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FORM R.2.SW.2

SOUTH AFRICAN

COUNCIL FOR SOCIAL SERVICE PROFESSIONS

APPLICATION FOR RESTORATION

SOCIAL AUXILIARY WORKER

To be completed by a social auxiliary worker for the purpose of restoring his or her name to the Register for Social Auxiliary Workers as contemplated in section 20(3) of the Social Service

Professions Act 110 of 1978

SACSSP

37 Annie Botha Avenue Riviera,

Pretoria 0084

SACSSP Private Bag X12 Gezina Pretoria

0031

ENQUIRIES:

Email: regtemp7@sacssp.co.za

Telephone: (012) 356 8300

www.sacssp.gov.za

GENERAL INSTRUCTIONS:

1.	FORM R.2.SW.2 needs to be completed
	by a social auxiliary worker who was
	registered with the SACSSP and
	who’s name was removed from the
	Register for Social Auxiliary Workers as
	contemplated in section 20 of the Social
	Service Professions Act 110 of 1978.
2.	IMPORTANT: Persons who register
	for the FIRST time as a social auxiliary
	worker should complete FORM R.1.SW.2
3.	FORM R.2.SW.2 must be completed
	personally by the applicant - in print
	or typed.
4.	Study FORM R.2.SW.2 carefully before
	completing it.
5.	Read the instructions with each section
	and answer all questions fully, clearly and
	correctly.
6.	Fields that do not apply to you must
	be clearly deleted. Draw a line through

SACSSP Registration as social auxiliary worker

5 0 -

This is number allocated to you when you registered as social auxiliary worker for the first time

A.PERSONAL PARTICULARS

Title*R

(mark ONE only with X)

Prof

Rev

Mrs

Miss

First names*R (as on ID)

Maiden name* (if applicable)

Surname*R (as on ID)

ID number*

Passport No1 (if applicable)

Country of origin

Date of birth* (YYYY/MM/DD)

Home language

Gender *R (mark with X)

Male

Female

Never

Marital status * (mark with X)

married

Married

Divorced

Widow

Widower

Population group2 (mark with X)

African

Coloured

Indian

White

Other

Disability2 (mark with X)

Yes

If YES, specify

B.CONTACT DETAILS

	such field.
7.	If you have to make any corrections
	to your answers - initial next to the
	correction made in the right margin.
8.	Incomplete and/or non-compliant
	applications will not be processed and
	will be referred back to the applicant.
	Therefore, make sure that the application
	is completed correctly and submitted with
	all the required supporting documents.
9.	See Section H for the documents that
	must accompany FORM R.2.SW.2.

10.Complete the checklist at the end of FORM R.2.SW.2 before you submit it.

11.Print and return this original FORM FORM R.2.SW.2 to the SACSSP by

registered mail or courier mail services for ease of tracking. Address is on page 7.

12.Council is required to keep a Register of

Postal address*

Residential address*

Town*R

Postal code

persons registered in terms of section 19 of the Act and the fields mark with a R will be visible to the public.

INSTRUCTIONS

Registration number

Must be completed by all applicants.Insert the registration number with the SACSSP

that was allocated to you when you registered for the first time as social auxiliary

worker.

SECTION A: Personal Particulars

•ALL fields in Section A marked with an * must be completed.

SECTION B: Contact details

•ALL fields in Section B marked with an * must be completed.

Province*R (mark with X in block)

Email* (write clearly)

Mobile / Cel number*

Telephone (work)*

Telephone (home)

Fax number

1Only complete if you do not have an ID number

EC ` FS GA KZ LP MP NW NC WC

2Information for equity and statistical purposes

Proceed to SECTION C on the next page

NON NOBIS - Not for ourselves

Page 1 of 6

South African Council for Social Service Professions	FORM R.2.SW.2

INSTRUCTIONS:

SECTION C-1: First qualification

•Must be completed by all applicants in order to be re-entered into the Register.

•NB: A certified copy of documentary proof of the qualification indicated in Section C-1 must be attached to this application (FORM R.2.SW.2).

SECTION C-2: 3 + 1 Qualification

•Only to be completed by persons with a 3

+ 1qualification.

•NB: A certified copy of documentary proof of the qualification(s) indicated in Section C-2 must be attached to this application (FORM R.2.SW.2).

SECTION C-3: Subjects

•	Must be completed by all applicants in
	order to be re-entered into the Register.
•	Mark in the box for each year you have
	taken a subject e.g. if you took a subject
	for 2 years then mark the first 2 boxes or if

Application for restoration: SOCIAL AUXILIARY WORKER

C. ACADEMIC PARTICULARS

C-1. Information on your first qualification as social auxiliary worker

Particulars of training institution (University, college, accredited training provider, etc)

Name of InstitutionR

Contact person

Telephone (work)

Country (If not in South Africa)

Academic information of applicant (mark with X)

Qualification

Degree

Diploma

Certificate in Social Auxiliary

Work

Duration of course

1 year

2 years

3 years

Name of qualificationR

e.g. Certificate in Social Auxiliary Work

Date on which you initially registered as a student for this qualification

Date on which this qualification was/will be conferred upon you:

C-2. ONLY applicable to persons with a 3 + 1 year qualification: (mark with X)

Qualification

Degree

Diploma

SW Certificate (NDP)

Duration of course

1 year

2 years

Name of qualification*R

e.g. BSocSc Hons(SW)

Date on which this qualification was/will be conferred upon you:

C-3.

Subjects related to qualification* (COMPULSARY to complete by all applicants) (mark with X)

Subject

Year courses

you have taken a subject only for one year

then only mark box 1.

• Indicate the subjects/modules in the

appropriate spaces.

• IMPORTANT: The SACSSP may request

that you submit the original (not copy) of

documentary proof issued by the training

institution, if this is not on record with the

SACSSP, in which an indication is given of

ALL the subjects you have passed during

all years of study and the duration of the

course in each subject if the subjects and

the duration of the course in each subject

have not been stated on the certificate, in

order to be re-entered into the Register.

Social work and/or social auxiliary work modules / subjects in 1st two years of training

Other subjects:

Other (specify):

Other(specify):

Other (specify):

1 2

3 4

SECTION C continues on the next page

NON NOBIS - Not for ourselves

Page 2 of 7

South African Council for Social Service Professions	FORM R.2.SW.2

INSTRUCTIONS:

SECTION C-4: Other qualifications

•Only complete if applicable.

•Date conferred refers to date when the qualification was conferred upon you by the training institution.

•NB: Certified copies of documentary proof of the qualifications in Section C-4 must be attached to this application (FORM R.2.SW.2).

SECTION D: General

•Must be completed by all applicants in order to be re-entered into the Register.

•Answer all questions honestly.

•If you need additional space, please add a page to FORM R.2.SW.2 and mark it clearly (on top of the page) “Section D” with the number of the question.

Application for restoration: SOCIAL AUXILIARY WORKER

C-4. Academic particulars of other qualification(s) in other fields of study which you possess

Qualification

Training institution

Date conferred

D.GENERAL

All of the following questions must be answered (mark with X)

Have you ever been found guilty of unprofessional or improper conduct by the

YES

SACSSP? If YES, complete the rest (mark with X in applicable block)

1.1

- were you reprimanded or cautioned?

1.2 - was your registration suspended?

1.3

- was your registration cancelled?

1.4 - was the imposition of a penalty postponed?

1.5

- was the execution of your penalty suspended?

Have you ever been found guilty of an offence by a court of law? If YES, specify the

YES

nature of the offence of which you were convicted, the year in which it took place and the sentence

passed:

Nature of offence

Year

Sentence

Are any legal steps pending against you at present? If YES, specify what steps below.

YES

SECTION E-1: Registration History

•To be completed by all applicants in order to be re-entered into the Register.

DISCLOSURE OF CRIMINAL OFFENCES

Any person who apply to be registered as a social auxiliary worker and who has been convicted of a criminal offence must disclose to

Council such offence as stipulated in regulation 15 of the Regulations relating to the registration of social auxiliary workers and the holding

of disciplinary inquiries (Government Notice 103 published in Government Gazette No 34020 of 18 February 2011)

E.REGISTRATION HISTORY

E-1. Have you previously applied for registration with the SACSSP? (mark with X)

YES

If YES, what was the result? (mark with X)

Approved

Declined

Incomplete

If APPROVED, were you registered as: (mark with X)

Social worker

Child & youth care worker

Social auxiliary worker

Auxiliary child & youth care worker

Student social worker

Student child & youth care worker

Student social auxiliary worker

Student auxiliary child & youth care worker

Indicate SACSSP registration number (see Registration Certificate)

Proceed to SECTION F on the next page

NON NOBIS - Not for ourselves

Page 3 of 7

If Other, specify

South African Council for Social Service Professions	FORM R.2.SW.2

INSTRUCTIONS:

SECTION F-1: Employment status

Must be completed by all applicants in order to be re-entered into the Register.

SECTION F-2: Current employment Must be completed by all applicants, EXCEPT persons who are unemployed or retired.

SECTION F-3: Previous employment

Must be completed by all applicants who had a previous employer.

Application for restoration: SOCIAL AUXILIARY WORKER

F. EMPLOYMENT PARTICULARS

F-1. Mark ONE most appropriate option (mark ONE only with X)

Full time employed	Part-time employed	Self-employed	Unemployed
RetiredR	Final year student	Other’ (specify)

F-2. Current employment (if applicable)

Name of employerR

Street address

TownR

Postal code

Postal address (if different)

Postal code

Telephone

Email (write clearly)

Fax number

Date started with present employer*

Post/designation*

e.g. social auxiliary worker

Nature of employer (mark ONE only with X):

National Government

Provincial Government

Local Government

Government entity

Industry

Academia

NPO or CBO

Training organisation

Other

F-3. Previous employment

Name of employer

Address

Postal code

e.g. social auxiliary worker

Post/designation*

Period of employment as a social auxiliary worker with PREVIOUS EMPLOYER*:

yy y y -

Telephone

Email (write clearly)

m m -

d d

y y y y -

m m -

d d

Proceed to SECTION G on the next page

NON NOBIS - Not for ourselves

Page 4 of 7

South African Council for Social Service Professions	FORM R.2.SW.2

INSTRUCTIONS

SECTION G: Documentary proof

•Read this part carefully as it will guide you on the documents that must accompany your application (FORM R.2.SW.2).

•Please number each Annexure.

SECTION H: Bank details

• See Section G-1 on fees payable

• ALWAYS use your registration

number as DEPOSIT REFERENCE. If

not avialable, in exceptionally cases, use

ID number or passport number.

• The reference number is the only way

Application for restoration: SOCIAL AUXILIARY WORKER

G. DOCUMENTARY PROOF THAT MUST ACCOMPANY THIS APPLICATION

This application must be accompanied by the following documents to be regarded as a complete and valid application:

G-1	Proof of payment (see Section H)
	Proof of payment to the value of the following prescribed fees in South African Rand:
G-1.1	Restoration fee as social auxiliary worker.
G-1.2	Prescribed annual fee as social auxiliary worker.

G-2	Proof of identity (see Section A)
	A certified copy of your identity document (ID) or passport or residence permit indicating your:
	a. full names and surname;
	b. date of birth or age; and
	c. identity number/passport number acceptable to the SACSSP
G-3	Proof of marital status (if married) (see Section A)
	A certified copy of the marriage certificate of a person who is married (should you wish to register in your married surname).
G-4	Proof of qualifications (RSA) (see Section C)
G-4.1	A certified copy of documentary proof of the the highest school grade (e.g. grade 12) you have passed.
G-4.2	A certified copy of documentary proof of the qualification(s) in social auxiliary work (e.g. Certificate in Social Auxiliary Work) which you have
	obtained from an accredited training institution or provider.
G-4.3	Certified copies of another degree/diploma/certificate which you have obtained and which you wish to submit to the Council for evaluation to
	determine whether it is equal to or higher than the qualification referred to in paragraph G-4.2.

G-4.4 Original of documentary proof (not a copy) issued by the training institution, if this was not submitted with your first application or has changed since your first application, in which an indication is given of –

a.ALL the subjects you have passed during all years of study and the duration of the course in each subject; and

b.The content of the learning programme of the qualification stipulated in G-4.2 and or G-4.3 above in which an indication is given of all the subjects/ modules you have passed and the duration of the course in each subject.

	NOTE: If the records mentioned in G-4.4 are not on record with the SACSSP, you will be requested to submit these, before the restoration
	of your name on the Register.
G-4.5	The SACSSP may order that an evaluation interview be conducted with applicants who obtained other qualification(s) than the
	qualifications referred to in paragraphs G-4.2 and/or G-4.3.
G-5	A written undertaking from your employer in Section I specifying the following:
G-5.1	Confirming that you will be supervised by a registered social worker.
G-5.2	The nature, content and duration of the above supervision.
G-5.3	Confirming that the social worker supervising you is aware of the fact that he or she is legally co-responsible for your acts as a social auxiliary
	worker.
G-5.4	The official title of the post you hold.
G-6	Proof of previous registration with SACSSP (see Section E)
	A certified copy of your registration certificate that was previously issued by the South African Council for Social Service Professions, if avialable.

Please keep a copy of this form and all the supporting documents for your own records.

H. FEES PAYABLE & BANKING DETAILS

Please consult the Regulations relating to the fees payable by social workers, child and youth care workers, social auxiliary workers, auxiliary child and youth care workers, student social workers and student child and youth care workers made under the Social Service Professions

Act 110 of 1978 to ascertain the applicable fee on the date of application for registration as a social auxiliary worker. These Regulations are available on Councils website www.sacssp.co.za

in which your payment can be traced in

Council bank account.

• Keep a copy of your proof of payment for

your own records.

Fees are to be paid into the bank account of the SACSSP

Account name:	SACSSP
Bank:	NEDBANK
Account number:	1190739410
Branch:	MENLYN MAINE
Branch Code:	198765
Reference:	A reference number must be provided for every deposit.

IMPORTANT

Proof of payment must accompany this application

Proceed to SECTION I on the next page

NON NOBIS - Not for ourselves

Page 5 of 7

South African Council for Social Service Professions	FORM R.2.SW.2

INSTRUCTIONS:

SECTION I: Undertakinng by employer

•	Only to be completed if employed (fulltime
	or part-time) at the time of application for
	restoration.
•	Section I must be completed by the
	employer or person designated by the
	employer in order to be re-entered into
	the Register.
•	The applicant may not complete Section I.
•	See G-5 of FORM R.2.SW.2 for more
	information.
•	The details of the registered social social
	who at the time of this application will be
	supervising the social auxiliary worker
	must be inserted in the applicable fields
	and he or she must sign in the designated
	space.
•	Section I must be signed by:
	• the manager of the unit where the
	social auxiliary worker will practise
	under the supervision of a registered
	social worker; and
	• CEO/Director of the organisation/
	head of the office in case of a
	decentralised organisation or in case
	of a government department by
	person with a designation not lower
	than that of a deputy director.
•	Section I must contain the official date
	stamp of the organisation or department to
	be valid. In the case where an organisation
	does not have an official stamp, the
	allocated space must be signed by

Application for restoration: SOCIAL AUXILIARY WORKER

I. UNDERTAKING FROM EMPLOYER OF THE SOCIAL AUXILIARY WORKER

full names and surname of person designated by the employing organisation

designated by

name of employing organisation

hereby declare and confirm that

full names and surname of social auxiliary worker

with ID number

a.is in employ of our organisation/department as a social auxiliary worker and will work under the direct supervision and guidance of a social worker registered with the SACSSP as contemplated in regulation 1 of the Regulations relating to the registration of social auxiliary workers and the holding of disciplinary inquiries (Government Notice 103 published in Government Gazette No 34020 of 18 February 2011) and that the social worker supervising the social auxiliary worker is aware of the fact that he/she is legally co-responsible for the acts of the social auxiliary worker when performing his/her duties as social auxiliary worker.

b.the name of the social worker supervising the social auxilairy worker will be inserted into the file of the social auxiliary worker and if there is a change the file will be updated without delay.

c.we understand and undertake that in the case where our organisation does not have a registered social worker in our employ, that we are obliged to find and contract at the cost of the organisation a registered social worker to supervise the social auxiliary worker.

d.we understand that if the social auxiliary worker is not working under the supervision of a registered social worker, he or she is contradicting the provisions of the Social Service Professions Act 110 of 1978 and the Regulations relating to the registration of social auxiliary workers and the holding of disciplinary inquiries (Government Notice 103 published in Government Gazette No 34020 of 18 February 2011) and that our organisation as employer will be equally liable for any legal actions that may be instituted.

another party other than the two parties

who signed the declaration.

• No application for the restoration

of a social auxiliary worker who is

employed at the time of registration

will be considered without all fields in

Section I been completed and it being

signed as required.

Street address*

Town*R

Telephone

Email (write clearly)

Postal code

Fax number						-

Details of social worker will be supervising the social auxiliary worker (must be provided) Name and surname

SACSSP Registration number	1	0	-		Years experience
Email* (write clearly)




Mobile / Cel number*

Telephone (work)*				-

Signature: Supervising social worker

Date

Declaration by employer

We declare that the information furnished is true and correct in all respects and that we undertand the content of this undertaking. We are unaware of anything which would serve as an impediment to the restoration of the social auxiliary worker mentioned in this section.

	place	on	day		month	20	year
Signed at		on		of		20

Signature: Person designated by employer

Initials and surname

Signature: CEO/ Director / Head of Office

Initials and surname

ORIGINAL OFFICIAL DATE STAMP OF ORGANISATION/ DEPARTMENT

Proceed to SECTION J on the next page

NON NOBIS - Not for ourselves

Page 6 of 7

South African Council for Social Service Professions	FORM R.2.SW.2

Application for restoration: SOCIAL AUXILIARY WORKER

INSTRUCTIONS:

SECTION J: Declaration

•Read all parts of the declaration in Section J carefully.

•Sign FORM R.2.SW.2 and append the date of completion in the provided spaces.

•Complete the check list below before you submit the application.

FINAL CHECK LIST FOR APPLICANT: Before submitting your application check the following:

FFORM R.2.SW.2 is completed correctly

FAll applicable fields and pages are completed and I have double checked

FSection I is completed and signed

FFORM R.2.SW.2 is signed on page 7 (Section J)

Attachments

FProof of payments (see Section G-1)

FCertificated copy of ID (see Section G-2)

FProof of marital status - if applicable (see

Section G-3)

FCertified copy of highest school qualification (see Section G-4.1)

FCertified copies of qualifications (see

Sections G-4.2 & G-4.3)

FProof of subjects - original - if applicable

(see Section G-4.4)

FProof of previous registration as social

auxiliary worker with the SACSSP (see

Section G-6)

IMPORTANT

Incomplete applications cannot be processed and will be referred back to the applicant. This will cause an

unnecessary delay in the processing and finalisation of restoration of your name to

the Register.

An additional fee will apply for incomplete applications that were referred back upon the resubmission of such an application.

J. DECLARATION

I, the undersigned, declare that the information furnished in this application form is true and correct in all respects and that I am unaware of anything which would serve as an impediment to restoration of my name to the Register for Social Auxiliary Workers in terms section 20(3) of the

Social Service Professions Act 110 of 1978.

Furthermore, I, the undersigned, -

(a) understand that I may only practise as a social auxiliary worker and use the title social auxiliary worker, subject to being registered as a social

auxiliary worker with the South African Council for Social Service Professions as contemplated in sections 15 and 18 of the Act and upon entry of my name into the Register for Social Auxiliary Workers as contemplated in section 19 of the Act;

(b) understand, as contemplated in section 15(1) of the Act, that no person may practise as a social auxiliary worker or pretend to be a social auxiliary worker if he or she is not registered as a social auxiliary worker under this Act. Any person who contravenes any provision of section

15(1), shall be guilty of an offence and on conviction be liable to a fine, or to imprisonment for a period not exceeding six months as contemplated in section 16 of the Act;

(c)understand that I am required by law to work under the direct supervision and guidance of a registered social worker as contemplated in the

Regulations relating to the registration of social auxiliary workers and the holding of disciplinary inquiries (Government Notice 103 published in Government Gazette No 34020 of 18 February 2011);

(d)may only, in terms of the Act, practise as a social auxiliary worker subject to the payment of my annual fees as prescribed on or before 1

January of every year. Failure to pay such fee or any other fee within three months after the due date will result in my name being removed from the Register for Social Auxiliary Workers in accordance with section 20(1)(d) of the Act;

(e) understand that it is my responsibility to keep my particulars in the Register for Social Auxiliary Workers up to date and that I need to notify

the Registrar of the South African Council for Social Service Professions as prescribed in the Regulations relating to the registration of social auxiliary workers and the holding of disciplinary inquiries (Government Notice 103 published in Government Gazette No 34020 of 18 February

2011) (regulation 13) within three months of any name change with supporting evidence and within six weeks of any change in my residential or postal address or other contact details as indicated in this form as to enable the Registrar to update my details in the Register for Social Auxiliary Workers as contemplated in section 19 of the Social Service Professions Act 110 of 1978. (This to be done through FORM-RR.1);

(f)studied the provisions of the Social Service Professions Act 110 of 1978, the Regulations relating to the registration of social auxiliary workers and the holding of disciplinary inquiries (Government Notice 103 published in Government Gazette No 34020 of 18 February 2011) and other relevant Regulations (available from the Government Printers or can be downloaded at www.sacssp.co.za); and

(g)agree that if the Registrar receives a request in terms of section 17(2)(b) for access to the Register for Social Auxiliary Workers kept in terms of section 19 of the Act for purposes of research that the following additional personal information (information not already available to the public from the Register), i.e. postal address3 and email address, may be made available to accredited/approved researchers/students registered with a recognised higher education institution under such conditions as Council may impose to prevent the misuse of such information. I do understand that notwithstanding the aforementioned, that I may opt out by informing the Registrar in writing that the aforementioned additional personal details may not be made available to anyone for the purpose of research.

	place		day		month		year
Signed at		on		of		20

Signature: Applicant

Send this ORIGINAL application form with all supporting documents:

by registered mail to:	OR	by courier to:
The Registrar		The Registrar
SACSSP		SACSSP
Private Bag X12		37 Annie Botha Avenue
Gezina		Riviera,
Pretoria		Pretoria
0031		0084

3Only if postal address is not a residential/ street address

FOR OFFICE USE ONLY

INTERNAL REVIEW

Do not complete

INTERNAL CHECK LIST

F Record of previous registration with the

SACSSP found

F No record of previous registration with

the SACSSP found. Applicant informed

accordingly with an indication that he or

she will be registered and not restored

(and that the additional information

required need to be submitted)

F Applicant informed about outcome on

________________________(date)

F Application and supporting documents

filed on applicant’s file

F Proof of subjects (G-4.4) on file, if not,

request

Name & Surname

SignatureDate

Aplication is (mark with X)

APPROVED

COMMENTS:

INCOMPLETE and is referred back to the applicant to		DECLINED and the reasons for the decision provided
provide the missing information.		to the applicant.

F Applicant’s details updated and restored

in the Register for Social Auxiliary

Workers against his or her name, if

approved

F Registration certificate issued, if approved

F Registration card issued, if approved

F If applicant indicated an opt out in terms

of Section J(g) it is recorded on the

Registration number allocated, if approved

5 0 -

APPROVED4 subject to the provision of the following records (if not on record with the SACSSP when person registered for the first time): (mark with X)

F Proof of subjects - original (see Section G-4.4)	F Portfolio of Evidence (if	F Evaluation interview (see G-4.5)
	applicable)
Date notice send on records required as indicated	Date records required as indicated above were
above	received from applicant

4This does not apply to incomplete applications. Only applicable to applications where the records as indicated in G-4.4, which should have been submitted with the original aplication that formed the basis for the registration of the person for the first time, are not on the person’s file. These are then requested as indicated.

NON NOBIS - Not for ourselves

Page 7 of 7

Question	Answer
Form Name	Social Auxiliary Work Form
Form Length	7 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 45 sec
Other names	sacssp registration status check, sacssp registration forms 2021, sacssp register, sacssp registration certificate

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