Please complete Section 1 – 3 and submit your signed application with the required supporting documentation to:

Mr Diale Mokgojwa

Potatoes South Africa

Private Bag X 135, PRETORIA, 0001

Fax Number: 012-349-2641/ 086-678-1148

E-mail:

SECTION 1: PERSONAL DETAILS

Name:
Surname:
Title:
ID number:
Date of Birth:
Gender:
Race
Nationality:
Home Language:
Disability Status:
Physical Address
Code: / Postal Address:
Code:
Province:
Telephone no.: (work)
Telephone no.: (home)
Cell phone no.:
Fax no.:
Email:

SECTION 2: INDUSTRY EXPERIENCE

State below the industry / technical experience you have in relation to the unit standards. Please attach a CV with this application form.

SECTION 3: REGISTERED UNIT STANDARD

Kindly indicate in the table below the registered unit standards against which registration as a subject matter expert is being sought.

PLANT PRODUCTION, LEVEL 1 / PLANT PRODUCTION, LEVEL 2
U/STD / Unit Standard Title / Tick / U/STD / Unit Standard Title / Tick
116199 / Demonstrate a basic understanding of the structure and function of a plant in relation to its environment / 116057 / Understand the structure and functions of a plant
116200 / Plant crops under supervision / 116079 / Monitor the establishment of a crop
116201 / Harvest agricultural crops / 116111 / Harvest Agricultural Crops: Procedures
116203 / Manipulate Plants / 116128 / Apply Plant Manipulation Methods
116204 / Recognise pests, diseases and weeds / 116124 / Control pests, diseases and weeds on all crops effectively and responsibly
116205 / Propagate plants / 116119 / Demonstrate an Understanding of Plant Propagation
116206 / Fertilise soil and attend to basic plant nutrition / 116053 / Understand basic soil fertility and plant nutrition
AGRICULTURAL BUSINESS, LEVEL 1 / AGRICULTURAL BUSINESS, LEVEL 2
U/STD / Unit Standard Title / Tick / U/STD / Unit Standard Title / Tick
116158 / Apply basic agricultural enterprise selection principles / 116081 / Identify and Recognise Factors Influencing Agricultural Enterprise Selection
116159 / Identify the need for capital and understand the need for the recording of the income and different costs in an agri-business / 116083 / Illustrate and understand the basic lay-out of financial statements
116160 / Apply basic human resource management principles and practices applicable in an agricultural environment / 116113 / Principles of human resources management and practices in agriculture
116163 / Handle inputs & stock in Agri-business / 116122 / Control inputs and stock in agribusiness
116164 / Demonstrate an understanding of the importance of marketing / 116126 / Apply Marketing Principles in Agriculture
116165 / Define production and understand the basic activities of production / conversion in the agri-business environment / 116115 / Define and understand production systems and production management.
NATURAL RESOURCE MANAGEMENT, LEVEL 1 / NATURAL RESOURCE MANAGEMENT, LEVEL 2
U/STD / Unit Standard Title / Tick / U/STD / Unit Standard Title / Tick
116157 / Demonstrate an understanding of the basic concepts of sustainable farming systems / 116064 / Recognise and identify the basic functions of the ecological environment
116169 / Understand how sustainable farming systems conserve natural resources / 116121 / Apply Sustainable Farming Practices to Conserve the Ecological Environment
116172 / Apply elementary farm layout and infrastructure / 116127 / Apply layout principles for conservation and infrastructures
GENERIC AGRICULTURAL PRACTICES, LEVEL 1 / GENERIC AGRICULTURAL PRACTICES, LEVEL 2
U/STD / Unit Standard Title / Tick / U/STD / Unit Standard Title / Tick
116156 / Collect agricultural data / 116080 / Monitor, collect and collate agricultural data
116166 / Apply basic food safety practices / 116070 / Operate and support a food safety and quality management system in the agricultural supply chain
116167 / Select, use and care for hand tools and basic equipment and infrastructure / 116060 / Utilise and perform minor repair and maintenance tasks on implements, equipment and infrastructure
116202 / Operate and maintain irrigation systems / 116066 / Operate and maintain specific irrigation systems
116077 / Monitor Water Quality
116125 / Apply Crop Protection Products Effectively and Responsibly

Signed by me the APPLICANT on this ______day of ______20_____.

APPLICANT signature:______

SECTION 4: CHECKLIST

Before submitting your application, please verify that the following documents have been included in your application:

Document type / Please , if incl.
  1. Fully completed and Signed Application Form

  1. Copy of ID document

  1. Comprehensive CV detailing relevant industry experience

For office use only:

Processed date:
Application number:
Date of registration: