Download application form - JIB-PMES

UK-PHMES CSCS Registration Card Application Form
Return Address:
JIB-PMES, Lovell House, Sandpiper Court, Phoenix Business Park, Eaton Socon, St. Neots, Cambridgeshire, PE19 8EP.
Section 1
Your Details
Title (Mr, Mrs, etc):
First name:
Surname:
Home address:
Postcode:
NI Number:
Date of Birth
D
D
M M
Y
Y
Home Telephone
Number:
Y Y
Mobile Telephone
Number:
Email Address:
Please provide your union membership number. If you are a member of Unite the Union, you may be entitled to a free card.
CARD DETAILS
New (see below)
Renewal of existing card £25.00 (complete section 19)
Type
Plumber Blue
Plumber Gold
Heating Fitter Blue
Heating Fitter Gold
Mechanical Pipe Fitter Blue
Mechanical Pipe Fitter Gold
Gas Service Fitter Blue
Gas Service Engineer Gold
Plumbing Related Occupations (Gas) White
Plumbing Related Occupations White
General Operative/Labourer Green
Plumbing Apprentice/Trainee Red
Supervisor Gold
Manager Black
Site Visitor Yellow
Cost
£30
£30
£30
£30
£30
£30
£30
£30
£30
£30
£30
£20
£30
£30
£30
Sections required
1,2,3 & 4
1,2,3 & 5
1,2,3 & 6
1,2,3 & 7
1,2,3 & 8
1,2,3 & 9
1,2,3 & 10
1,2,3 & 11
1,2,3 & 12
1,2,3 & 13
1,2,3 & 14
1,2,3 & 15
1,2,3 & 16
1,2,3 & 17
1,2,3 & 18
Affix photo
here
Remember to
write your NI
number on the
back
Please make cheques payable to JIB-PMES.
FAST TRACK OPTION
For an additional payment of £55.00 (plus standard card fee) you can request that your card is fast tracked. We aim for you to receive your card
within 4 working days. In order to process a fast track application we require a completed application form, all supporting documentation and
cleared payment by credit/debit card, postal order or BACS transfer (cheques not acceptable). Please tick this box to fast track your application:
UK Plumbing, Heating & Mechanical Engineering Services
REGISTRATION SCHEME (CSCS Affiliated)
© JIB-PMES 2014
Section 2
Health, Safety and Environment Training
SECTION 2: Health, Safety and Environment Training
1. NVQ/SVQ Exemption
If you have obtained relevant Level 2 or 3 National or Scottish Vocational Qualification (NVQ/SVQ) or NVQ Diploma
within the past two years, tick this box:
(To ensure the NVQ/SVQ exemption is accepted, you must attach a copy of your NVQ/SVQ or NVQ Diploma completion certificate to this
application). Please Note: C&G 6129 or 6035 VRQ certificates are NOT acceptable. The exemption period is for a maximum of 2 years from
the date on the completion certificate.
2. CITB Health, Safety and Environment (HS&E) Test
If you have completed the CITB HS&E test (Plumbing or Gas) please tick this box
this application.
and ensure you send a copy of your test pass letter with
3. CITB Supervisors + CITB Managers and Professionals HS&E Test
If you have completed either the CITB Supervisors or the CITB Managers and Professionals HS&E Test please tick this box
send a copy of your test pass letter with this application.
and ensure you
4. Other applicable Health and Safety Tests
If you have completed any other applicable Health and Safety tests/courses please tick this box
and ensure you send copies of your test/
course certificates or test pass letter with this application. Failure to provide a copy of your H&S test pass could result in your application form
being returned.
For a list of acceptable tests, please visit our website: www.jib-pmes.org
Section 3
Declaration
SECTION 3: Applicants Declaration
I certify that the details on this application form are correct and completed to the best of my knowledge.
I agree that the information contained on this application form may be used by the JIB-PMES and its related companies in connection with
my application for a UK JIB-PHMES card and the provision of other services associated with my employment in the plumbing and mechanical
engineering services industry. I acknowledge that the personal information given here will be used for the purpose of processing my application
for a UK JIB-PHMES card, and that this may include passing on information to Employers, Labour Agencies or Training Providers and for
purposes of verification. I also agree that information from this application may be held on a database in accordance with the Data Protection
Act 1998.
Important Information:
* If your application has been through the initial assessment stage and you decide to withdraw your application an administration fee will
be deducted from the refund of your fee.
* The card remains the property of the JIB-PMES and can be withdrawn at any time.
* If all the relevant documentation is not enclosed with the application form, all documentation will be returned.
* I agree and accept that the JIB-PMES bear no responsibility or liability for my Registration Card should it be lost in the post.
Signed:
Date:
D D
M M
/
Y
Y Y
Y
/
Notes:
The website www.jib-pmes.org contains all the latest amendments to the UK-PHMES Registration Scheme rules or call 01480 476925
UK Plumbing, Heating & Mechanical Engineering Services
REGISTRATION SCHEME (CSCS Affiliated)
© JIB-PMES 2014
Section 3A
Credit/Debit card payment authorisation
I hereby authorise the JIB-PMES to charge the required fee (plus any applicable handling charges) to my credit/debit card as detailed below.
Cardholder signature:
Date:
/
/
Upon receipt of this instruction the JIB-PMES will process the amount to be paid in accordance with the appropriate fee plus handling charge.
Card details
Cardholder name:
Cardholder daytime contact number (including STD code):
Cardholder address (billing address for card statements):
Card number:
Expiry date:
M M / Y Y
Security code:
Postcode:
Last 3 digits on signature
strip on back of card
Note: If the JIB-PMES is unable to process payment from the Credit/Debit card that is specified, the application will be rejected.
UK Plumbing, Heating & Mechanical Engineering Services
REGISTRATION SCHEME (CSCS Affiliated)
© JIB-PMES 2014
Section 4
Plumber Blue Card
(For guidance notes see reverse)
Name:
National Insurance Number:
Plumber Blue Card
Minimum qualification - Level 2 NVQ Diploma in Plumbing and Heating, NVQ/SVQ Level 2 Plumbing or City & Guilds Craft
Certificate - Important note: City & Guilds 6089 NVQ or 6189 NVQ Diploma is required not the City & Guilds 6129 Level 2
Technical Certificate or 6035 Diploma (see over for details).
Plumbing
Please tick against qualifications obtained.
L2 NVQ/SVQ or L2 NVQ Diploma
SCOTVEC Modules
City & Guilds Craft (Pre - 1995)
NARIC Equivalence Report
Please ensure you send copies of all your completion certificates with
this application
Employment Details
JIB-PMES Participant Company Y/N
If you are self employed the contact details below must be from a registered company (not your own), JIB-PMES registered agency* or public
sector organisation (this should not be from a domestic client); if you are unemployed, this can be a previous employer.
Confirmation of the details I have included on this application form can be obtained from:
Contact person (must be a senior member of staff/Director):
Name of Employer/Company:
Address:
Postcode:
Telephone Number:
–
Email Address:
Please note that checks will be made with the contact person to ensure that details included on this form are accurate and that you are, or have
been employed in the PHMES sector.
* For details of JIB-PMES registered agencies please phone 0800 197 1060 or visit the website www.jib-pmes.org
UK Plumbing, Heating & Mechanical Engineering Services
REGISTRATION SCHEME (CSCS Affiliated)
© JIB-PMES 2014
Section 4
Guidance Notes:
Plumber UK-PHMES CSCS Registration Card (Blue)
i.
A Blue UK-PHMES CSCS Registration Card is issued to those who have achieved
either a Level 2 NVQ Diploma in Plumbing and Heating, a Level 2 NVQ or SVQ in Plumbing
or an equivalent qualification (i.e. City and Guilds Craft Certificate). Please note
VRQ certificates (C&G 6129 Technical Certificate; C&G 6035 Diploma or equivalent BPEC
and EAL qualifications) are not acceptable.
ii.
UK-PHMES CSCS Registration Cards issued on this basis are valid for up to five years,
and may be renewed after that period (subject to renewal rules).
iii.
This route of entry is permanently open.
iv.
Those who have achieved their NVQ Diploma or NVQ/SVQ less than two years
before applying for their UK-PHMES CSCS Registration Card do not need any further
health and safety training/testing to obtain the card, until the card needs renewing.
The achievement of a relevant NVQ Diploma or NVQ/SVQ is accepted as evidence
of health and safety awareness, because there is a health and safety unit
within the qualification. Note: The exemption period is for a maximum of 2 years from
the date on the completion certificate.
Those who have completed their NVQ Diploma or NVQ/SVQ training more than
two years ago or hold City & Guilds Craft Certificates must pass the CITB
Health, Safety and Environment test, or hold a valid exemption.
For Applicants with qualifications achieved outside the UK, please refer to the JIB-PMES
Registration Scheme Guidance or the JIB-PMES website.
v.
To obtain a Plumber UK-PHMES CSCS Registration Card (Blue), applicants
must submit:
• A correctly completed application form plus appropriate fee.
• A copy of the Level 2 NVQ Diploma, Level 2 NVQ/SVQ or City & Guilds
Craft Certificate.
• Evidence of completing appropriate Health, Safety and Environment training
(CITB or other applicable test/course).
• Evidence of working within the Plumbing and Mechanical services
industry - contact details of an appropriate industry referee must be
included on the application form.
IF YOU HAVE COMPLETED THE LEVEL 2 PLUMBING TECHNICAL CERTIFICATE (CITY & GUILDS
6129) OR THE LEVEL 2 PLUMBING DIPLOMA (CITY & GUILDS 6035, EAL OR BPEC EQUIVALENT
QUALIFICATIONS) AND ARE NOT CONTINUING YOUR STUDIES ONTO THE LEVEL 2 NVQ
DIPLOMA IN PLUMBING AND HEATING (CITY & GUILDS 6189, BPEC OR EAL EQUIVALENT
QUALIFICATIONS), THE ONLY CARD YOU WILL BE ELIGIBLE TO APPLY FOR IS THE GENERAL
OPERATIVE/LABOURER CARD. YOU MUST ALSO PASS AN APPLICABLE HEALTH, SAFETY AND
ENVIRONMENT TEST.
IF YOU ARE CONTINUING WITH YOUR STUDIES, YOU WILL NEED TO APPLY FOR A RED TRAINEE
CARD.
UK Plumbing, Heating & Mechanical Engineering Services
REGISTRATION SCHEME (CSCS Affiliated)
© JIB-PMES 2014

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