PROVIDER: ____________________________________________
Address: _______________________________________________
_______________________________________________
_______________________________________________
Postal Code: ____________
Managerial Representative: __________________________________
Telephone No: _____________
| Learning Programmes Offered | Codes | Reqistration No. |
| ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ | ||
Course Notes and Handouts available: Yes/No
| Facilitator/Assessor Name | Course/Codes | Reqistration No. |
| ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ | ||
| List and Addresses of Satellite or "In House" Centres |
| ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ |
Facilities
Lecture Rooms No ___________________ Size ___________________
Seating ____________________________ Flipcharts_______________
V.C.R.’s ____________________________O/H Projector ____________
Othorator __________________________ Simulator (optional) ________
Plan of Test Area Yes/No
Area for Testing ___________m X ___________m
Covered/Open
Noise level ___________ Distractions ___________
Rest Rooms ___________ Ablution Facilities ___________
Access to the above-mentioned Equipment:
___________________________________________________________
Forklift Trucks ______________Cranes ___________
Pallets ____________________Slings ___________
Racking ___________________Chains ___________
Containers_________________ Dummy loads ___________
Ramps ____________________Crates ___________
Dock levellers _______________Steel Sections ___________
Box Cars ___________________Attachments ___________
Administrative
Attendance Register _________________Registration Certificates of Training Centre
___________________________
Registration Certificates of Facilitators/Assessors
___________________________
Registration Certificates of Courses
___________________________
Insurance Indemnity (optional)
___________________________
Recommendation of Auditor
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
Signed _______________________ Date _________________
Approved by ___________________ Date _________________
Confirmed with Department of Labour Date _________________
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