Part B Application Form

Part B Application Form

PART B APPLICATION FOR ACCREDITATION TO DELIVER NEBOSH QUALIFICATIONS OR UNITS This form should be read in conjunction with the relevant guide associated with the qualification being applied for, the NEBOSH Course Provider Accreditation Agreement, and the guidance in the NEBOSH Course Provider Handbook. Please complete a separate form for each qualification. This form may also be used for notification of significant changes to an existing accredited programme. 1 Course provider details 1.1 Provider contact details NEBOSH Course Provider Number: (if applicable)

Course Provider Name:

2 Qualification / Unit applied for 2.1 Programme details Proposed mode(s) of study Part time and evenings (i.e. part-time, full-time Block week block release, open/ Open / Distance distance learning etc) E-learning 2.2 Proposed date of first programme (DD/MM/YY)

______/______/_____

3 Partnership Arrangements Please provide details of any partnership, consortium, sub-contracting or franchise arrangements linked to the above qualification outlining the roles and responsibilities of each organisation. eg, use of training materials, visiting tutors, visiting assessors. Name of partner / sub contractor etc

Role and responsibility of partner

Insert additional rows if required

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4 Personnel resources 4.1 Tutorial team Please list below the persons involved in programme delivery. A fully completed, signed CV in the standard NEBOSH format (attached to this application form) is required for every member of the tutorial team including guest speakers. Please note that applications without this information will not be considered. Lead Tutor Additional Tutors

1. 2. 3. 4. 5. 6. If there are more than six tutors, continue on a separate sheet (marked 4.1 / tutors) and tick this box 4.2 Qualification requirements 4.2.1 Certificate-level qualifications Practical application assessor(s) Please list below the persons nominated as the practical assessor(s) responsible for overseeing and marking candidates practical application assessments, whether or not they are also listed as tutors in section 4.1. An up to date summary CV in the standard NEBOSH format (attached to this application form) is required for every practical assessor unless also a member of the tutor team in 4.1 above. Please note that applications without this information will not be considered.

Practical assessor Additional practical assessors 1. 2. 3.



If there are more than three practical assessors, please continue on a separate sheet (marked 4.2.1 / practical assessors) and tick this box

4.2.2 Practical application (NGC3/NCC2/FC2) assessment in the candidates workplace Please tick this box if it is intended that the practical assessment will be held in the candidates own workplace and that you agree to comply with the NEBOSH Code of Practice in relation to practical assessments undertaken in candidates workplaces.

4.2.3 Workplace-based project marker(s) - Environmental Diploma only Please list below the persons nominated as Workplace-based project marker(s) who will be responsible for overseeing and marking candidates Environmental Audit of their place of work. An up to date summary CV in the standard NEBOSH format (attached to this application form) is required for every workplace-based project marker unless also a member of the tutor team in 4.1 above. Please note that applications without this information will not be considered. Lead project marker

Additional Project Markers 1. 2. 3. If there are more than three project markers, please continue on a separate sheet (marked 4.2.3 / project markers) and tick this box 5 Proposed programme content

Please include one copy of the outline timetable for each mode of study, showing the content and contact time for each session and the tutor(s) who will normally deliver them. Where appropriate the names of reserve tutors who will be available to deliver sessions should be included, as should an indication of when tutorials will be held, and where directed private study is set. Please tick the box to indicate that the timetable is included with the application.



6 Qualification Approval Declaration 6.1 Staff Related Declarations Please read, tick the boxes and sign below. This declaration must be signed by an authorised signatory in his/her own name for and on behalf of the course provider I declare that the course provider:

will ensure that staff involved with the qualification will fully understand the qualification guide provided by NEBOSH, and will comply with its provisions.

will undertake to make available evidence of tutorial team qualifications to NEBOSH in a timely manner upon request.

will understand that any misleading information provided above, and/or failure to supply CVs and / or other evidence upon request, may prevent accreditation being granted and may impact on other related qualification accreditation or recognition status

6.2 Qualification Declarations I declare that the course provider:

will enrol / register candidates for assessment within the deadlines specified in NEBOSH timetables.

will ensure that appropriate learning materials are provided to all students to support the course programme.

In the event of an unavoidable course termination, agrees to provide reasonable advance notice to candidate(s) and NEBOSH, and will continue to provide tutor support and examination facilities (appropriate to the NEBOSH qualification) for a minimum of two Standard examination sittings following the course end date, or arrange for the transfer of candidates to another course provider with the same method of course delivery, at no additional cost to the candidate or NEBOSH.

will take all necessary steps to ensure that work submitted is the candidates own and authentically completed.

will ensure that assessments marked by the course provider are submitted to agreed deadlines as specified by NEBOSH, and the results of such assessments are sent to NEBOSH within the deadlines specified. will adhere to all assessment requirements as stipulated in the relevant NEBOSH qualification guide.



will keep complete and accurate records, for at least three years from the end of the year to which they relate, for all qualifications and make these available to NEBOSH upon request.

will keep representative samples of assessments marked by the course provider (eg, practical assessments and workplace-based projects) for a rolling three year period and make these available to NEBOSH and/or the regulator upon request.

agrees to inform NEBOSH immediately should any changes occur to the information supplied in this application.

6.3 Course provider agreement to the terms and conditions set out

Please note that NEBOSH reserves the right to view all materials identified within this application either through the application process (inclusive of a site visit) or via a post-approval monitoring activity. I [insert name of head of course provider] declare that this course provider agrees to adhere to the procedures and policies of NEBOSH, including those set out in the Course Provider Accreditation Agreement, in respect of this application and accept that if the course provider defaults on the commitments made in this application it may lead to the removal of its accredited status. I confirm that I have read and understand the information in the relevant guide to the qualification applied for and that I and my organisation will comply with the requirements set out in that document and will update NEBOSH immediately on any significant changes to the programme delivery arrangements (including the composition of the tutorial and practical assessment team) subsequent to the date of this application. I confirm that the course provider understands that if this application is accepted it will form part of the contract between the course provider and NEBOSH I declare that I am authorised by the above course provider to supply the information given above and, at the date of signing, the information provided is a true and accurate record to the best of my knowledge. Signature Position Date



Please ensure all parts of the form have been completed, including all contact details, all Agreement and Declaration tick boxes and that the form has been signed and dated. Please ensure that you include with the application: Completed NEBOSH CV forms for all proposed tutors/practical

application/project assessors (as specified in section 4.1) an outline timetable for each mode of study (as specified in section 5) Electronic applications: only a SINGLE copy of the completed form and all the accompanying attachments is required. This should be sent to [email protected] whereupon an electronic confirmation of receipt will be returned within 3 working days. Paper based applications: please submit TWO COPIES of the completed form and its attachments to: Accreditation Department, NEBOSH, Dominus Way, Meridian Business Park, Leicester LE19 1QW whereupon a letter of confirmation of receipt will be forwarded. Please retain a copy of the application and all attachments for your own records. Please also ensure that you make arrangements to pay the relevant application fee as specified in the current NEBOSH Schedule of Fees. A cheque, official purchase order or order number is acceptable but if wishing to pay by bank transfer please contact the Finance Department on 0116 263 4700 for NEBOSH bank details. Until receipt of this fee is confirmed no formal accreditation activity will commence.


Practical application assessor(s)

Documents

Part B Application Form