/ Competence and Commitment Form
Chartered Scientist / MF5
Revision: 03
Date: 30 April 2014
Page: 1 of 4
NOTES FOR COMPLETING THE COMPETENCE AND COMMITMENT REPORT
This form is designed to demonstrate that you have acquired the necessary competences and commitment levels required for Chartered Scientist (CSci).
Please complete each section in full; you should not refer to any other document. This form must be totally free standing as it is the only document used in your assessment. As general guidance you will need about 2500 words in total.
Ensure that it is verified by people familiar with your work, who do not have to be either the proposer or referee of the applicant. If the experience described covers more than one employment then each section should be initialled by someone familiar with it and all should sign at the end.
Please read the relevant sections of the Science Council’s requirements and the Nuclear Institute’s Code of Conduct before completing this form

PERSONAL DETAILS
MR/MRS/MISS/MS/OTHER (please state):______/ DATE OF BIRTH:
SURNAME: / FORENAME(S):
MEMBERSHIP GRADE APPLIED FOR
Fellow □ / Member □ / Associate Member □ / Technician Member □
COMPETENCE AND COMMITMENT REPORT
Section A: Deal with complex scientific issues, both systematically and creatively, make sound judgements in the absence of complete data and communicate their conclusions clearly to specialist and non specialist audiences
1)Use a combination of general and experiential knowledge, understanding and skills to be able to optimise and engage in the application of existing and emerging science and technology.
2)Use theoretical and practical methods in the analysis and solution of problems, typically by being able to carry out experimental work, advise on and manage the work of others and collect, analyse and evaluate relevant data and offer possible solutions
3)Communicate effectively
Section B: Exercise self direction and originality in solving problems, and exercise substantial personal autonomy in planning and implementing tasks at a professional level
1)Plan and organise projects effectively
2)Work effectively in a team
3)Use effective influencing and negotiation skills
Section C: Continue to advance knowledge, understanding and competence to a high level and demonstrate a commitment to CPD
1)Complywith the rules of professional conduct of own professional body
2)Workconstructively within all relevant legislation and regulatory frameworks; Including social and employment legislation
3)Apply professional work ethics
Section D: Demonstrate an understanding and commitment to Health and Safety and environmental issues related to employment
1)Demonstrate a commitment to operate and act responsibly, taking account of environmental and socioeconomic factors
Section E: Comply with the relevant Codes of Conduct
1)Comply with the rules of professional conduct of own professional body
2)Workconstructively within all relevant legislation and regulatory frameworks; including social and employment legislation
3)Apply professional work ethics
CERTIFICATION
This document is a true account of my competencies and CPD.
Applicant’s Signature: / Date:
VERIFICATION
This is a true account of the competencies and CPD of Applicant’s Name:
Signatory’s Name: / Relationship to candidate:
Title: / Professional Qualifications:
Date: / Signature:

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