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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 admin@cimap.co.za 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 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. Surname First Names Title (Dr, Mr, Mrs, Ms etc) Identity Number(Please submit a copy of your ID) Professional Qualifications (Please submit proof of your stated qualifications) Company Name (If applicable) Physical Address Postal Address E-mail address Telephone number Cell number Fax Number CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2
2.
What are your
ETD areas of specialisation? Facilitation Assessment Moderation Coaching Project (learnership) management Materials Development Do you belong to any other professional body or Yes No association? Please specify. If you are a constituently registered assessor, ETQA Qualifications registered against list the ETQAs where you have constituency. (As per report attached) (Please submit relevant documentation as proof of registration in support of your application). (As per report attached) (As per report attached) If you are a moderator, list the ETQAs where ETQA Qualifications you have constituency. (Please submit relevant documentation as proof of 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
3.
Practice Arts
& Food and Local Social Entertainment Beverage Government development Banking and Finance and Manufacturing Sports and related services Accounting Recreation Communication Health & Safety Management Wholesale and Retail Cleaning Hospitality and Marketing Tourism Chemical H. R. Mining Construction Health & Welfare Project Management Design and Insurance Public service fashion Education IT Public Relations Entrepreneurship Labour Relations Quality and Innovation Management Other: I hereby give permission for my membership status and areas of specialisation Yes No to be made available to third parties. (This service includes distributing my constituent status to membership companies and other professional bodies / associations, regulators etc. that may want to contract the services of independent assessors and moderators) CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2
4.
Membership Affiliate Membership
Annual Fee Please indicate Affiliate Membership for 1 year: Renewable each year in joining month at Assessors that are not constituently normal annual fee of R 600.00 registered by an ETQA Affiliate Membership (renewal) : Renewable each year in joining month at the Constituently Registered Assessors with current annual fee of R 400.00 an ETQA – (First year of registration) Affiliate Membership (new): New member offer of R 280.00. Constituently Registered Assessors with an ETQA – (First Time Membership – not for applicable renewals). Affiliate Corporate Membership (Must Renewable each year be in the process of registering with Current annual fee of R 500.00 DHET as a FET College). Chartered Corporate Membership (must Renewable each year be registering with DHET as a FET Current annual fee of R 1200.00 College). 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 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. CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2
5.
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 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
6.
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; Continue to develop my competencies and keep up to date with best practice. CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2
7.
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
8.
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
9.
Signature
Date CIMAP Core Values: - Integrity, Credibility & Discipline © 2012 doc ref 23/2
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