UKIC Fast Track Accreditation
Draft Sponsor's Form

APPLICATION FORM

SPONSOR

This document is in support of accreditation for: _______________________________________

1. SPONSOR

Surname:
First name:
Title:

2. CORRESPONDENCE

HOME WORK
Address:
 
 
 
 Address:
 
 
 
Telephone No.: Telephone No.:
Facsimile No.: Facsimile No.:
e-mail: e-mail:
For correspondence please indicate contact: home/work

3. EDUCATION AND TRAINING

CONSERVATION TRAINING
(If course has not been full time please state number of hours/week and number of weeks/year)
College/University/Other Course (please state if full or part time) Degree/Qualification Dates
       
       

OTHER QUALIFICATIONS
College/University/Other Course Degree/Qualification Dates
       
       

INTERNSHIPS AND POST CONSERVATION TRAINING
Institution/Course/Exchange Programme Degree/Qualification Dates
     
     
     

4. EMPLOYMENT HISTORY

(List all conservation employment beginning with present position. Include self-employment history)
Employer name Position Line manager Dates
       
       
       
       
       

5. MEMBERSHIP

Organisation Membership class Year Joined
     
     
     
     
     

6. CONSERVATION REPRESENTATION

(e.g. UKIC Archaeology Section Committee)
Society/Committee Role Dates
     
     
     
     
     
     

7. AWARDS

Award Date
   

8. CONSERVATION REGISTER

Registration Number Date of Registration
   

9. PUBLICATIONS

 
 
 
 
 
 
 
 
 
 
 
 

10. SUMMARY OF SPONSOR'S KNOWLEDGE OF CANDIDATE

Number of years I have known candidate:
I have visited applicant in his/her place of work:
I have examined portfolios/specimen conservation reports:

11. SUPPORT STATEMENT

Write in less than 300 words your working connection with the candidate and your reasons for supporting the application
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

12. DECLARATION

The information I have provided is a true and accurate statement of facts. On the basis of my knowledge of the candidate and examination of the self-assessment questionnaire I propose that the candidate merits consideration for accreditation.

Signed:__________________________________________     Date:______________________

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