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APPLICATION FOR THE BPSYCH EQUIVALENCEPROGRAMME(BPEP)

DEPARTMENT OF INDUSTRIAL PSYCHOLOGY,

UNIVERSITY OF STELLENBOSCH

SECTION ONE
NAME AND ADDRESSES OF APPLICANT
[To be completed by all applicants]
Surname:
First names:
Residential address:
Postal address [if different]:
Business address [if employed]:
Telephone [home]: / Telephone [work]:
Fax: / Cell phone:
E-mail:
SECTION TWO
BIOGRAPHICAL AND RELATED DETAILS
[To be completed by all applicants]
If you have been registered at the University of Stellenbosch before, please state your student number:
Date of birth: / Age:
Identity number: / Citizenship:
Gender: / Male / Female / Marital Status: / Single / Married
Home language:
Language proficiency [mark all appropriate blocks with a cross]:
Language /

Speak

/ Write / Read / Understand
Afrikaans
English
Other [specify]:
SECTION THREE
EDUCATION AND TRAINING
[To be completed by all applicants]
If you are studying at the moment, provide the following details:
Institution: / Degree/diploma enrolled for:
Year of study [e.g. final]: / Student number:
Majors, marks and symbols achieved thus far:
Provide details of all tertiary academic qualifications already obtained in the following table (An official academic record, or a certified copy thereof, pertaining to the honours degree, as well as the syllabus for the postgraduate assessment module that you have followed, is to be submitted with your application:

Institution

/ Qualification / Year obtained / Major/s / Mark/ symbol
SECTION FOUR
WORK-RELATED EXPERIENCE
[To be completed by all applicants]
Your present employment status [mark one of the blocks with a cross]:
Employed / Self-employed
Unemployed / Full time student
Present Employer [if employed]:
From [date]: / Telephone:
Position:
Brief job description:
Previous Employer:
From [date]: / To [date]: / Telephone:
Position:
Brief job description:
Other work experience, including significant temporary work experience [please list from most recent]:

From [date] to [date]

/ Employer [provide telephone number] /

Position

If self-employed, provide full details:
SECTION FIVE
YOUR PERSONALITY AND OTHER QUALITIES
[To be completed by all applicants]
What do you regard as your greatest strengths:
What do you regard as your greatest weaknesses:
What do you regard as your biggest accomplishments so far in life:
Briefly describe your philosophy of life:
SECTION SIX
MOTIVATION FOR APPLYING FOR THE BPSYCH EQUIVALENCE PROGRAMME (BPEP)
[To be completed by all applicants]
Your expectations:
How would the BPEP programme support your own personal career development
Briefly furnish any additional/other information that you want to submit in support of this application:
SECTION SEVEN
REFERENCES
[To be completed by all applicants]
Provide the following details of at least three individuals [not relatives] who may be contacted as references, including at least one previous/present superior if you are employed or have been employed:

Name

/ Telephone [work] / Telephone [home] / Relationship [e.g. team captain, supervisor] / Period known [years]
Provide the name and telephone number of one academic reference – indicate course taught and where

Name

/ Course/Courses/Supervisor / Telephone no
Signature of applicant:
Date:

The BPEP Coordinator, Department of Industrial Psychology, University of Stellenbosch, Private Bag X1, MATIELAND, 7602

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