APPLICATION FOR NATIONAL REFRIGERANT HANDLING LICENCE

APPLICATION FOR NATIONAL REFRIGERANT HANDLING LICENCE
SUPERVISOR DECLARATION
Applicant Details
Title
First Name
Last Name
D.O.B.
Initial
Student's email
example@example.com
Supervisor's email
example@example.com
Click the submit button below to forward this form to your Supervisor for signing.

Supervisor Declaration
For this Trainee Licence to be issued the supervisor's declaration must be provided Supervisor Declaration (to be completed by the supervisor below).
I have been nominated as Supervisor by
who is undertaking
I declare I have read the following and understand my obligations under the Ozone Protection and Synthetic Greenhouse Gas Management Regulations 1995.

A trainee is entitled to carry out work in relation to RAC equipment while undertaking the training or assessment for which the licence was granted while under the supervision of the holder of a licence that entitles the holder to engage in the work for which the licensee is being trained or assessed. Carrying out work in relation to RAC equipment means doing anything with a refrigerant that involves a risk of refrigerant being emitted.

Licensees that are supervising a refrigeration and air conditioning trainee licensee must ensure that any work carried out by the trainee licensee is done in accordance with the standards set out in column 2 of Table 135 that relates to the work.
Name of Supervisor
Licence No.
Signature of Supervisor
Date

DayMonthYear
Date
Witness details
Name of Witness
Date

DayMonthYear
Date
Signature of Witness
Please click the submit button to email this form to {firstName}.
Should be Empty:

Applicant Details