Membership Form May2012 (2)

7/31/2019 Membership Form May2012 (2)

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Please complete this application form and submit by fax or e-mail with yourproof of payment.

Fax 086 762 9357 / e-mail to [email protected]

Banking Details - For Audit trail purposes please pay directly to CIMAP'sAccountants: Ref: CIMAP

MFD Financial Services

ABSA Cheque Account - Branch 632005

Account number: 406 994 1796

I herewith apply for membership of CIMAP. I confirm by submission of thisapplication that I have read the code of conduct and terms and condition of

membership.Please Note: All new applicants will be awarded affiliate members status.Applications for higher designations will be confirmed on application by the

membership status subcommittee.

Surname

First Names

Title (Dr, Mr, Mrs, Ms etc)

Identity Number(Please submit a copyof your ID)

Professional Qualifications (Pleasesubmit proof of your stated qualifications)

Company Name (If applicable)

Physical Address

Postal Address

E-mail address

Telephone number

Cell number

CIMAP Core Values: - Integrity, Credibility &

Discipline 2012 doc ref 23/2

Membership ApplicationFormChartered Institute for theManagement ofAssessment Practice
mailto:[email protected]:[email protected]


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Fax Number

What are your ETD areas ofspecialisation?

Facilitation

Assessment

Moderation

Coaching

Project(learnership)management

MaterialsDevelopment

Do you belong to any otherprofessional body or association?Please specify.

Yes No

If you are a constituently registeredassessor, list the ETQAs where youhave constituency.

(Please submit relevant documentationas proof of registration in support of

your application).

ETQA Qualifications registeredagainst

(As per report attached)



If you are a moderator, list theETQAs where you haveconstituency.

ETQA Qualifications




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(Please submit relevant documentation

as proof of registration)

Please indicate in which sectors you consider yourself an expert?

Agriculture Engineering Legal Real EstatePractice

Arts &Entertainment

Food and Beverage

LocalGovernment

Socialdevelopment

Banking andrelatedservices

Finance andAccounting

Manufacturing

Sports andRecreation

Communication

Health &Safety

Management

Wholesaleand Retail

Cleaning Hospitality and Tourism

Marketing

Chemical H. R. Mining

Construction

Health &Welfare

ProjectManagement

Design andfashion

Insurance Publicservice

Education IT PublicRelations

Entrepreneurship andInnovation

LabourRelations

QualityManagement

Other:

I hereby give permission for my membership status andareas of specialisation to be made available to third

parties. (This service includes distributing my constituentstatus to membership companies and other professional

Yes No




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bodies / associations, regulators etc. that may want to

contract the services of independent assessors andmoderators)




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Membership

Affiliate Membership Annual Fee Pleaseindicate

Affiliate Membership for 1year: Assessors that are notconstituently registered by anETQA

Renewable each year in joining monthat normal annual fee of R 600.00

Affiliate Membership(renewal) : ConstituentlyRegistered Assessors with an

ETQA (First year of registration)

Renewable each year in joining monthat the current annual fee of R 400.00

Affiliate Membership (new):Constituently RegisteredAssessors with an ETQA (FirstTime Membership not forapplicable renewals).

New member offer of R 280.00.

Affiliate CorporateMembership (Must be in theprocess of registering withDHET as a FET College).

Renewable each year

Current annual fee of R 500.00

Chartered CorporateMembership (must beregistering with DHET as aFET College).

Renewable each year

Current annual fee of R 1200.00

Banking Details - For Audit trail purposes please pay directly to CIMAP's Accountants:Ref: CIMAP

MFD Financial Services

ABSA Cheque Account - Branch 632005

Account number: 406 994 1796

Professional designations

Please note that professional status designations information is available on our web

site: http://cimap.co.za/professional-designations.htm . CIMAP members will receive


http://cimap.co.za/professional-designations.htmhttp://cimap.co.za/professional-designations.htm


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detailed information regarding the cycle professional designation application process

in their membership confirmation pack.

Professional designations are awarded and must be maintained through the

participation of Continuous Professional Development (CPD) activities on an annual

basis.

Please note: If your evaluation for a higher designation is not successful, you will

automatically be accepted as an Affiliate Member. Affiliate members will be provided

with a personal development plan to assist you in planning for your future

development.

Undertaking of Commitment

I, the undersigned, agree that, by becoming a member of the Chartered Institute for

the Management of Assessment Practice (CIMAP), I will adhere to the CIMAP

Constitution and the Code of Conduct and undertake to support the principles

and objectives of CIMAP. I certify that statements made in this application and

supporting documentation is true and correct.

Signature Print Name Date

For Office Use:

R CofC Received Replied Mailing List



Important

Please ensure that you read the Code of Conduct before signing yourapplication. You are signing to commit to adherence to the standards of

conduct, competence and practice as set out in this Code, and an ongoing

commitment to your personal self-development and the requirements of

CIMAP.


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CIMAP Membership Code of Conduct

The Chartered Institute for the Management of Assessment Practice (CIMAP) is

the chartered professional body dedicated to supporting individuals to achieve

success through higher standards in assessment, education and training

practices. Its objectives are to promote for the benefits of its members and

the public the practice of education, training and development and to advance

public education in the role of the assessor, moderator, facilitator and

instructional designer in the economic and socio-economic environment.

This Code sets a high standard of professionalism and CIMAP provides support

and advice to members as they strive to embed the code in their day-to-day

professional activities.

The principles underlying this Code are:

Management of self;

Management of others;

Management of clients;

Management of business partners and colleagues;

Service to the wider community;

Support of the professional body.

When managing myself I will:

Strive for excellence at all times;

Exemplify high standards of professional behaviour and performance;

Be accountable for my actions;

Disclose anything that may create conflict of interest and maintain high

ethical standards;

Act only within my level of competence;




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Continue to develop my competencies and keep up to date with best

practice.

When managing others I will:

Treat everybody on an equitable basis, with no discrimination,

recognizing their individual needs and responding accordingly;

Support my immediate team and others to fully understand their

responsibilities, areas of authority and accountability;

Empower my immediate team by facilitating the development of skills

and qualities evident within the team and recognize their achievements;

Foster a culture of transparency and address issues in a frank and timely

manner;

Communicate effectively, openly and clearly.

In my dealings with clients and their companies, I will:

Uphold internal policies and practices in the interest of good practice;

Reconcile my personal values with those of the client and the company;

Be accountable for achieving the objectives, projects and tasks that I

undertake to deliver;

Safeguard the reputation and assets of the organisation;

Exhaust all available internal remedies for dealing with matters I

perceive to be improper before resorting to public disclosure.

When interacting with suppliers, business partners and other

stakeholders I will:

Ensure that I clarify their interests and respond to them in a balanced

and ethical manner;




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Establish, develop and maintain business relationships based on mutual

confidence and trust;

Refrain from entering into any agreement that is unlawful or unethical;

Neither offer nor accept gifts, hospitality or services which could create,

or imply improper obligation;

Safeguard all confidential information, which comes into my possession.

Within my community, I will:

Ensure that I am aware of, and comply with all relevant legislation and

regulations;

Act to avoid or mitigate any adverse outcomes, of present and proposed

managerial actions;

Be honest, open and truthful in all external communications;

Respect the environment and seek to conserve resources wherever

possible;

Respect the customs and practices where these may differ from my

own.

As a member of the Chartered Institute for the Management of

Assessment Practice,I will:

Promote its mission, aims and objectives;

Uphold its integrity and good standing, and refrain from conduct that willbring it into disrepute;

Promote its image and standing as a professional body;

Support the bodys initiatives for continuous professional development

and lifelong learning;




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Observe the standards of conduct as set out in this Code, and re-sign my

commitment as they change from time to time.

Signature Date



Membership Form May2012 (2)

Documents

Transcript of Membership Form May2012 (2)