WORKPLACE APPROVAL FORM APPLICANT DETAILS # This form must be completed by workplaces that have/ will partner with theoretical training based providers accredited by CHIETA. The form must be completed per learning programme. APPLICATION TYPE (tick the applicable NEW APPLICATION EXTENSION OF SCOPE 1 ORGANISATION NAME SKILLS DEVELOPMENT LEVY L TOTAL NUMBER OF 2 NUMBER (if applicable) EMPLOYEES 3 SETA REGISTERERD WITH 4 LEVY PAYING YES NO 5 REGISTRATION NUMBER 6 CORE BUSINESS NAME OF TRAINING PROVIDER 5 (that you intend partnering with) If no theoretical training provider 6 partner identified yet, please indicate 7 TYPE OF PROVIDER PUBLIC PRIVATE NAME(S) OF OWNER(S) OF 8 YOUR WORKPLACE (if applicable) 9 SITE NAME DEGREES MINUTES SECONDS Latitude GPS 10 DEGREES MINUTES SECONDS Longitude Street PHYSICAL City/ Town 11 ADDRESS OF Postal WORKPLACE PROVINCE Code P.O. Box City/ Town 12 POSTAL ADDRESS Postal PROVINCE Code Prof Dr Mr Mrs Ms Title First Names Last Name CONTACT PERSON OF Position ORGANISATION Tel 13 OR WORKPLACE Number (delete whichever Fax not applicable) Number Cell Number Email WORKPLACE APPROVAL HISTORY Previously Approved as a workplace for Artisan Learning? Approval by which SETA List Range of Approval for Trade Training (Including Artisan Related
WORKPLACE APPROVAL FORM # APPLICANT DETAILS This form must be completed by workplaces that have/ will partner with theoretical training based providers accredited by CHIETA. The form must be completed per learning programme. APPLICATION TYPE (tick the applicable NEW APPLICATION EXTENSION OF SCOPE 1 ORGANISATION NAME 2 SKILLS DEVELOPMENT LEVY NUMBER (if applicable) L TOTAL NUMBER OF EMPLOYEES 3 SETA REGISTERERD WITH 4 LEVY PAYING YES NO 5 REGISTRATION NUMBER 6 CORE BUSINESS 5 NAME OF TRAINING PROVIDER (that you intend partnering with) 6 If no theoretical training provider partner identified yet, please indicate 7 TYPE OF PROVIDER PUBLIC PRIVATE 8 NAME(S) OF OWNER(S) OF YOUR WORKPLACE (if applicable) 9 SITE NAME 10 GPS Latitude DEGREES MINUTES SECONDS Longitude DEGREES MINUTES SECONDS 11 PHYSICAL ADDRESS OF WORKPLACE Street City/ Town Postal Code PROVINCE 12 POSTAL ADDRESS P.O. Box City/ Town Postal Code PROVINCE 13 CONTACT PERSON OF ORGANISATION OR WORKPLACE (delete whichever not applicable) Title Prof Dr Mr Mrs Ms First Names Last Name Position Tel Number Fax Number Cell Number Email WORKPLACE APPROVAL HISTORY Previously Approved as a workplace for Artisan Learning? Approval by which SETA List Range of Approval for Trade Training (Including Artisan Related
WORKPLACE_APPROVAL_FORM.docx