Apply to be a CESA / ECSA Verified CPD Service / Training Provider

* = required field

 Organisation Details
Company Name *
Known As / Trading As
New or Renewal * New Renewal
Previous CESA CPD Verification Service Provider Number
Previous CESA CPD Verification Service Provider Certificate
Other Volunteer Association CPD Verified Service Provider Number
Other Volunteer Association CPD Verified Service Provider Certificate
Phone Number
Format e.g.: +27 (0)11 463 2022		 +(0)
Cell Number *
Format e.g.: +27 (0)82 XXX YYYY		 +(0)
Website
Email Address *
VAT No
 Physical Address
Physical Address Line 1
Physical Address Line 2
City *
Code *
Province *
Country *
 Person who is applying for verification on behalf of the organisation
Title *
Initials
First Name (Known As) *
Surname *
Position Held
ID / Passport Number
Phone Number +(0)
Cell Number * +(0)
Email Address *
 Person who is acting as the administrator on behalf of the organisation
Same as above
Title
Initials
First Name (Known As) *
Surname *
Position Held
ID / Passport Number
Phone Number +(0)
Cell Number * +(0)
Email Address *
 Upload Documents
The CPD Service/Training Provider is required to upload evidence of the following, related to your company, the administration and offering of CPD Activities.
Company Profile *
Valid certified company registration certificate *
Valid tax clearance certificate (good standing with SARS or equivalent) *
BBBEE Certificate or Affidavit
FICA compliant / Proof of office/residential address *
Any valid documents reflecting your company's name and physical office address. i.e. Recent active lease or rental agreement, Municipal rates and taxes invoice
Copy of ID book or driver's license of applicant *
Evidence of a comprehensive Quality Management System (QMS), which includes the following elements:
      • A broad outline of the programme for the forthcoming year *
      • Quality assurance / strategies employed for the CPD Activities *
      • Method for recording attendance *
      • Intended mechanism for monitoring attendance (per hour or per session) for the duration of the activity *
      • Proposed attendance register (with evidence of copy) *
      • Attendance certificate that will be provided on completion of the activity *
      • Method to be used for obtaining feedback or evaluation of the CPD event *
      • Database containing list of information of CPD Activities with CPD Validation Numbers *
      • Process and reimbursement clause for the reimbursement for registration fees, accommodation and other costs incurred during the validation of the CPD Activity *
      • Accountability Structure/Organigram for CPD Management *
      • Procedure to Assess the Learners *
Accountability Structure

I confirm that I am an authorised representative of the above organisation, and authorised to hereby apply on behalf of the organisation to be recognised as a ECSA CPD Verified Service Provider in terms of the Rules: Continuing Professional Development and Renewal of Registration (Board notice 86 of 2017) and Section 10 of the Standard for Continuing Professional Development (ECPD-01-STA).

I confirm that the information and documentation supplied is, to the best of my knowledge, accurate and complete.