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CIMAP Membership form may2012 (1)
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CIMAP Membership form may2012 (1)
SA SMME Foundation
Jun 18, 2012
Economy & Finance
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Transcript of "CIMAP Membership form may2012 (1)"
1. Membership Application Form Chartered Institute for the Management of Assessment Practice Please complete this application form and submit by fax or e-mail with your proof of payment. Fax 086 762 9357 / e-mail to firstname.lastname@example.org Banking Details - For Audit trail purposes please pay directly to CIMAPs Accountants: 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 this application 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.SurnameFirst NamesTitle (Dr, Mr, Mrs, Ms etc)Identity Number(Please submit a copy of your ID)Professional Qualifications (Please submit proof ofyour stated qualifications)Company Name (If applicable)Physical AddressPostal AddressE-mail addressTelephone numberCell numberFax Number CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2
What are your ETD areas of specialisation? Facilitation Assessment Moderation Coaching Project (learnership) management Materials DevelopmentDo you belong to any other professional body or Yes Noassociation? Please specify.If you are a constituently registered assessor, ETQA Qualifications registered againstlist the ETQAs where you have constituency. (As per report attached)(Please submit relevant documentation as proofof registration in support of your application). (As per report attached) (As per report attached)If you are a moderator, list the ETQAs where ETQA Qualificationsyou have constituency.(Please submit relevant documentation as proofof registration)Please indicate in which sectors you consider yourself an expert?Agriculture Engineering Legal Real Estate CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2
PracticeArts & Food and Local SocialEntertainment Beverage Government developmentBanking and Finance and Manufacturing Sports andrelated services Accounting RecreationCommunication Health & Safety Management Wholesale and RetailCleaning Hospitality and Marketing TourismChemical H. R. MiningConstruction Health & Welfare Project ManagementDesign and Insurance Public servicefashionEducation IT Public RelationsEntrepreneurship Labour Relations Qualityand Innovation ManagementOther:I hereby give permission for my membership status and areas of specialisation Yes Noto be made available to third parties. (This service includes distributing myconstituent status to membership companies and other professional bodies /associations, regulators etc. that may want to contract the services ofindependent assessors and moderators) CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2
MembershipAffiliate Membership Annual Fee Please indicateAffiliate Membership for 1 year: Renewable each year in joining month atAssessors that are not constituently normal annual fee of R 600.00registered by an ETQAAffiliate Membership (renewal) : Renewable each year in joining month at theConstituently Registered Assessors with current annual fee of R 400.00an ETQA – (First year of registration)Affiliate Membership (new): New member offer of R 280.00.Constituently Registered Assessors withan ETQA – (First Time Membership – notfor applicable renewals).Affiliate Corporate Membership (Must Renewable each yearbe in the process of registering with Current annual fee of R 500.00DHET as a FET College).Chartered Corporate Membership (must Renewable each yearbe registering with DHET as a FET Current annual fee of R 1200.00College).Banking Details - For Audit trail purposes please pay directly to CIMAPs Accountants: Ref: CIMAP MFD Financial Services ABSA Cheque Account - Branch 632005 Account number: 406 994 1796Professional designationsPlease note that professional status designations information is available on our web site:http://cimap.co.za/professional-designations.htm . CIMAP members will receive detailed informationregarding the cycle professional designation application process in their membership confirmation pack.Professional designations are awarded and must be maintained through the participation of ContinuousProfessional Development (CPD) activities on an annual basis. CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2
Please note: If your evaluation for a higher designation is not successful, you will automatically beaccepted as an Affiliate Member. Affiliate members will be provided with a personal development planto assist you in planning for your future development.Undertaking of CommitmentI, the undersigned, agree that, by becoming a member of the Chartered Institute for the Management ofAssessment Practice (CIMAP), I will adhere to the CIMAP Constitution and the Code of Conduct andundertake to support the principles and objectives of CIMAP. I certify that statements made in thisapplication and supporting documentation is true and correct.Signature Print Name DateFor Office Use:R CofC Received Replied Mailing List Important Please ensure that you read the Code of Conduct before signing your application. 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. CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2
CIMAP Membership Code of ConductThe Chartered Institute for the Management of Assessment Practice (CIMAP) is the charteredprofessional body dedicated to supporting individuals to achieve success through higherstandards in assessment, education and training practices. Its objectives are to promote for thebenefits of its members and the public the practice of education, training and development andto advance public education in the role of the assessor, moderator, facilitator and instructionaldesigner in the economic and socio-economic environment.This Code sets a high standard of professionalism and CIMAP provides support and advice tomembers 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; Continue to develop my competencies and keep up to date with best practice. CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2
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; Establish, develop and maintain business relationships based on mutual confidence and trust; Refrain from entering into any agreement that is unlawful or unethical; CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2
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 will bring it into disrepute; Promote its image and standing as a professional body; Support the body’s initiatives for continuous professional development and lifelong learning; Observe the standards of conduct as set out in this Code, and re-sign my commitment as they change from time to time. CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2
Signature Date CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2