.) HSC / GCE A Level Alternative Qualification/Equivalent Qualification (specify:.) Other Alternative Qualifications Yes No D. Academic / Professional & Technical Qualifications (For renewal of Registration, please provide only updates) Qualification / s Awarding Body / Bodies Page 2

3 E. Other Relevant Training Followed (For renewal of Registration, please provide only updates) Training Organisation Course Title Date From To F. Employment History (For renewal of Registration, please provide only updates) Employer/s Job Title Date From To G. Evaluation of Training (Only applicable in case of Renewal of Registration as Trainer) G1. Training Delivery Please provide an indicative list of training delivered: Name of Training provider Course Description Note: Please attach additional sheet(s) if necessary Page 3

4 G2. Self Evaluation Details (Please tick as appropriate) (Optional) Yes No Any major contribution & achievement in the TVET sector?(for example Research, Publications etc) If yes, Please provide details Any participation in forum, seminar, conference at national or international level for training & development? If yes, please provide details. Any new acquisition in terms of mode of learning & training Methodology? (For example online mode, web base approach, team building exercises, etc) If yes, please provide details. H. Referees Referee 1 Referee 2 Name: Address: Tel: Name: Address: Tel: I. General Notes & Attachments 1. This form should be filled in after consultation of the Quality Assurance Framework(QAF) which can be downloaded from the MQA website at 2. A non-refundable processing fee of Rs 1500/- per Field of Competence is applicable. 3. A registered Trainer is authorised to provide training only in the relevant Field of Competence. 4. A registered Trainer may also opt to upgrade the Field of Competence at a higher level on the National Qualifications Framework, or apply for extension of Field of Competence. 5. Incomplete, inadequate or inaccurate filling of the application form may result in the latter being rejected. 6. A health clearance certificate must be submitted. Page 4

5 Checklist Duly filled in application form should be submitted accompanied with the following: (Please tick as appropriate to indicate whether documents are attached) All Applicants Yes No For office use only 1. A non-refundable and non-transferable processing fee (Rs1,500) as applicable 2. Photocopies of all qualifications 3. Photocopies of evidence of working experience 4. Health Clearance Certificate specifying that you are medically fit to act as trainer 5. Photocopy of Mauritius National Identity Card 6. Agreement with Training Institution * For Renewal of Registration, please provide updates only. In addition to the above, Foreign Nationals should also submit the following:- Yes No For office use only Work/Residence/Occupation Permit Photocopies of all certificates duly certified as true copies Photocopies of relevant pages of Passport Curriculum Vitae Note: Payment can be effected by cash at the counter only or by cheque drawn in favour of the Mauritius Qualifications Authority. This form together with attachments and accompanied with the processing fee should be submitted to: The Director Mauritius Qualifications Authority Pont Fer Phoenix, It is an offence to give false information or to conceal any relevant information in this form. We declare that the particulars in the application form and in the sheets attached thereto are true to the best of our knowledge and belief. Name: Trainer Manager of Training Institution Name:.. Signature:.. Signature: Date: / / Date: / /. Page 5