Record of skills maintenance form - Business.govt.nz

Record of skills maintenance formReturn this form with your annual licence feeFull nameLBP numberActivity CategoriesApprenticeships (supervising) Lecturing Seminars and workshopsConferences LBP licensing assessor Service to industryCommittee representation Meetings Structured on the job trainingDiscussion groups Mentoring Tertiary educationIndustry based education Publications Workplace safetyInformation or trade eventsPrivate individual studyEnter the details of your Skills Maintenance. Remember to include all of your activities, and includeadditional pages if needed.Activity PublicationsDate Completed 14 th March 2013 Hours 1Details of Activity Read BRANZ timber cladding book, regarding E2/AS1 change.ActivityDate CompletedDetails of ActivityHoursActivityDate CompletedDetails of ActivityHoursActivityDate CompletedDetails of ActivityHoursLBP 3.6.02

ActivityDate CompletedDetails of ActivityHoursActivityDate CompletedDetails of ActivityHoursActivityDate CompletedDetails of ActivityHours1 hour = 1 pointPoints earned in Year 1Points earned in Year 2Total points earnedDeclarationI declare this is a true record of my skills maintenance activities. I understand that the Registrar can ask to seemy personal skills maintenance records that support this claim. I understand that it is an offence under theBuilding Act 2004 to provide incorrect or misleading information./ /SignatureDatePrivacy notice: Any personal information submitted in this form will be kept and maintained by theRegistrar and the Building Practitioners Board in accordance with the Privacy Act 1993. Information willbe used to determine whether your initial and continued licensing may be granted, and for complaintsand disciplinary processes. Personal information may also be used to maintain and administer theRegister. You have the right to access, and to have corrected, any information about you that is held bythe Registrar and the Building Practitioners Board.Please post to:The RegistrarMinistry of Business, Innovation and EmploymentPO Box 50041Porirua 5240LBP 3.6.02