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.

Course provider details

1.1

Provider contact details

NEBOSH Course Provider Number:

(if applicable)
Course Provider Name:
2
2.1

Qualification / Unit applied for

Programme details

Proposed mode(s) of study

(i.e. part-time, full-time
block release, open/
distance learning etc)
2.2

Part time and evenings

Block week
Open / Distance
E-learning

Proposed date of first programme (DD/MM/YY)

______/______/_____

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

Insert additional rows if required

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Role and responsibility of partner

Part B Application Form

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.

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Part B Application Form

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.

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Part B Application Form

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.

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Part B Application Form

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

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Part B Application Form

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
accreditation@nebosh.org.uk 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.

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