Renewal Application for Authorised Gas Practitioner
I hereby apply for registration as a Refrigerant gas installer for Air Conditioning and Refrigeration in terms of the Occupational Health and Safety Act (No. 85 of 1993) – Sections 43 and 44 and Regulation R734 of 15 July 2009 – “Pressure Equipment Regulations (PER)”
Registration Type
New
Renewal
Update/Upgrade
Registrations are only valid within the borders of the Republic of South Africa
Registrations are only valid for a period of 3 years, after which a refresher course must be attended, and renewal of registration is completed.
In the interest of speedy processing of application, it is imperative that you complete all required fields and fully comply with the SARACCA Scope and Competency Policy Guide (as amended) for being an Authorised Refrigeration Gas Practitioner.
Supporting Documents for your application
Photo
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ID or Passport with Valid Work Permit
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Trade Certificate and/or Industry Related Qualifications
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Company Letterhead confirming VAT/Invoicing Details
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Safe Handling of Refrigerants and/or Ammonia Certificate not older than 6 Months
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Only electronic copies of applications will be accepted in PDF format.
Application must be submitted within 6 MONTHS of completion of the Safe Handling Course
Bank account details
First National Bank; Branch : 252155 – Bedford Gardens Account : 59630030903 (current account)
Payment to be made once SARACCA Reference Number is confirmed
Proof of payment to be emailed to suzette@saracca.co.za or cathy@saracca.co.za
NEW Registration Fee &- Renewal Fee - R2530.00 Vat INCLUDED
If paid by a VAT Registered Company, a FULL company letter head confirming the VAT /Invoicing details is required before the application will be processed. Fee and Application form valid until February 2025
Practitioner Personal Details
Training Manual Number
Date of Certificate
Training Centre
SAQCC License #
Full Name
First Name
Last Name
ID Number
Please ensure to fill in all remaining blocks with zeros if you are using your passport number.
Contact Number
Please enter a valid phone number.
Email Address
example@example.com
Current Position at Company
Details to be double checked to ensure you receive an OTP for the SAQCC Gas App Registration
Employer Details
Company Name
Company Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Accounts Contact name
Accounts Contact Number
Accounts Email
Company VAT for Invoicing and Accounting Purposes
Previous Employer
Company
Dates Difference
Position Held
Contact Person for Reference
If paid by a VAT Registered Company, a FULL company letter head confirming the VAT /Invoicing details is required before the application will be processed.
EDUCATION
Secondary
Tertiary
Trade Qualification - Red Seal
Other Qualifications
AIR CONDITIONING & REFRIGERATION EXPERIENCE
Describe your duties responsibilities specific to air conditioning / refrigeration installation, maintenance, and repair with reference to the type of refrigerant used
Refrigerant/s Used
Refrigerant/s Used
Refrigerant/s Used
Registration Categories
Categories Renew / Upgrade to completed this section.
Mark existing Categories in "B" and mark additional section "C" if you are upgrading to new Categ ories
A
Rows
B
C
1
2
3
4
B
Rows
B
C
6
7
8
9
10
11
C
Rows
B
C
12
13
14
SAQCC Gas has been officially appointed and mandated by the Department of Employment and Labour to register gas practitioners within the various gas industries in South Africa, as represented by the 4 member associations in respect of which SARACCA is one. Accordingly, your personal information will be disclosed to and processed by the SAQCC Gas, however such processing will be compliant with the Protection of Personal Information Act No 4 of 2013 and only to perform the functions of the SAQCC as mandated or as otherwise allowed by law.
I,
First Name
Last Name
being the Line Manager/Supervisor/Mentor (Cross out which is not applicable) hereby confirm that the above registration categories are in line with the applicant’s job level and as such are recommended for registration. Signed by Manager/Supervisor/Mentor
Date
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Month
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Day
Year
Date
I confirm that the information provided by me in my application is correct, valid and that all certificated and documentation is attached. I shall sign and abide by the SAQCC gas Code of practice attached. Signed by Applicant
Date
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Month
-
Day
Year
Date
I,
First Name
ID Number
PRACTITIONER
Date
FOR OFFICE USE ONLY – DO NOT COMPLETE THIS BLOCK
SAQCC Reg No.
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