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Page 1 of 4
A. ASSESSOR/MODERATOR INFORMATION
Title (Dr/Mr/Mrs/Ms/Prof)
Name/s
Surname
ID or Passport no.
Designation
Gender (for equity purposes)
Race (for equity purposes)
Disability (for equity purposes)
Postal Address
Contact details
Tel.
Mobile
E-mail
B. EMPLOYMENT VERIFICATION DETAILS
Employment status (cross out
relevant response)
Unemployed Employed Self-employed
Position in Company (if relevant)
Name of Employer (if relevant)
Contact details of Employer (if
relevant)
Address
Tel no.
Email address
APPLICATION FORM FOR ASSESSOR AND MODERATOR APPOINTMENT
Page 2 of 4
C. EXPERIENCE
Relevant Industry Experience
How many years of experience do you have?
Experience as an Assessor (only those applying to be a moderator fill in)
How many years of experience do you have?
D. QUALIFICATION VERIFICATION DETAILS
No. Name of Educational Institution Name of Qualification attained
Date
conferred
1.
2.
3.
4.
Achievement of unit standards
Do you have the unit standard “Conduct outcomes-based
assessment” at NQF Level 5? YES NO
Do you have the unit standard “Design and develop outcomes-
based assessment” at NQF Level 5? YES NO
As a moderator do you have the unit standard “Conduct
moderation of outcomes-based assessments” at NQF 6? YES NO
I solemnly declare that, to the best of my knowledge, all the information contained in my application is
true and correct.
Applicant’s Signature: Date:
For Office Use
Confirmation of supporting documents (tick if submitted)
Certified Copies of ID document
Curriculum Vitae
Supporting Documents (letters of reference which confirm the claims made in the CV,
contact details of referees, service certificates, etc)
Certified copies of all qualifications (including unit standards)
Letter of Appointment as assessor (only required for moderator applicants)
Registration Certificate
Signed Code of Conduct
Page 3 of 4
Code of Conduct for Assessors
I, the undersigned, am applying to become an assessor. I agree that, if my application is
successful, I hereby commit myself to abide by the SACPCMP Code of Conduct in relation to all
my work conducted as a SACPCMP assessor. The Code of Conduct to which I agree is as
follows:
1. I shall conduct my work as a SACPCMP assessor with integrity, seeking at all times to
create a positive environment for assessment and to take note of and respect the
historical diversity of applicants’ cultural, linguistic and educational backgrounds;
2. Any conflict of interest, existing between any applicant, and myself shall be declared in
advance, and, if requested, I shall recuse myself from the process in such instances;
3. All information received during my work as an assessor about individuals or organisations
will be treated with the strictest confidentiality unless it is relevant to the fairness, reliability
and validity of the assessment process;
4. All relevant information about any irregularities in the assessment process of which I
become aware will be included in my reports to the moderator; these will include:
a. unplanned environmental, personal or other problems which may have
interfered with the performance of the applicant
b. suspected or proven irregularities committed by the applicant
c. suspected or proven irregularities committed by any other parties to the
assessment
d. any suspected or proven bribery, threats or sexual or other harassment of or by
applicants
e. any grounds for doubting the authenticity of the evidence presented during the
assessment process;
5. If I have reason to believe the moderator is not addressing irregularities brought by myself
to his or her notice, I shall draw these irregularities to the attention directly to the
SACPCMP Education Operations Committee.
Names in full: ID No.
Signed: Date:
Page 4 of 4
Code of Conduct for Moderators
I, the undersigned, am applying to become a moderator. I agree that, if my application is successful, I
hereby commit myself to abide by the SACPCMP Code of Conduct in relation to all my work conducted
as a SACPCMP moderator. The Code of Conduct to which I agree is as follows:
6. I shall conduct my work as a SACPCMP moderator with integrity, seeking at all times to create a
positive environment for assessment and moderation and to take note of and respect the historical
diversity of applicants’ and assessors’ cultural, linguistic and educational backgrounds;
7. Any conflict of interest, existing between any applicant or assessor, and myself shall be declared
in advance, and, if requested, I shall recuse myself from the process in such instances;
8. All information received during my work as an moderator about individuals or organisations will
be treated with the strictest confidentiality unless it is relevant to the fairness, reliability and validity
of the assessment process;
9. Any unevenness in the standards of different assessors will be noted, and every effort will be
made through feedback and constructive support to achieve a common standard amongst all
assessors under my moderation; in this way I shall try to promote quality assessments and avoid
standards drift;
10.If I identify a particular assessor as unreliable and am unable to correct his or her weaknesses
through a supportive and transparent process I shall inform the SACPCMP about this problem
and ask the Council to take appropriate steps;
11.All relevant information about any irregularities in the assessment process of which I become
aware will be included in my reports to the SACPCMP; these will include:
a. unplanned environmental, personal or other problems which may have interfered with
the performance of the applicant
b. suspected or proven irregularities committed by the applicant
c. suspected or proven irregularities committed by any other parties to the assessment
d. any suspected or proven bribery, threats or sexual or other harassment of or by
applicants or assessors
e. any grounds for doubting the authenticity of the evidence presented during the
assessment process;
12.Any constructive comments about the assessment guides, instruments or procedures which I can
make by reflecting on their use on the ground shall be collated and sent to the SACPCMP
Registration committee; this feedback will be used to improve old guides and instruments and
develop new ones in a continuing process of renewal and improvement of quality.
Names in full: ID No.
Signed: Date:

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Assessor-or-Moderator-Application-Form-002.pdf

  • 1. Page 1 of 4 A. ASSESSOR/MODERATOR INFORMATION Title (Dr/Mr/Mrs/Ms/Prof) Name/s Surname ID or Passport no. Designation Gender (for equity purposes) Race (for equity purposes) Disability (for equity purposes) Postal Address Contact details Tel. Mobile E-mail B. EMPLOYMENT VERIFICATION DETAILS Employment status (cross out relevant response) Unemployed Employed Self-employed Position in Company (if relevant) Name of Employer (if relevant) Contact details of Employer (if relevant) Address Tel no. Email address APPLICATION FORM FOR ASSESSOR AND MODERATOR APPOINTMENT
  • 2. Page 2 of 4 C. EXPERIENCE Relevant Industry Experience How many years of experience do you have? Experience as an Assessor (only those applying to be a moderator fill in) How many years of experience do you have? D. QUALIFICATION VERIFICATION DETAILS No. Name of Educational Institution Name of Qualification attained Date conferred 1. 2. 3. 4. Achievement of unit standards Do you have the unit standard “Conduct outcomes-based assessment” at NQF Level 5? YES NO Do you have the unit standard “Design and develop outcomes- based assessment” at NQF Level 5? YES NO As a moderator do you have the unit standard “Conduct moderation of outcomes-based assessments” at NQF 6? YES NO I solemnly declare that, to the best of my knowledge, all the information contained in my application is true and correct. Applicant’s Signature: Date: For Office Use Confirmation of supporting documents (tick if submitted) Certified Copies of ID document Curriculum Vitae Supporting Documents (letters of reference which confirm the claims made in the CV, contact details of referees, service certificates, etc) Certified copies of all qualifications (including unit standards) Letter of Appointment as assessor (only required for moderator applicants) Registration Certificate Signed Code of Conduct
  • 3. Page 3 of 4 Code of Conduct for Assessors I, the undersigned, am applying to become an assessor. I agree that, if my application is successful, I hereby commit myself to abide by the SACPCMP Code of Conduct in relation to all my work conducted as a SACPCMP assessor. The Code of Conduct to which I agree is as follows: 1. I shall conduct my work as a SACPCMP assessor with integrity, seeking at all times to create a positive environment for assessment and to take note of and respect the historical diversity of applicants’ cultural, linguistic and educational backgrounds; 2. Any conflict of interest, existing between any applicant, and myself shall be declared in advance, and, if requested, I shall recuse myself from the process in such instances; 3. All information received during my work as an assessor about individuals or organisations will be treated with the strictest confidentiality unless it is relevant to the fairness, reliability and validity of the assessment process; 4. All relevant information about any irregularities in the assessment process of which I become aware will be included in my reports to the moderator; these will include: a. unplanned environmental, personal or other problems which may have interfered with the performance of the applicant b. suspected or proven irregularities committed by the applicant c. suspected or proven irregularities committed by any other parties to the assessment d. any suspected or proven bribery, threats or sexual or other harassment of or by applicants e. any grounds for doubting the authenticity of the evidence presented during the assessment process; 5. If I have reason to believe the moderator is not addressing irregularities brought by myself to his or her notice, I shall draw these irregularities to the attention directly to the SACPCMP Education Operations Committee. Names in full: ID No. Signed: Date:
  • 4. Page 4 of 4 Code of Conduct for Moderators I, the undersigned, am applying to become a moderator. I agree that, if my application is successful, I hereby commit myself to abide by the SACPCMP Code of Conduct in relation to all my work conducted as a SACPCMP moderator. The Code of Conduct to which I agree is as follows: 6. I shall conduct my work as a SACPCMP moderator with integrity, seeking at all times to create a positive environment for assessment and moderation and to take note of and respect the historical diversity of applicants’ and assessors’ cultural, linguistic and educational backgrounds; 7. Any conflict of interest, existing between any applicant or assessor, and myself shall be declared in advance, and, if requested, I shall recuse myself from the process in such instances; 8. All information received during my work as an moderator about individuals or organisations will be treated with the strictest confidentiality unless it is relevant to the fairness, reliability and validity of the assessment process; 9. Any unevenness in the standards of different assessors will be noted, and every effort will be made through feedback and constructive support to achieve a common standard amongst all assessors under my moderation; in this way I shall try to promote quality assessments and avoid standards drift; 10.If I identify a particular assessor as unreliable and am unable to correct his or her weaknesses through a supportive and transparent process I shall inform the SACPCMP about this problem and ask the Council to take appropriate steps; 11.All relevant information about any irregularities in the assessment process of which I become aware will be included in my reports to the SACPCMP; these will include: a. unplanned environmental, personal or other problems which may have interfered with the performance of the applicant b. suspected or proven irregularities committed by the applicant c. suspected or proven irregularities committed by any other parties to the assessment d. any suspected or proven bribery, threats or sexual or other harassment of or by applicants or assessors e. any grounds for doubting the authenticity of the evidence presented during the assessment process; 12.Any constructive comments about the assessment guides, instruments or procedures which I can make by reflecting on their use on the ground shall be collated and sent to the SACPCMP Registration committee; this feedback will be used to improve old guides and instruments and develop new ones in a continuing process of renewal and improvement of quality. Names in full: ID No. Signed: Date: