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STREET WORKS QUALIFICATIONS REGISTER (SWQR)
CANDIDATE RE-ASSESSMENTREGISTRATION FORM
FORM SWQR5
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5
PLEASE NOTE THAT THE APPLICATION SHOULD BE RETURNED ALONG WITH COPIES OF YOUR REASSESSED AWARDING BODY CERTIFICATES, ONE PASSPORT SIZE PHOTO AND THE APPROPRIATE FEE.
FEES & PAYMENT (valid until 31 March 2012)
  • £21.50 to register your reassessed qualifications.
(a)I enclose a cheque/postal order to the value of £21.50 made payable to SWQR.
(b)Major companies and centres can be invoiced by listing their centre number in the box
provided.
Purchase Order number (Cross if applicable) BATCH OR YEARLY ------

CANDIDATE DETAILS

SWQR NUMBER IF REGISTERED PREVIOUSLY

AWARDING BODY REGISTRATION NUMBER

SURNAME

FORENAME(S)

TITLE

DATE OF BIRTH
ADDRESS: Note – the I/D card and documentation will be sent to this address (include Company name if applicable)

LINE 1

LINE 2

TOWN

REGION/
COUNTY

POSTCODE
REASSESSED QUALIFICATION(S) COMPLETED

Please Cross (X)OPERATIVES

O1– Reassessed excavation in the road/highway
O2–Reassessed excavation, backfilling reinstatement – cold lay
O3 - Reassessed reinstatement – hot cold lay bituminous materials
O4–Reassessed reinstatement of concrete slabs
O5–Reassessed reinstatement of modular surfacesconcretefootways
O6 – Reassessed signing, lighting and guarding /

Please Cross (X)SUPERVISORS

S1–Reassessed monitor excavation in the road/highway
S2–Reassessed monitor excavation, backfilling & reinstatement – construction layers
S3–Reassessed monitor reinstatement – hot cold laybituminousmaterials
S4–Reassessed monitor reinstatement of concrete slabs

S5–Reassessed monitor reinstatement of modular surfacesconcrete footways

S6 –Reassessed monitor signing, lighting and guarding

I hereby certify that the above person has completed all the requirements of the reassessment qualification(s), and that a copy of thecandidate’s reassessment certificate has been included.

Signature Date

RETURN TO: SWQR, THE OPTIMABUILDING, 58 ROBERTSON STREET, GLASGOW, G2 8DQ
TEL: 0845 270 2720FAX: 0845 213 5000WEBSITE:

GUIDANCE NOTES TO ASSIST IN THE COMPLETION OF

SWQR5 FORMS

Fill in this Form in CAPITAL LETTERS. Please write only within the white boxes. We will electronically scan and store the information provided. The I/D card will have a digital image of the applicant’s photo. Please follow the guidance notes carefully.Put a cross (X) in the relevant box. Use one box for each letter and leave an empty box between names or words. Applications may be delayed if there is a mistake on the Form or the photograph sent in does not meet our guidance note.

1CENTRE DETAILS
  • Enter your Centre name
  • Enter your Centre number. This number was allocated by the Awarding Body when your Centre was approved to conduct reassessment in relation to the Street Works Qualifications
  • Enter the name of the Awarding Body which has approved your Centre to conduct reassessments in relation to the Street Works Qualifications in the following way:

Awarding Body / Enter As:
City and Guilds / C&G
CABWI / CAB
Scottish Qualifications Authority / SQA
  • If you are a centre that uses Purchase Order Numbers, please provide details clearly on the form in the space provided

NBIf the Purchase Order Number is not on the form, it will be returned to you

2CANDIDATE DETAILS
  • Enter the candidate’s existing Registration Number.

NBReassessment qualifications are only valid if they match the existing registration already held on the Street Works Register.

If an individual fails to register their re-assessed qualifications in the six months after their current expiry date, their registration will expire and they will be required to retake the full units.

  • A photocopy of the Reassessment certificate must be returned to SWQR at the time of application.
  • Enter the candidates Awarding Body registration number. This number is allocated by the Awarding Body when registering candidates for the Street Works Qualifications. This must be written on the Form to allow us to find the candidate result
  • Attach a current passport size photograph of the candidate (see separate guidance leaflet on acceptable photographs)
  • Full candidate details should be entered. This includes: full name, title, sex, date of birth and address details (include Company name if applicable)

NBThe I/D card will be returned to this address. Please ensure that this address is correct.

Covering letters/compliment slips etc will not accepted as a change of address

3FEES

  • Reassessment registration of candidate - £21.50

4QUALIFICATION(S) COMPLETED

  • Achievement of a qualification(s) should be indicated by crossing the relevant box. Below is a breakdown of the qualifications and associated units:

Operative / Supervisor
01 / Excavation in the road/highway (R001, R002 & R003) / S1 / Monitor excavation in the road/highway (R001, R010 & R011)
02 / Excavation, backfilling & reinstatement – cold lay (R001, R002, R003, R004, R005 & R006) / S2 / Monitor excavation, backfilling & reinstatement - construction layers (R001, R010, R011, R012, R013 & R014)
03 / Reinstatement – hot & cold lay bituminous materials (R001, R002, R006 & R007) / S3 / Monitor reinstatement – hot &cold lay bituminous materials (R001, R010 & R014)
04 / Reinstatement of concrete slabs (R001, R002 & R008) / S4 / Monitor reinstatement of concrete slabs (R001, R010 & R015)
05 / Reinstatement of modular surfaces & concrete footways (R001,R 002 & R009) / S5 / Monitor reinstatement of modular surfaces & concrete footways (R001, R010 and R016)
06 / Signing, lighting and guarding (R002) / S6 / Monitor signing, lighting and guarding (R010)

5SIGNATURE

  • The SWQR Centre nominated contactis required to confirm that all the details recorded on the form are accurate. Please sign and date the form in the space provided

6PHOTOGRAPHS

All applications must include a recent photograph and must be a true likeness of the applicant. Please ensure that the photograph meets the criteria on the separate guidance note. This will help avoid the need for us to ask for more photographs

Please note that photographs become part of our official records and we will not return them.

7CONTACT US

The Street Works Qualifications Register

The OptimaBuilding

58 Robertson Street

GLASGOW

G2 8DQ

Telephone: 0845 270 2720

Email: