SOCIAL AUXILIARY WORK TRAINING LEARNER APPLICATION FORM
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1 2018 SOCIAL AUXILIARY WORK TRAINING LEARNER APPLICATION FORM Company Reg. No. 2013/ /07 Minimum Entry Requirements: Learners in possession of a Minimum pass in Grade 12 (NQF Level Equivalent) can register, providing that their application has been approved by the Messiah Private Training Institution's Selection Committee.. ABET Level 4, Subject Certificates, etc. do not meet the minimum requirements. You will be notified of the outcome of your application after scrutiny and processing by our Selection Committee. You need to volunteer or be employed at a recognised or registered Organisation where you will work under guidance of a registered social worker for the duration of this course. Learners are required to read and write in English, as the Language medium for this programme is English. Programme, Duration & Credits This is a full time course run over a minimum of 12 months, consisting of theoretical training and practical training. As part of the qualification you would need to complete the following; Knowledge Training at NQF Level 5, 50 Credits Practical Skills Training, at NQF Level, 33 Credits Work Experience Training, NQF Level 4 & 5, 46 Credits. Credits to this programme is a total of 129 Credits, Application Process: Complete the attached Application Form. Return your application with the following; certified copies of your ID, Certified Copy of your Matric Certificate, Certified Copies of your Marriage Certificate (where applicable) & Your CV. A copy of your deposit slip/s for the Admin fee must accompany your application form. Please keep a copy of the slip/s for your own reference. Only posted or hand delivered applications will be accepted. No Faxed or ed Applications will be accepted By signing your application form you declare that you have read and understood the terms and conditions of Messiah Private Training Institution for this programme
2 Intakes First Intake: January Second Intake: July Registration Closes 05 January June 2017 Would you prefer ; 1. Online Study 2. Face to Face (In class) LEARNING METHOD OPTIONS PROGRAMME COST STRUCTURE ADMIN FEE : R200 (due upon your application, please attach proof of payment with your application) Course Fees: DEPOSIT/REGISTRATION FEE: R (DUE DATES BELOW) BALANCE: R (MONTHLY PAYMENT ARRANGEMENTS ARE AVAILABLE) TOTAL COST: R (incl. Deposit + Balance) Registration fee Due Dates for: First Intake : 31 January 2018 Second Intake: 31 July 2018 Banking Details; Standard Bank, Kuils River Bank Account No (Savings Account) Branch Code: Reference: YOUR ID no. Postal Address Messiah Private Training PO BOX 1545 Brackenfell
3 Student: Personal Information Full Name Surname Identity Number Physical Address Postal Address Cellphone Number Telephone Number address Employee Details Name of Organisation/Company Telephone Number Address Next of Kin Details Full Name Surname Cellphone Number Telephone Number 3
4 INDIVIDUAL: PERSON/S RESPONSIBLE FOR PAYMENT (Spouse/Parent/Guardian/Company/Organisation) Full Name & Surname: _ Identity Number: Contact Number: Postal Address: Residential Address: Relationship to Learner: COMPANY / ORGANISATION Company / Organisation Name: Contact Number : REPRESENTATIVES DETAILS Full Name & Surname: _ Identity Number: Contact Number: Postal Address: Residential Address: PLEASE TE: 1. No Learner will be allowed to enrol without proof of how fees will be paid. 2. Learners under 18 and/ or sponsored by a company/organisation, must ensure this section is completed by the responsible parties. I, the undersigned, declare that: I have acquainted myself with and agree to the above applicant declaration and that the particulars provided by him / her in this application form are true and correct; I hereby accept responsibility together with the applicant (person) I am sponsoring for the payment of all moneys that are due to Messiah Private Training Institution, which may include any legal costs during the total duration of his or her Social Auxiliary Work training study at Messiah Private Training Institution and undertake to ensure that they are paid punctually when due. RESPONSIBLE PERSON/S FOR PAYMENT: Full Name & Signature: Witness Full Name & Signature Date: 4
5 LEARNER HISTORY PLEASE TELL US ABOUT WHO YOU ARE, YOUR STRENGTHS, WEAKNESSES, LIKES, DISLIKES, PASSIONS & WHAT MAKES YOU, YOU? SOCIAL RESPONSIBILITY: Have you been involved any volunteer work with a Charity Organisation/Church? If so, how would you describe your experience? I hereby confirm that: 1. The information provided is true and correct to my understanding; 2. The certified attached documents are authentic; 3. I am fully aware that I am responsible for the payment of fees and personal expenses and all other costs not included in my course fees; 4. I am aware that it is compulsory to do my practical training under the guidance of a Registered Social Worker (mentor) at an approved organisation on a full time basis, for the duration of the12 months of this training programme. SIGNED AT THIS DAY OF 20 LEARNER SIGNATURE 5
6 THIS PAGE MUST BE COMPLETED BY YOUR MENTOR and ORGANISATION MANAGER Dear Mentor and Manager, Kindly complete the following consent form with your organisation stamp and ensure that the learner returns this form together with the mentors CV & Proof of registration with SACSSP to MPTI. Social Worker (Mentor s) consent: I herewith give my consent and offer my availability and willingness to function as Mentor for.. (learner) and thus embark on this process with the learner at... (Organisation). MENTOR: First Name...Surname. Physical address:.... Contact numbers (w) (...) (c).. address SACSSP Registration number:... Expiry date of Registration with SACSSP:... Signature (Mentor): Date:... MANAGERS CONSENT I,...(Name & Surname), manager of...(organisation) give my consent to...(social Worker) acting as mentor for....(learner). Signature (Department Manager): Date:.. Your Organisation Stamp 6
7 CHECKLIST; 1. ALL PAGES SIGNED BY THE RELEVANT PARTIES. 2. X3 CERTIFIED COPIES OF YOUR ID 3. X3 CERTIFIED COPIES OF YOUR GRADE 10, 11 REPORT OR MATRIC CERTIFICATE. 4. X3 CERTIFIED COPIES OF YOUR MARRIAGE CERTIFICATE (IF APPLICABLE) 5. MENTORS PROOF OF SACSSP REGISTRATION & CV 6. YOUR CV TE: THE FOLLOWING WILL T BE ACCEPTED; 1. COPIES OF CERTIFIED DOCUMENTS 2. CERTIFIED DOCUMENTS OLDER THAN 1 MONTH FROM DATE OF APPLCATION. REQUIRED DISCLOSURE SHOULD YOU HAVE ANY CRIMINAL RECORDS, PLEASE TE THIS MUST BE DISCLOSED, AS WE ARE PROHIBITED TO ALLOW LEARNING FOR PERSONS WITH CRIMINAL RECORDS THAT INVOLVES VIOLENCE OR ANY ABUSE, UNLESS THERE IS SUFFICIENT EVIDENCE OF REHABILITATION, THE DECISION FOR ENTRY WILL BE MADE AT THE DISCRETION OF THE MESSIAH PRIVATE TRAINING ISTITUTIONS BOARD OF DIRECTORS. Dear Applicant, Please ensure that you have attached all the relevant documents as per the above Checklist. We thank you in advance for your interest in learning with Messiah Private Training Institution, and will keep you informed of your application outcome within 6 weeks from date of submission. Yours Sincerely, Melanie Francis & Karen Robinson Directors Messiah Private Training Institute 7
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