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Form 1

Building Professionals Act 2005


Application for accreditation
The Accreditation Scheme (the Scheme) made under the Building Professionals Act 2005
(the Act) establishes the criteria to be met by any person seeking to be accredited by the
Board as an accredited certifier. Applicants must demonstrate they have the qualifications,
skills, knowledge and experience required by the Scheme. Applicants may do so by
completing this Application Form.

Who should use this form


Applicants who seek accreditation for the first time, or applicants whose previous
accreditation has expired, lapsed or otherwise been withdrawn, should complete this form.
Accredited certifiers, who wish to seek an additional Category of accreditation or change a
Category they hold to another Category, should also complete this form.

How to complete the form


Complete the Application Form using BLOCK LETTERS and, where required, write
clear crosses in the appropriate boxes ().
Please ensure the information in your Application is complete, that all of the required
documentation is included and that the Application is legible. Incomplete information
or illegible writing may cause delays in processing Applications.
You are encouraged to refer to Applying for accreditation: a guide to assist you in
completing the form (available at www.bpb.nsw.gov.au).
Please sign and date each page of your Application.

Supporting documentation
The form sets out the information you need to provide, and the documents you need
to attach, to support your Application. Any additional forms you need to complete and
attach are available at www.bpb.nsw.gov.au.
If you do not provide all of the information required, your Application will not be
considered until all of the information is received. You can attach additional pages if
needed.
If your supporting documents are not in English, you must provide a certified copy of
translated versions of those documents, in addition to certified copies of the original
documents.
The Board can require applicants to provide further written information, attend an
interview, undertake an oral examination and/or provide a demonstration of their
skills.

Inquiries about your Application


You may direct any inquiries you have about your Application to an accreditation officer on 02
9860 1800.

Notice of the Boards decision


The Board will notify you in writing of its decision on your Application.

Office use only


Date received: _____/_____/_____

Applicants Signature: Date: www.bpb.nsw.gov.au 1


1. Applicant details
Name and date of birth
Title Given Names
Surname
Date of Birth

Residential address
Unit/Street no. Street
Suburb State Postcode

Business address/details
Business Name
Unit/Street no. Street
Suburb State Postcode
PO Box State Postcode

Address for correspondence (select one)


Residential Business PO Box

Contact details
Res. Tel. ( ) Bus. Tel. ( )
Mobile Fax ( )
Email

Applicants must attach a certified copy of their drivers licence, both the front and back,
showing their current address. Copies must be certified by a Justice of the Peace.

Have you attached a certified copy of your drivers licence? Yes No

If you do not hold a current drivers licence, you should attach certified copies of documents
that prove your identity and address (such as a passport and a council rates notice).

Note: The Board may require you to provide additional documents or information if you provide
identification evidence other than a drivers licence.

2. Current/previous accreditation and/or registration


Are you currently, or have you previously been, accredited to practise as an accredited
certifier in New South Wales? Yes No

If yes, please provide the following information:


Accreditation Date you were first
Body accredited
Level(s) or Date your accreditation
Category(ies) of expires or expired
accreditation

Applicants Signature: Date: www.bpb.nsw.gov.au 2


Do you hold, or have you held, a registration issued by a regulatory or accrediting authority in
another state or territory for a similar occupation? Yes No
If yes, please provide the following information:
State/Territory of Registration Authority
registration
Type of Registration Number
registration
Date you were Date your registration expires or
registered expired

3. Category of accreditation sought


Please select the Category or Categories of accreditation for which you are applying:

A1 Accredited certifier building surveying A3 Accredited certifier building surveying


grade 1 grade 3
A2 Accredited certifier building surveying A4 Accredited certifier building inspector
grade 2

B1 Accredited certifier subdivision certification

C1 Accredited certifier private road and C9 Accredited certifier mechanical services


drainage design compliance compliance
C2 Accredited certifier private road and C10 Accredited certifier fire safety
drainage design compliance engineering compliance
C3 Accredited certifier stormwater C11 Accredited certifier energy management
management facilities design compliance compliance (Classes 3, 5 to 9)
C4 Accredited certifier stormwater C12 Accredited certifier geotechnical
management facilities construction engineering compliance
compliance
C5 Accredited certifier subdivision works C13 Accredited certifier acoustics
& building works (location of works as compliance
constructed) compliance
C6 Accredited certifier subdivision road C14 Accredited certifier building hydraulics
and drainage construction compliance compliance
C7 Accredited certifier structural C15 Accredited certifier stormwater
engineering compliance compliance
C8 Accredited certifier electrical services C16 Accredited certifier - speciality hydraulic
compliance services compliance

D1 Accredited certifier strata certification

Note: the authorities conferred by each Category are identified in Schedule 1 of the Building Professionals
Regulation 2007 (available at www.legislation.nsw.gov.au).

Applicants Signature: Date: www.bpb.nsw.gov.au 3


4. Core Performance Criteria
Applicants must demonstrate they have the Core performance criteria set out in Schedule 1
of the Scheme by successfully completing the Certification Short Course, University of
Technology, Sydney (UTS) or its equivalent, or by passing the Boards accreditation exam..
In limited circumstances the Board may permit an applicant to fulfil the requirements of the
exam by an alternative means.

I have completed the Certification Short Course, UTS, or its equivalent in the last
twelve months. Please attach a certified copy of your Certificate of Successful
Completion, OR

I have previously successfully completed the Certification Short Course, University of


Technology, Sydney, in connection with a previous application and I am seeking an
exemption from the Board from the requirement to have completed the Certification
Short Course, University of Technology, Sydney, within twelve months prior to
submitting my application. Please attach reasons why the Board should grant you
an exemption; OR

I have passed the Boards accreditation exam in the last six months; OR

I have previously passed the Boards accreditation exam in connection with a


previous application and I am seeking an exemption from the Board from the
requirement to have passed the Boards accreditation exam within six months prior to
submitting my application. Please attach reasons why the Board should grant you
an exemption; OR

I seek alternative testing because I have a medical, physical or other condition that
would prevent me from being able to fairly demonstrate my knowledge and skills by
undertaking the accreditation exam. Please provide details as to why you cannot
undertake the exam and attach evidence of your relevant condition:

Please nominate the alternative means of testing you seek to undertake to


demonstrate the core knowledge and skills and how that means of assessment will
allow for a true and accurate demonstration of your skills and knowledge:

Applicants Signature: Date: www.bpb.nsw.gov.au 4


5. Specialty Performance Criteria & Specialty Qualifications for
Categories A1, A2 and A3
If you are applying for A1, A2 or A3 complete this section and then go to Section 10.
If you are applying for A4 go to Section 6.
If you are applying for another Category, go to Section 7.

To satisfy the Specialty Performance Criteria for categories A1, A2 and A3 an applicant must
hold a qualification specified in Schedule 3, Part 2 of the Accreditation Scheme or an
equivalent qualification.

Please provide the following details of the qualification(s) you hold that are specified in of
Schedule 3, Part 2 of the Accreditation Scheme relevant to the Category of accreditation
applied for:

Name of qualification Graduation date Institution attended

Please attach a certified copy of your testamur or qualification and a full academic transcript
for the qualification.

The Board will verify your qualification(s). Please complete and attach a Verification of
academic qualifications and registrations form [Form 2] to allow the Board to make the
necessary inquiries.

If you do not hold a qualification specified in Schedule 3, Part 2 of the Accreditation Scheme
you must provide evidence from the provider of one of the specified qualifications that the
qualification you hold is equivalent of the qualification issued by that provider. Providers of
the qualifications specified in Schedule 3, Part 2 of the Accreditation Scheme have processes
to address this.

You must provide the following details of the qualification(s) you hold for which you are
providing evidence from the provider of one of the qualification specified in Schedule 3, Part
2 of the Accreditation Scheme that your qualification is equivalent to the qualification issued
by that provider:

Name of your qualification Graduation date Institution attended

Name of the provider of the Name of the qualification issued Description of evidence of
qualification specified in by provider specified in Schedule equivalence*
Schedule 3, Part 2 3, Part 2

Please attach your original evidence of equivalence or a certified copy of it.

Applicants Signature: Date: www.bpb.nsw.gov.au 5


Please attach a certified copy of your testamur or qualification and a full academic transcript
for the qualification. If your supporting documents are not in English, you must provide a
certified copy of translated versions of those documents.

The Board will verify your qualification(s). Please complete and attach a Verification of
academic qualifications and registrations form [Form 2] to allow the Board to make the
necessary inquiries.

6. Qualification Requirements for Category A4


Complete this section only if you are applying for A4.

The Accreditation Statement for A4 sets out the qualification requirements for A4 and
provides five (5) Pathways for A4 applicants.

Please indicate which of the five (5) pathways you are applying under:

Pathway 1 - Qualified
Pathway 2 - Student or Qualified Builder or Pre-Purchase inspector
Pathway 3 Builders qualification
Pathway 4 Pre-purchase qualification
Pathway 5 Experience only

Applicants who are applying under Pathway 5 Experience only are not required to hold a
qualification and can go to section 10.

If you are applying for Category A4 under one of the Pathways that have a qualification
requirement, please provide the following details of your qualification relevant to the Category
A4.

Name of qualification Graduation date Institution attended

Please attach a certified copy of your testamur or qualification and a full academic transcript.

The Board will verify your qualification(s). Please complete and attach a Verification of
academic qualifications and registrations form [Form 2] to allow the Board to make the
necessary inquiries.

If you are applying under Pathway 2 you and your supervisor need to complete and attach
Attachment 1 Verification of supervision statement

If you are a student applying under Pathway 2 please attach evidence of your current
enrolment in a relevant course.

If you are applying under Pathways 1 and 2 you do not need to demonstrate experience so
please go to Section 12.

If you are applying under Pathways 3, 4 and 5 please go to Section 10.

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7. Specialty Performance Criteria for Categories B1, C1 C16 and D1
Complete this section only if you are applying for a Category other than A1, A2, A3 or A4.

To identify whether you automatically have the Specialty Performance Criteria by having a
recognised qualification or a recognised registration, please refer to the Evidence checklist
that relates to the Category of accreditation in which you seek to be accredited (available
at www.bpb.nsw.gov.au).

NPER
Where you seek accreditation in Categories of accreditation C1 - C16 (except C5) and you
are registered in the general area of practice on the National Professional Engineers Register
(NPER) identified in the relevant Accreditation Statement and Evidence checklist, go to
Section 11.

BOSSI
Where you seek accreditation in Category of accreditation C5 and you are registered as a
land surveyor with the Board of Surveying and Spatial Information (BOSSI), go to Section
11.

Others
Where the relevant Evidence checklist indicates that your qualification / registration does not
cover all of the Specialty Performance Criteria for the Category of accreditation you seek, or
you do not hold the relevant NPER or BOSS registration you need to need to complete and
attach the relevant Evidence checklist and Annotated performance criteria report [Form
3] (available at www.bpb.nsw.gov.au) to demonstrate you have the specialty performance
criteria you were not able to check in the relevant Evidence checklist.

Please go to Section 8.

8. Specialty qualification for Categories B1, C1 C16 and D1


If you have a recognised specialty qualification listed in Schedule 3, Part1 of the
Accreditation Scheme, please complete this section. If you do not have a recognised
specialty qualification, do not complete this section and go to Section 9.

Please provide the following details of the recognised specialty qualification(s) you hold
relevant to the Category(ies) of accreditation for which you are applying:

Name of qualification Graduation date Institution attended

Please attach a certified copy of your testamur or qualification and a full academic transcript.

The Board will verify your qualification(s). Please complete and attach a Verification of
academic qualifications and registrations form [Form 2] to allow the Board to make the
necessary inquiries.

Please go to Section 10

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9. Other qualifications for Categories B1, C1 C16 and D1
If you have a recognised specialty qualification and you completed Section 8 above, you do
not need to complete this section - go to Section 10.

If you do not hold a qualification specified in Schedule 3, Part 1 of the Accreditation Scheme
you must provide evidence from the provider of one of the specified qualifications that the
qualification you hold is equivalent of the qualification issued by that provider. Providers of
the specialty qualifications have a specific process in place to address this.

You must provide the following details of the qualification(s) you hold for which you are
providing evidence from the provider of one of the qualification specified in Schedule 3, Part
1 of the Accreditation Scheme that your qualification is equivalent to the specialty
qualification issued by that provider:

Name of your qualification Graduation date Institution attended

Name of specialty qualification Specialty Description of evidence of


Institution qualification equivalence*
issued by
Institution

Please attach your original evidence or a certified copy of it.

Please attach a certified copy of your testamur or qualification and a full academic transcript
for the qualification. If your supporting documents are not in English, you must provide a
certified copy of translated versions of those documents.

The Board will verify your qualification(s). Please complete and attach a Verification of
academic qualifications and registrations form [Form 2] to allow the Board to make the
necessary inquiries.

Please go to Section 10

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10. Experience
Applicants must have the experience required by the Accreditation statement in Schedule 2
of the Scheme for the relevant Category of accreditation they seek.

Please complete and attach an Annotated resume [Form 5] for the Board to determine
whether you have the required experience (available at www.bpb.nsw.gov.au).

Applicants for Category A1 are advised to refer to the Experience Guide for Category A1
(available at www.bpb.nsw.gov.au).

All applicants, including Category A1, are to attach the following:

A list of projects you have worked on to demonstrate the extent of your experience.
The list needs to briefly describe the projects you have worked on, the work you
carried out and the dates you carried out the work.
A detailed report of your work experience in relation to six of the most complex,
major or significant projects you have worked on. Provide a detailed narrative of the
work you carried out to demonstrate the extent of your experience.

The Board requests that you do not submit copies of lengthy reports such as BCA
assessment reports or fire engineering reports you have prepared or considered. Instead,
you are to provide a narrative describing the work you have carried out.

Applicants must also provide the names of at least two referees who can verify the
experience required by the relevant Accreditation statement:

Name of Referee Business Telephone


1.
2.
3.

The Board requires the nominated referees to verify the applicants experience. Please
attach a Referees statement [Form 6] for each referee you have listed above, completed
by that referee (available at www.bpb.nsw.gov.au).

The Referees statement [Form 6] should provide verification of the information provided in
the Annotated resum [Form 5], the list of projects and the detailed report of your work
experience in relation to six of the most complex, major or significant projects you have
worked on.

Referees and Referees statements should be provided from persons who are currently
accredited in the category of accreditation being applied for.

Referees and Referees statements are not to be provided by family members unless there
are exceptional circumstances. In such cases, attach reasons explaining why you have
relied on a family member to be a referee.

Go to Section 12

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11. Relevant registration
You only need to complete this section if you hold a registration on the National Professional
Engineers Register (NPER) in a relevant general area of practice, or as a land surveyor
issued by the Board of Surveying and Spatial Information (BOSSI) and seek accreditation in
Categories of accreditation C1 - C16.

Where you seek accreditation in Category of accreditation C5 you must be registered as a


land surveyor with the Board of Surveying and Spatial Information (BOSSI).

Please list the current registration you hold on NPER, or as a land surveyor issued by
BOSSI, which is relevant to the Category(ies) of accreditation for which you are applying:

Registration held Registration number Date of registration

Where you hold a relevant registration on NPER, please attach a certified copy of your
current certificate of registration.

The Board will verify your registration on NPER or as issued by BOSSI. Please complete and
attach a Verification of academic qualifications and registrations form [Form 2] to allow
the Board to make the necessary inquiries. Please go to Section 12

12. Suitability of applicant to be an accredited certifier


Under section 7 of the Act, an Application for accreditation can be refused on certain
grounds, including where the Board is not satisfied the applicant is a fit and proper person.

All applicants are required to complete and attach a Fit and proper person declaration
[Form 7] for the Board to make an assessment under section 7 (available
at www.bpb.nsw.gov.au).

Please go to Section 13

13. Professional indemnity insurance


All applicants are required to complete this section.

Name of your professional indemnity insurer

Is the contract an individual, partnership or company contract, or council general insurance


policy?

Attach a certified copy of a certificate of currency, which includes all of the following
information:
the name of the insurer
the identifying number of the insurance contract
period covered by the insurance
a retroactive date
confirms that the insurance covers the certifiers statutory liability under the Building
Professionals Regulation 2007 as an accredited certifier
the limit of indemnity in respect of any one claim (in $)

Applicants Signature: Date: www.bpb.nsw.gov.au 10


whether the limit in respect of any one claim is inclusive or exclusive of relevant
expenses as defined in clause 14(5)(c) of the Building Professionals Regulation 2007
the limit of indemnity in respect of all claims made in any one year (in $)
whether the limit in respect of all claims made in any one year is inclusive or
exclusive of relevant expenses as defined in clause 14(5)(c) of the Building
Professionals Regulation 2007

In addition, for partnership and company contracts, you also need to provide the following
information:
the number of accredited certifiers who are directors or employees of the company
as at the date on which the contract was issued:
or
if the contract is the fourth or subsequent contract issued to the company, whether by
the same or another insurer, the average number of accredited certifiers who have
been directors or employees of the company during the previous three years:

Note: An insurance contract must be held by an accredited certifier that satisfies section 63 of the Act and
Part 4 of the Building Professionals Regulation 2007.

Please go to Section 14

14. General declaration


All applicants are to complete the following declaration.

I acknowledge and agree that:


I will provide any information, documents or assistance required by the Board to assess
the Application.
I have made myself aware of, and understand, my statutory responsibilities under the
Environmental Planning and Assessment Act 1979, the Environmental Planning and
Assessment Regulation 2000, the Building Professionals Act 2005 and the Building
Professional Regulation 2007 or in the Accreditation Scheme.
The Board may provide any information about me as may be required by law.
I will maintain the required professional indemnity insurance during any period of
accreditation granted by the Board and I will provide evidence of this insurance to the
Board.
I will abide by the code of conduct contained in Schedule 4 of the Accreditation Scheme.
The Board or its officers or agents are not liable for any loss or damage that may arise
by virtue of any documentation or information provided in relation to this Application or
pursuant to any inquiry made by the Board.
I will advise the Board immediately of any change in circumstance which may be
relevant to my accreditation.

I solemnly and sincerely declare that:


The particulars contained in this Application and accompanying statements are true and
correct.

I acknowledge that:
Under section 307A of the Crimes Act 1900, I can be found guilty of an offence if I make
a false or misleading statement in this Application and the penalty for making a false or
misleading statement is two years imprisonment and/or a fine of $22 000, and
Under section 8(2)(a) of the Building Professionals Act 2005, the Board may suspend or
cancel my certificate of accreditation if I have been issued with the certificate on the
basis of a misrepresentation I have made, whether or not made knowingly.
Please go to Section 15

Applicants Signature: Date: www.bpb.nsw.gov.au 11


15. Signatures
All applicants must complete this section.

Applicants signature:

Date of Application: / /

Witness signature:

Witness name:

Date: / /

16. Fee
All applicants must pay the application fee.

The following Application fees apply.


$1500 for Categories of accreditation A1, A2, A3, A4 and B1 or a combination of any
of these Categories applied for in this Application, or
$750 for Categories of accreditation C1-C16 or D1 or a combination of any of these
Categories applied for in this Application.

Please identify your payment method and include the appropriate Application fee with this
Application:
cheque or money order (made payable to the Building Professionals Board)
MasterCard or Visa card please contact the BPB on 02 9860 1800 to arrange
payment.

NB: If your Application is refused, your Application fee will not be refunded. If you withdraw your
Application before it is determined, part of your Application fee may be refunded. If you apply for
accreditation in multiple categories of accreditation, the maximum fee you need to pay is $1500.

If you are applying for accreditation in Categories A1, A2, A3 and A4 please go to Section
17. If you are applying for accreditation in any other category please go to Section 18.

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17. Checklist for A1, A2, A3 and A4
Please identify the information you have attached to support your Application. Where a
certified copy of a supporting document is required, the copy must be certified by a Justice of
the Peace.
A certified copy of your drivers licence, both front and back for identification.
A certified copy of Certificate of Successful Completion of the Certification Short
Course, from the University of Technology, Sydney.
Evidence of medical, physical or other condition to support an Application to
undertake alternative testing in lieu of the accreditation exam.
Reasons why an exemption is being sought in relation to the requirement to apply for
accreditation within 6 months of successfully completing the Certification Short
Course, from the University of Technology, Sydney or within 6 months of passing the
Boards accreditation exam.
Certified copy of testamur or qualification and academic transcript(s).
Evidence from the provider of one of the qualifications specified in Part 2 of Schedule
3 of the Accreditation Scheme that you hold a qualification that is equivalent to the
specified qualification issued by that provider.
Verification of academic qualifications and registrations form [Form 2].
Evidence of enrolment (for A4 student applicants applying under Pathway 2)
Attachment 1 Verification of supervision statement (for A4 applicants applying under
Pathway 2)
Annotated resume [Form 5].
List of projects
Six experience reports
Referees statement 1 [Form 6].
Referees statement 2 [Form 6].
Fit and proper person declaration [Form 7].
Certified copy of a certificate of currency of insurance.
Applicable payment for Application fee.
Other please list any other information you have attached to support your
Application:

Applicants Signature: Date: www.bpb.nsw.gov.au 13


18. Checklist for B1, C1 C16 and D1
Please identify the information you have attached to support your Application. Where a
certified copy of a supporting document is required, the copy must be certified by a Justice of
the Peace.
A certified copy of your drivers licence, both front and back for identification.
A certified copy of Certificate of Successful Completion of the Certification Short
Course, from the University of Technology, Sydney.
Evidence of medical, physical or other condition to support an Application to
undertake alternative testing in lieu of the accreditation exam.
Reasons why an exemption is being sought in relation to the requirement to apply for
accreditation within 6 months of successfully completing the Certification Short
Course, from the University of Technology, Sydney or within 6 months of passing the
Boards accreditation exam.
Evidence checklist for the Category(ies) of accreditation sought.
Annotated performance criteria report [Form 3].
Certified copy of testamur or qualification and academic transcript(s).
Evidence from the provider of one of the qualifications specified in Part 1 of Schedule
3 of the Accreditation Scheme that you hold a qualification that is equivalent to the
specified qualification issued by that provider
Certified copy of an approved translation of academic transcripts (where necessary).
Annotated resume [Form 5].
List of projects
Six experience reports
Referees statement 1 [Form 6].
Referees statement 2 [Form 6].
Certified copy of current certificate of registration on NPER.
Verification of academic qualifications and registrations form [Form 2].
Fit and proper person declaration [Form 7].
Certified copy of a certificate of currency or insurance contract.
Applicable payment for Application fee.
Other please list any other information you have attached to support your
Application

State of New South Wales through the Building Professionals Board


January 2015
Level 3, 3 Marist Place, Parramatta NSW 2124 www.bpb.nsw.gov.au

Disclaimer: While every reasonable effort has been made to ensure that this document is correct at the time of publication, the State
of New South Wales, its agents and employees, disclaim any and all liability to any person in respect of anything or the consequence
of anything done or omitted to be done in reliance upon the whole or part of this document.

Applicants Signature: Date: www.bpb.nsw.gov.au 14


Attachment 1
Verification of supervision statement
1. I (Print supervisors name)..,
am an accredited certifier or person seeking accreditation in:

Category A1

Category A2

Category A3

2. I am currently employed by

...

as

(Print applicants name).. ..is an


applicant for accreditation in Category A4 working under my supervision carrying out
critical stage inspections and pre-construction certificate and pre-complying
development certificate inspections for class 1 and class 10 buildings.

Signature of supervisor Date .

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