WWW / ETQA DIVISION
ASSESSOR/ MODERATOR
REGISTRATION FORM

ASSESSOR AND MODERATOR REGISTRATION FORM

STATUS
CUSTODIAN / ETQA MANAGER
APPROVED / ETQA MANAGER
DECISION DATE / 03 DECEMBER 2012
REVIEW DATE / NOVEMBER 2013
VERSION NUMBER / ETQA/GL/ Assessor and Moderator Application Form /vs2/2012
AMENDMENT DATE / 05 November 2012
Office use Only
Date Received / d / d / m / m / y / Y / y / y / Received by

Dear Assessor/Moderator,

The following is required with your application form. Please confirm that you have noted these criteria and include relevant material with your application.

DOCUMENTS REQUIRED / NOTED / INCLUDED
Please tick (x)
An UpdatedComprehensive Curriculum Vitae (CV) including references (relating to Insurance and/or Fundamentals)
A CertifiedCopy of your Identity Document (ID)
Copies of all relevant qualifications, certificates, statement of credits, etc. to show evidence of learning in the subject you are applying to assess or moderate (also relating to Insurance activities and/or Fundamentals)
A CertifiedCopy of your assessor/moderator ETDP SETA Statement of Results
The INSETA Code of Conduct with new applications. NB: this should be initialled on each page and signed in full where applicable
Confirm that you have read and understood the INSETA Assessor policy and/or Moderator policy
Fill in the Assessor and/or Moderator Application form in detail and send back
Please indicate INSETA unit standards/qualifications that you are applying to assess and/or moderate – NB: we require the full title and ID number of each unit standard and/or qualification that you are applying to assess and/or moderate.
Complete details of the company/companies you will be doing assessments / moderations for and update these details with each application for additional scope.
For applications to extend your assessor and/or moderator scopeplease complete only SECTIONS A, B, C, F, H, J of the application form. However, please indicate if details have changed in any other section so we may update your records.
Assessor/Moderator Signature / Date

Your application will be referred to our ETQA specialists for evaluation. Our turn-around rime for initial evaluation is approximately 6 weeks, depending on the quality and completeness of your application documents.

The following may be found on the INSETA website, as follows:

> divisions > ETQA > assessor pack

  • Assessor/Moderator Application Form
  • Assessor Policy
  • Code of Conduct

> divisions > ETQA > moderator pack

  • Assessor/Moderator Application Form
  • Moderator Policy
  • Code of Conduct

Post to: / Hand/Courier deliveries:
Ouma Mmethi
ETQA Division
INSETA
P.O. Box 32035
Braamfontein
2017 / Ouma Mmethi
ETQA Division
INSETA
Oakhurst (North Wing)
11 St. Andrews Road
Parktown
Johannesburg
Please contact us if you have any other enquiries.
Tel:(011) 544 – 2000
Fax:(011) 484 – 9878 / Email:

Notes:

  • Please ensure that the following application form is completed fully and with as much detail as possible.
  • Please do not put in “refer to CV” in the application form. All questions to be answered in full.
  • Incomplete forms will not be evaluated until outstanding information/documentation is supplied and will delay our evaluation.
  • Evaluations are done on a monthly basis – please allow 12 weeks after applying before enquiring on the progress.

SECTION A:APPLICATION FOR REGISTRATION:

Please mark with (X) in the appropriate block(s)

Assessor / I am competent against “Conduct outcomes-based assessments” US
Moderator / I am competent against “Conduct moderation of outcomes based assessments”US
Extension of Scope
Re-Registration / Assessor Registration No / Moderator Registration No

SECTION B:APPLICANT’S PERSONAL DETAILS:

Title / Ms. / Mrs. / Mr. / Dr. / Prof.
Surname
First Names
Identity Number
Date of Application / D / D / M / M / Y / Y / Y / Y

SECTION C:APPLICANT’S CONTACT DETAILS:

Physical Address
Postal Code
Postal Address
Postal Code
Telephone Number / CODE / N U M B E R
Fax Number / CODE / N U M B E R
Cell Number / CODE / N U M B E R
Email Address
Province

SECTION D:ADDITIONAL APPLICANT’S DETAILS:

Please refer to the equity keys below when completing the equity section

Gender / Male / Female
Disability / Yes / No
Nationality
Highest Educational Level
Current Occupation
Years in Occupation
Racial Group / BA / BC / BI / WH / O / Specify:

EQUITY KEYS

BA > Black AfricanBC > Black ColouredBI > Black Indian/ AsianWH > WhiteOOther

SECTION E:Formal Education and Training Occupational Qualification(s) Obtained

(Show your competency and proficiency in the scope you are requesting)

(NB: provide this separately from your CV)

Please complete this section of the registration application form by providing the INSETA with the details of all thequalifications that you have acquired thus far. Please try to provide the details of those qualifications that are relevant to the qualification(s) and/ or unit standard(s) that you want to be registered against.

Please note that your qualification must be at a level higher, and in the subject field, of what you are applying to assess and/or moderate.

Qualification Name
(Learning Programme) / Modules/subjects/Unit Standards / Duration / Specialisation
(If applicable)

SECTION F:ASSESSOR AND/OR MODERATOR STANDARD / TRAINING OBTAINED

Standard / Name of Awarding Provider / Registration Number
ASSESSOR
MODERATOR
Experience / Number of years assessing / moderating / Description of Experience
ASSESSOR
MODERATOR

SECTION G:INSURANCE – RELATED WORKING EXPERIENCE

(Show your competency and proficiency in the subject(s) that you are applying to assess and/or moderate)

(NB: provide this separately from your CV)

Employer / Job Title / Functions / Duration

WWW / ETQA DIVISION
ASSESSOR/ MODERATOR
REGISTRATION FORM

SECTION H:QUALIFICATION(S) AND/ OR UNIT STANDARDS TO BE REGISTERED AGAINST

A.Registration Criteria:

  1. Assessors
  • A assessors need to have at least 3 years relevant work (occupational) experience in the field that they want to assess in,
  • Possess relevant qualification/skills programme (refer toETQA Circular 4/2007).
  • An assessor needs to have at least 1 year’s facilitation experience.
  • Possess relevant assessor unit standard

2.Moderators

  • Have knowledge and/or expertise of the learning field.
  • Have at least 2 years assessing experience before applying.
  • Have more than 3 years relevant occupational experience
  • Possess relevant qualification/skills programme (refer to ETQA Circular 4/2007).
  • Possess relevant moderator unit standard

Notes:

1.INSETA requires compliance with the following for any scope request to be consider:

“any person performing assessment or moderation functions for such qualification/unit standards must have aqualification at a level higher, and in the subject field, of what they are assessing and/or moderating” (refer toETQA Circular 4/2007, annexure 1, below)

  1. Identify Qualification(s) and/or Unit Standard(s) you wish to be registered to assess or moderate against. Applicants who wish to be registered only for the INSETA unit standard(s) and not the entire qualification(s) must check the details of the unit standard(s) within the relevant qualification(s). In order to access the specific unit standard(s) that you want to be registered against; you are advised to visit the following website ( Please only apply for qualification(s) and unit standard(s) that you qualify for as per your qualifications.
  1. Your academic learning does not necessarily have to be NQF-based.
  1. If you have work experiencein the field you would like to be registered against, you will need to approach a provider for RPL for NQF credits and then apply for assessor / moderator scope.
  1. If applying for a full qualification subject-matter expertise must be shown for each of the core, fundamental and elective components.
  1. A subject-matter expert needs to sign-off your requested unit standard and/or qualification as an indication that he/she can confirm that the applicant will be able to assess or moderate against the requested field.
  1. In the event that your application is successful, please read the Assessment and Moderation Guidelines, available on to guide you on INSETA’s requirements for assessments and moderation.

COMPLETE THE FOLLOWING TABLE FOR SCOPE REQUESTED (separately from your CV)

Note: Please complete this section fully.

Your application will not be considered if any of the grey columns are not completed.

Please do not fill in any information in the green fields.

Qualification(s)/ Unit Standard(s) ID / NQF Level / Qualification / Unit Standard (US) Title
(Refer to for expiry date and full details) / Give details of Qualification / Formal Learning achieved in the subject matter of qualification / unit standards requested.
(NQF or non NQF – Based) / Name of provider / awarding institution and date achieved / FOR INSETA USE ONLY
APPROVED / NOT APPROVED

Declaration by a Subject-Matter Expert:

(Confirming that the applicant can assess or moderate this qualification and/or unit standard)

I ______the subject matter expert in the field of ______, has ______years experience in ______and belong to the ______(professional body) hereby declare that to the best of my knowledge the applicant, ______, is qualified to assess and/or moderate the abovequalification and/or unit standards.

Signed at ______on this ______day of ______200____

______

Subject-Matter Expert signature:

Please note:

  • Applications will not be considered without endorsement by a subject-matter expert
  • Registration is awarded on a provisional basis until at least 5 assessments or moderation interventions are conducted successfully and approved by INSETA verifiers; approvals by other SETAs may be considered

INSETA USE ONLY

Registration Recommended / Yes / No
If “YES” Type of Registration Recommended / Assessor / Moderator
ETQA Specialist Consultant Name / Comments
Signature / Date
Recommendation Approved / Yes / No
ETQA Manager Name / Comments
Signature / Date

WWW / ETQA DIVISION
ASSESSOR/ MODERATOR
REGISTRATION FORM

SECTION I:TRAINING PROVIDER / EMPLOYER CONTACT DETAILS

Yes / No

Are you representing a training provider / employer?

If your answer is YES, fill in the table below:

(more that one training provider / employer may be listed – if you work for more that two providers / employers please complete the details for all the providers / employers)

Training Provider / EmployerTrading Name
Region
Telephone No
Email address
Training Provider / EmployerTrading Name
Region
Telephone No
Email address

SECTION J:DECLARATION BY THE “APPLICANT”:

Yes / No / Not Applicable
I have read the Assessor’s Code of Conduct.
I have read the Moderator’s Code of Conduct.
I have read the INSETA Assessor Policy and I will uphold the Assessor Code of Conduct to the best of my ability.
I have read the INSETA Moderator Policy and I will uphold the Moderator Code of Conduct to the best of my ability.

I ______the undersigned hereby declare that the above information provided in this application form is correct and truthful, to the best of my knowledge.

Signed at ______on this ______day of ______200____

______

Signature of Applicant

ANNEXURE 1

ETQA CIRCULAR 4/2007

QUALIFICATIONS REQUIRED FOR ASSESSORS AND MODERATORS OF QUALIFICATIONS/UNIT STANDARDS QUALITY ASSURED BY INSETA ETQA

This circular serves as a notification to all INSETA ETQA accredited education and training providers, and registered assessors and moderators, regarding the qualification requirements, to function as an assessor or moderator for qualifications/unit standards quality assured by INSETA ETQA.

Please note that under the advisement and instruction from the South African Qualifications Authority, the INSETA ETQA is instituting an additional requirement for all its currently registered assessors and moderators, and for those wishing to apply to be registered assessors and/or moderators, of INSETA accredited Qualifications/unit standards. The additional requirement is that all any person performing assessment or moderation functions for such qualifications/unit standards must have a qualification at a level higher, and in the subject field, of what they are assessing and/or moderating.

For all our currently registered assessors and moderators, INSETA ETQA is giving an opportunity for you to comply with this requirement by 31 December 2007, after which your continued registration may be affected. For any new applications to be registered as an assessor and/or moderator of qualifications/unit standards quality assured by INSETA ETQA, this requirement is implemented with immediate effect.

INSETA -accredited education and training providers will also have until 31 December 2007, to ensure compliance with this requirement.

Kind regards

Shirley Steenekamp

ETQA/SD Manager

ANNEXURE 2

ETQA CIRCULAR 3/2007

ALL FACILITATORS TO BE REGISTERED AS CONSTITUENT

ASSESSORS WITH INSETA ETQA

  1. The INSETA ETQA is instituting an additional requirement for new or continued accreditation as an INSETA ETQA accredited education and training provider, under the advisement and instruction of the South African Qualifications Authority.
  1. By 31 December 2007, all facilitators/teachers/lecturers who facilitate/teach/lecture programmes for the INSETA ETQA accredited education and training providers, will have to be registered as constituent assessors with the INSETA ETQA. This must be done for each of the unit standards/qualifications they wish to facilitate/teach/lecture.
  1. Facilitators/teachers/lecturers who currently are registered with the South African Council of Educators, (SACE), or who perform these functions at Department of Education-registered Further Education and Training (FET) institutions (public or private) or Higher Education and Training institutions (public or private), are exempt from this requirement. Should such persons be used by an INSETA accredited education and training provider, they are required to provide the education and training provider with their SACE registration number or proof of facilitator/teacher/lecturer status with a FET or HET institution.
  1. This means that currently accredited education and training providers, as well as those who intend being accredited by the INSETA ETQA, will need to ensure that all facilitators/teachers/lecturers who perform such functions for the education and training provider, meet the requirement in paragraph 2, above.
  1. This rule applies even if the facilitator/teacher/lecturer is not conducting assessments. If current education and training providers fail to meet this requirement, after 31 December 2007, they will not be re-accredited. For education and training providers who intend submitting applications for accreditation to INSETA ETQA, this rule applies with immediate effect.

Kind regards

Shirley Steenekamp

ETQA/SD Manager:INSETA