ASSESSOR / MODERATOR

REGISTRATION FORM

TYPE OF APPLICATION (TICK THE APPROPRIATE BLOCK)

Tick Tick

New Assessor Registration Assessor Re-Registration

New Moderator Registration Moderator Re-Registration
Assessor Extension of Scope Moderator Extension of Scope

PERSONAL DETAILS

Title First Names Surname

SA ID No Passport No Citizenship
(Please attach certified copy)

Date of Birth YYYY / MM / DD Gender

RACE
AFRICAN WHITE COLOURED OTHER INDIAN

Disability Y N Specify

Physical Address Postal Address

City City

Post Country Post Code Country

Code

Province Magisterial
District

E- mail Phone Code Number Cell

Document Title Assessor/Moderator Registration Form

Document Number ETQ–FM–006 Date Compiled 31 July 2007
Page Number Page 1 of 5 *Last Revision Date 28 October 2015
Revision Number Rev 06 Access Controlled
Review: Senior Manager: ETQA & Approved: CEO
Partnerships
9 January 2018 *The document with the latest revision date is the current official document
 Language Speak Read Write

Home Language Y N Y N Y N
Other Language 1 Y N Y N Y N
Other Language 2 Y N Y N Y N

Present Job Title

APPLICANT’S QUALIFICATIONS

Generic Assessor / Moderator

Certificate Number (Please attach
certified copy)

Qualifications Achieved
(Please attach certified copy)

APPLICANT’S RELATED WORK EXPERIENCE

Attach CV to this application with specific reference to related work experience and period.

SPECIFIC INFORMATION

If applying for registration against a qualification, complete section 1.

If applying for registration against a Unit Standard, complete section 2.

1. Name(s) and NQF level(s) of whole qualification(s) or unit standard based qualification you wish to be
registered against:

QUALIFICATION (S) NQF LEVEL SAQA ID NUMBER

2. Name(s) and NQF level(s) of unit standard(s) you wish to be registered against (only to be completed if the
unit standard is not included in the qualification listed in the Table above)

SAQA ID
NAME OF UNIT STANDARD (S) NQF LEVEL
NUMBER

EMPLOYER/PROVIDER INFORMATION

Document Title Assessor/Moderator Registration Form

Document Number ETQ–FM–006 Date Compiled: 31 July 2007
Page Number Page 2 of 5 *Last Revision Date 28 October 2015
Revision Number Rev 06 Access: Controlled
9 January 2018 *The document with the latest revision date is the current official document
 Full Name of
Employer /Training
Provider

Physical Address

City

Post Code

Phone Code Number

Fax Code Number

AUTHORISATION

APPLICANT’S SIGNATURE

DATE OF APPLICATION

Return completed application form to: The merSETA Head Office

Tel: 010 219 3000 Email: admin@merseta.org.za

NB!!! PLEASE NOTE THAT APPROVAL OF APPLICATIONS TAKES BETWEEN 6-8

WEEKS

Document Title Assessor/Moderator Registration Form

Document Number ETQ–FM–006 Date Compiled: 31 July 2007
Page Number Page 3 of 5 *Last Revision Date 28 October 2015
Revision Number Rev 06 Access: Controlled
9 January 2018 *The document with the latest revision date is the current official document
 APPLICANT SELF CHECK

Copy of Originally Certified Identity Document by commissioner of oath

Copy of Qualification Originally Certified by commissioner of oath

Copy of CV

Copy of Originally Certified Assessor / Moderator Certificate from ETDP accredited Provider by
commissioner of oath
OR

Copy of Originally Certified ETDP Statement of Results by commissioner of oath

Signed Code of Conduct

Note: All supporting documents should be certified, applications with outstanding

documents wont be processed

Document Title Assessor/Moderator Registration Form

Document Number ETQ–FM–006 Date Compiled: 31 July 2007
Page Number Page 4 of 5 *Last Revision Date 28 October 2015
Revision Number Rev 06 Access: Controlled
9 January 2018 *The document with the latest revision date is the current official document
 CODE OF CONDUCT FOR ASSESSORS / MODERATORS

All assessors / moderators registered by the merSETA will be expected to adhere to a

Code of Conduct. This Code of Conduct is built on the basic principles of good
assessment / moderation practice and around ensuring that all learners have a fair, valid
and reliable assessment experience.

The purpose of the Code of Conduct is to:

 Define accepted and acceptable assessment / moderation behaviours;
 Promote high standards of assessment / moderation practice;
 Provide a benchmark for assessors / moderators to use for evaluating their own practices
and behaviours; and
 Establish a framework for professional assessment / moderation behaviour and
responsibilities.

All assessors / moderators will:

1. Conduct assessment / moderation within the accreditation requirements of an accredited
provider;
2. Comply with all criteria for registration as assessors / moderators with the merSETA;
3. Comply with and carry out all assessment / moderation responsibilities in accordance
with the assessment / moderation criteria and guidelines set for the qualifications and/or
unit standards they are registered by the merSETA to assess / moderate;
4. Use plain language during the assessment / moderation and in all reports, excepting
where technical language or terms are required;
5. Treat all those they assess / moderate with dignity and respect;
6. Behave in a supportive and encouraging manner towards all assessment / moderation
candidates;
7. Behave towards candidates in ways that are not intimidating;
8. Be honest in all their dealings with assessment / moderation;
9. Maintain the confidentiality of assessments / moderation and respect the right to privacy;
10. Record the outcomes of assessments / moderation in the appropriate format during or
immediately after the assessment / moderation; and
11. Report the outcomes of each assessment / moderation together with recommendations
for further development as soon after the assessment / moderation as possible.

NAME OF ASSESSOR /
SIGNATURE
MODERATOR
DATE SIGNED

Document Title Assessor/Moderator Registration Form

Document Number ETQ–FM–006 Date Compiled: 31 July 2007
Page Number Page 5 of 5 *Last Revision Date 28 October 2015
Revision Number Rev 06 Access: Controlled
9 January 2018 *The document with the latest revision date is the current official document