DG03 Legal Employer ApplicationAugust 2012

Discretionary Grants:

DG03 Legal employer Application

(application to be accompanied by a provider application)

August 2012 Funding Window

Chamber
Project Reference No
Closing date for submission

A separate application should be completed for each project.

Document Reference

Document Ref No: / SPRGL003
Document Title: / DG03 Legal Employer Application
Version No: / V .05
Date: / August 2012
Author: / SENIOR MANAGER: Skills Implementation & Monitoring

Document Approval

Name / Signature / Date
Compiled by: / Senior Manager: SI & M
Recommended by: / Chief Executive Officer
Approved by: / Board/EXCO

Table of Contents

Discretionary Grants Employer Application 2012 – 2013

PART A: ADMINISTRATIVE DETAILS

PART B: APPLYING, COMPLETING AND SUBMITTING THE APPLICATION

PART C: HIGH LEVEL PROJECT PLAN

PART D: CALCULATING THE COST PER LEARNER (Please attach the three provider applications as supporting evidence)

PART E: BUDGET SUMMARY

PART F: APPLICANT’S DECLARATION

Definition of Acronyms

SDLA / Skills Development Levies Act
SDA / Skills Development Act
SETA / Sector Education & Training Authority
NSF / National Skills Fund
SARS / South African Revenue Services
HRDS / Human Resources Development Strategy
JIPSA / Joint Initiative on Priority Skills Acquisition
ASGISA / Accelerated and Shared Growth Initiative for SA
NSDS / National Skills Development Strategy
SSP / Sector Skills plan
SASSETA / Safety & Security Sector Education and Training Authority
SMME / Small Medium and Micro Enterprise
SLA / Service Level Agreement
DOL / Department of Labour
ETQA / Education and Training Quality Assurance
DG / Discretionary Grants
NSDS / National Skills Development Strategy
SAQA / South African Qualification Authority
NQF / National Qualification Authority
ESDA / Employment and Skills Development Agency
ISOE / Institute of Sectoral and Occupational Excellence
NGO / Non Governmental Organisation
CBO / Community Based Organisation
NLPE / Non Levy-Paying Enterprises

Discretionary Grants
Employer Application
2012 – 2013

August 2012 Funding Window

Registered Name:
Trading as:
Skills Development Levy (SDL) Number: (Where applicable)

Skills Development Levy (SDL) Number: (Where applicable)

Please take note that when completing this application form reference should be made to the SASSETA Discretionary Grants Guidelines and Criteria for 2012-2013.

This application must be down –loaded.

Contact details:

Call Centre:

Date Stamp: / Received by:
Name:
Reference Number: / Signature:

PART A: ADMINISTRATIVE DETAILS

A1 Details of the Applicant (The Employer)
Company/Organization:
Postal Address:
Postal Code:
Size of the Organization/Company: / 0- 49 / 50 – 149 / 150+ / Mark with an X
A2 Provider Details: (Attach the provider application)
Preferred Provider Name:
Accreditation Number:
Quality Assuring Body:
Programme Approval Details
Tel No: / Fax No:
Cell: / E-mail:
A3 Banking Details:
Account Holder: / Bank:
Branch: / Branch Code:
Account Number: / Type of Account:

N.B: Attach letters of accreditation as well as a cancelled cheque/stamped bank Statement

PART B: APPLYING, COMPLETING AND SUBMITTING THE APPLICATION

Guidelines: Applying for DG funding

  • Each application should respond to the advertisement.
  • Ensure that you are familiar with the NSDS111 document of the Department of
  • Higher Education, especially the NSDS111 key developmental and transformative imperatives as well as the NSDS111 goals
  • The project should be linked to SASSETA’s Sector Skills Plan (SSP) as well as your organisation company’s / organisation’s WSP

Completing the DG Application

  • A project proposal must be submitted in the prescribed template available on
  • the SASSETA website (
  • A separate application must be completed for each project being applied for.
  • Ensure that each relevant field in the application is completed
  • Application should include a valid tax clearance and current CIPRO documents.

Include the fully completed Provider Application(s) with full supportingevidence with your application.

Complete the comparative cost per learner template

  • Each application (where appropriate) to be signed off by the employer and a labour representative
  • Incomplete applications would be disqualified

Submitting the Discretionary Grant application

  • Both the Application form as well as CV’s should be originals.
  • Certified copies of supporting documents should not be older than three months
  • All submissions must either :

-be hand delivered to the mailroom at the SASSETA Office: Level 3 East · Gallagher House · Gallagher Estate · 19 Richards Drive · Midrand

or

-Posted to SASSETA at PO Box 7612 · Halfway House · 1685

  • Please indicate on the outside of the envelope:

That it is an application for Discretionary Grant funding– August Funding Window

-Employer Name

-Provider Name

-The Chamber

-The Project Name

-The Project Number

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DG03 Legal Employer Application August 2012

Please note that each application covers ONE project only

No / Discretionary Grants Project as advertised for the specific Chamber / LS or
SP / NQF
level / No of learners / NSDS 111
Goal
18.1 / 18.2

Company Details

Full Name of Employer
Trading as / BEE / Yes / No
Company Owned exclusively by / Youth / Women / People With Disability
Management includes / Youth / Women / People With Disability
Provider Contact Details / Physical Address (including Postal Code)
Postal Address (including Postal Code)
Phone / Fax
E-mail
Company Registration No. /
(Attach certified CIPRO Docs) / Company Tax No
Location of company / Rural / Urban / Province
Provider Contact Person / Name & Surname
Phone / Cell / E-mail
Please complete the following tables to indicate the equity spread of the learners across provinces
Provincial
Distribution / Equity
Black / Coloured / Indian / White / Disability
M / F / M / F / M / F / M / F / M / F
-35 / + 35 / -35 / + 35 / -35 / + 35 / -35 / + 35 / -35 / + 35 / -35 / + 35 / -35 / + 35 / -35 / + 35
WC
Gauteng
NWP
Limpopo
KZN
Mpumalanga
FS
EC
NC
Please complete the following tables to indicate the Urban / Rural provincial spread of the learners
EC / FS / GP / KZN / LP / MP / NC / NWP / WC
R / U / R / U / R / U / R / U / R / U / R / U / R / U / R / U / R / U
Please complete the following tables to indicate the spread provincial of People With Disabilities (PWD’s).
EC / FS / GP / KZN / LP / MP / NC / NWP / WC

Please provide details of each of the following indicated in the table below

PART C: HIGH LEVEL PROJECT PLAN

FUNDING WINDOW:
Project Title / NQF Level / Credits
Start Date:
End Date:
Primary ETQA:
Provider Name:
Executive Summary
Provide a brief summary of what the project is going toachieve as well as the strategic objectives of the NSDS and SETA targets
Scope of work
Provide the work breakdown structure of the project
Project Deliverables
Provide concrete deliverables that the project aims to achieve and how they will be measured.
FUNDING WINDOW:
Project Title / NQF Level / Credits
Start Date:
End Date:
Primary ETQA:
Provider Name:
Project Management
Details of how the project is going to be managed as well as reporting
Monitoring and Evaluation
Indicate how the project will be monitored and evaluated.

PART D: CALCULATING THE COST PER LEARNER (Please attach the three provider applications as supporting evidence)

Learning Programme
Number of training days / Provider 1 / Provider 2 / Provider 3 / Comment
-Consecutive days training
-Portfolio-building Workshop
Item / Cost Per Item Per Learner Per Provider (Group of 25 Learners)
Provider 1 / Provider 2 / Provider 3
Workshop Training costs
Training Materials
Facilitator(s) fee
Venue hire
Audio-visual equipment
Catering
Assessments of Portfolios
Moderation of Portfolios
Certification of learners
Road Travel (R per km)
Toll fees (where appropriate)
Flights (where appropriate)
Car hire (where appropriate)
Accommodation
Sub-Total
Project Management Cost
TOTAL COST
Reasons for the choice of preferred provider
Capacity to deliver / Qualified and experienced Project Team
Qualified and experienced facilitators
Qualified and experienced moderators
Costing / Within the budget
Reasonable Cost Per Learner
First time entrant / Had not previously been awarded a SASSETA Discretionary Grant training project?
Project plan / Well structured Project / Implementation plan
Value add / What does the provider offer that November add value to this project?
Vulnerable Group / Company owned by Youth, Women and People with Disabilities

PART E: BUDGET SUMMARY

Project # / Project Title / Overall Cost
= Cost per learner X the Targeted No. of Learners)
Grand Total
No / Supporting Evidence: / Included
  1. Certified copies Novembernot be older than three months
/ Yes / N/A / No
Annexure / Certified Company Registration documents
Annexure / Current Valid Original Tax Clearance (No copies would be accepted)
Annexure / Organogram of the management of the company to show the inclusion of Youth, Women and PWD

PART F: APPLICANT’S DECLARATION

I/We the undersigned hereby declare and certify that:

  • The information provided in this application is factually correct in all material respects
  • I/We are duly authorized to submit this application on behalf of Click here andtype the name of applying organization.
  • Confirm that Levy-Paying Organizations are up-to-date with levy payments to the Commissioner of the South African Revenue Services (if applicable) and that the application is supported by management and employees.

Employer Representative/Organization

Full Name:
Designation:
Signature: / Date:
Employee (Labour )
Representative:
(Where applicable)
Full Name:
Position in Union:
Signature: / Date:
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