Department of Labour

DEPARTMENT OF LABOUR

OCCUPATIONAL HEALTH AND SAFETY ACT 85 OF 1993

APPLICATION FOR ACCEPTANCE AS A CANDIDATE FOR THE EXAMINATION/S

The Secretary

Commission of Examiners COMPLETE CLEARLY

Private Bag X117

PRETORIA

0001

According to regulation 2 (5) of the Regulations concerning the Certificate of Competency, 1990, I hereby apply to be accepted as a candidate for the examination for a Certificate of Competency as *Mechanical / Electrotechnical Engineer. (Factories)

1.  Surname (block letters) : ______

2.  First name (block letters) : ______

______

3.  Postal Address : ______

______Code: ______

4.  Date and place of birth: ______

5.  Identity No (Immigration permit No.): ______

6.  Telephone No.: (h) ______(w) ______

Included are copies of my engineering qualifications, certified to be true copies of the original documents by a Commissioner of Oaths. Listed below are the necessary documents:

1. 1.1 Certified copy of my B. Sc Degree in *Mechanical/Electrical engineering.
1.2 Certified copies of other degrees / certificates / diplomas.

2. 2.1 Certified proof of a completed apprenticeship.

2.2 A letter of good conduct from and verified by signature of the employer.

2.3 Records of service describing all my practical experience in the maintenance

and operation of mechanical / electrical machinery until present, verified by

signature of my employer/s.

2.4 Certified copy of the first page of my identity document.

2.5 Certified copy of mine certificate.

2.6 Proof of payment: R130

IMPORTANT: Foreign qualifications must first be evaluated by the Department of Education, Private Bag X110 PRETORIA, 0001.

SIGNATURE OF APPLICANT DATE

* Delete whichever is not applicable.

WET OP BEROEPSGESONDHEID EN VEILIGHEID, 1993

AANSOEK OM AS KANDIDAAT VIR DIE EKSAMEN/S AANVAAR TE WORD

Die Sekretaris

Eksamenkommissie VOLTOOI DUIDELIK

Privaatsak X117

PRETORIA

001

Volgens regulasie 2(5) van die Regulasie oor die Sertifikaat van Bevoegdheid, 1990 doen ek aansoek om as ‘n kandidaat vir die eksamen vir ‘n Sertifikaat van Bevoegheid as *Meganiese/Elektrotegniese ingenieur aanvaar te word. (Fabriek)

1.  Van (blokletters):

2. Voorname (blokletters):

3. Posadres:

Kode:

4. Datum en plek van geboorte:

5. Identiteitsno. (Immigrasiepermit No.):

6. Telefoon No.: (H) (W)

Hierby ingesluit afdrukke van my ingenieurskwalifikasie wat deur ‘n Kommissaris van Ede gesertifiseer is as ware afdrukke van die oorspronklike dokumente. Die nodige dokumente word onder genoem:

1. 1.1 Gewaarmerkte afskrif van B. Sc graad in *Meganiese-, Elektriese Ingenieurswese.

1.2 Gewaarmerkte afskrif van ander grade / sertifikate / diplomas.

2. 2.1 Gewaarmerkte bewys van voltooide vakleerlingskap.

2.2 ‘n bewaarheid getuigskrif van die werkgewer.

2.3 ‘n dienssertifikate wat tot op datum al my praktiese ondervinding beskrywe ten

opsigte van die instandhounding en bediening van meganiese / elektriese

masjienerie geteken deur my werkgewer/s.

2.4 Gewaarmerkte afskrif van die eerste bladsy van my identiteitsdokument.

2.5 Gewaarmerkte afskrif van myne sertifikaat.

BELANGRIK: Buitelandse kwalifikasies moet eers deur die Departement van Onderwys, Privaatsak X110, PRETORIA, 0001 geëvalueer word.

ONGEROJEERDE SA

HANDTEKENING VAN APPLIKANT DATUM INKOMSTESEEL/S

TER WAARDE VAN

R130.00

* Skrap wat nie van teopassing is nie.

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