Fire Industry Competence Form for Qualifying Manager / Nominated Designer / Validator
This form is confidential when completed Please answer ALL questions using CAPITALS (If an entry is not applicable insert ‘NO’ or ‘N/A’)

Section 1 Personal Information
Surname (family name)	Title (Mr/Mrs/Miss/Ms/other)
All Forenames

Section 2 Current Employment
Name of company
Address
Post code	Your office email
Telephone number	Fax number
Current job title	Reporting to
Date employment commenced	Click here to enter a date.
What is your role with regard to this fire application (please check the box as required)	Qualifying Manager
Nominated Designer
Validator

Section 3 Qualifications and Industry Experience
3.1 Please complete Para 3.2. then complete 3.3 to 3.7 dependant on the scopes that your company is applying for - see right (please check the box as required)	Fire Detection & Alarms Para 3.3
Gaseous Suppression Systems Para 3.4
Emergency Lighting Systems Para 3.5
Contract Fire Maintenance of Portable Extinguishers Para 3.6
Fire Risk Assessment Para 3.7

3.2 Qualifications List vocational, trade, apprenticeship or professional qualifications
3.3 BAFE SP203-1 Fire Detection & Alarms (complete as appropriate)
3.3.1 Summary of relevant training Note: The purpose of this summary is to demonstrate the extent and nature of the Qualifying Manager/Designer training in Fire Detection & Alarm Systems. This should make reference to relevant British Standards, Codes of Practice etc.
3.3.2 Summary of responsible experience (including relevant previous employment) Note: The purpose of this summary is to demonstrate that technical competence has been developed and that a satisfactory range of experience has been attained.

3.4 BAFE SP203-3 Gaseous Suppression Systems (complete as appropriate)
3.4.1 Summary of relevant training Note: The purpose of this summary is to demonstrate the extent and nature of the Qualifying Manager/Designer training in Fire Gaseous Suppression Systems. This should make reference to relevant British Standards, Codes of Practice etc.
3.4.2 Summary of responsible experience (including relevant previous employment) Note: The purpose of this summary is to demonstrate that technical competence has been developed and that a satisfactory range of experience has been attained.
3.5 BAFE SP203-4 Emergency Lighting Systems (complete as appropriate)
3.5.1 Summary of relevant training Note: The purpose of this summary is to demonstrate the extent and nature of the Qualifying Manager/Designer training in Emergency Lighting Systems. eg. Has an ICEL Competent Engineers course or equivalent been attended and exam passed? This should make reference to relevant British Standards, Codes of Practice etc.
3.5.2 Summary of responsible experience (including relevant previous employment) Note: The purpose of this summary is to demonstrate that technical competence has been developed and that a satisfactory range of experience has been attained.
3.6 BAFE SP101 Contract Fire Maintenance of Extinguishers (complete as appropriate)
3.6.1 Summary of relevant training Note: The purpose of this summary is to demonstrate the extent and nature of the Qualifying Manager training in Contract Fire Maintenance of Extinguishers. This should make reference to relevant British Standards, Codes of Practice etc.

3.6.2 Summary of responsible experience (including relevant previous employment) Note: The purpose of this summary is to demonstrate that technical competence has been developed and that a satisfactory range of experience has been attained.
3.7 BAFE SP205-1 Fire Risk Assessors (complete as appropriate)
3.7.1 Summary of relevant training Note: The purpose of this summary is to demonstrate the extent and nature of the Qualifying Manager/Fire Risk Assessor (Validator) training. This should make reference to relevant British Standards, Codes of Practice etc.
3.7.2 Summary of responsible experience (including relevant previous employment) Note: The purpose of this summary is to demonstrate that technical competence has been developed and that a satisfactory range of experience has been attained.

Have continuation sheets been attached?	No	Yes
If YES, please state the number of sheets

Declaration
For the purposes of compliance with current data protection legislation and generally, I acknowledge and certify as follows:
4.1	I have completed this form myself and all the information is correct;
4.2	I acknowledge that the information and data set out in this form is required by NSI in connection with and for the purposes of the appraisal by NSI for an application for approval or continuation of approval;
4.3	I consent to the processing by NSI of the information and data contained in this form for the purposes set out in 4.2 above;
4.4	I agree that NSI (or any agency appointed by it) may make any enquires in relation to this information and data for the purposes of verifying it;
4.5	I agree that NSI may disclose the information and data contained in this form for any purpose in connection with this application for approval or continuation of NSI Approval, or in connection with any other application for Approval or request for continuation of Approval. For more information about how NSI processes data and the lawful bases for processing, please refer to the NSI Privacy Notice on the NSI website.
Signature	Name in full	Date
Click here to enter a date.

Please submit this form by email to: applications@nsi.org.uk or your NSI Head Office contact