Accreditation Form

Organizational details

Name of Company *

Company Registration Number *

Tax Number *

VAT Number *

Number of Training Venues *

Company Physical Address/Location *

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Facilitators

Intended Training Personnel for ICITP accreditation *
Name & Surname, ID N0 / Passport, Designation and E-mail of all the facilitators
Please Attach CV’s of the above mentioned personnel *

Existing Accreditations or Professional Affiliations

Accreditations your Institution/Organization currently hold (e.g.) SETA, Umalusi, QCTO, Council of Higher Education (CHE), Comptia, Department of Higher Education & Training (DHET), SAGE, ICB, Information Technology Association (ITA) etc *
Name of Accrediting Body Accreditation Number Year of Accreditation

Courses or Programs offered

Qualifications, Skills programs, Conferences, seminars, Workshops, Short courses, etc., offered by your institution/organization *
Title of Courses Type

Contact Person

Name & Surname *
Telephone Number
Cellphone Number *
Fax Number
Email *

Declaration by Applicant

Full Name *
Identification Number *
hereby declare that I fully understand & accept the declaration. I hereby declare and confirm that all information herein contained is to the best of my knowledge true and correct and that any false declaration or withholding of information by myself/ourselves would result in my/our application for accreditation as a Training Center being rejected.
Signed this on the
Date
Your Official Stamp

Verification

Please enter any two digits *Example: 12
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