Application form SEASEP Phase 2

South East Asia Skills Enhancement Programme (SEASEP) is a collaboration between

TWI and the Lloyd’s Register Foundation (LRF) to upskill people in South and East
Asia countries with specific focus on improving safety and trade standards in the work
environment.

Under this program, financial assistance is available for Indonesian citizens wishing to
pursue a career in Welding, Non-Destructive Testing (NDT), Occupational Health and
Safety (HSE), Blasting and Painting, and plant Inspection.

SEASEP offers partial subsidies towards the cost of training. Any remaining course
fees should be paid by yourself, your employer, a government schemes
(e.g. apprenticeships) or other national or international charities.

In order to be considered eligible for a Lloyd’s Register Foundation Scholarship you

must be a national of Indonesia, agree to participate in marketing, promotion and
similar activities in relation to the scholarship and agree to the use of your personal
data by TWI to fulfil its legal and contractual obligations.

Applications will be assessed so that those from underrepresented communities are

afforded the opportunity to gain employment through upskilling or furthering their
career in current employment.

SEASEP Ph.2 enrolment (rev.5) Page 1 of 8

SECTION 1: PERSONAL INFORMATION

Candidate’s full name (as per ID / Passport)

Title

Mr: ☐ Ms: ☐ Miss: ☐ Mrs: ☐ Other:

Gender

Male: ☐ Female: ☐ Non-Binary: ☐

Date of Birth
D D M M Y Y Y Y

Country of Birth

Permanent Address

City / Town: Post Code:

Country: Telephone:

Mobile: Email:

Correspondence Address (if different from the above)

City / Town: Post Code:

Country: Telephone:

Mobile: Email:

SEASEP Ph.2 enrolment (rev.5) Page 2 of 8

SECTION 2: COURSE SELECTION

Which course(s) are you interested in undertaking?

Please pick one of the following combinations
Note: Attendance on H&S course as a pre-requisite to attending the second course of your choice. The H&S course is online and
must be completed before the second course.
Safety

☐ IOSH Working safely & IOSH Managing Safely

☐ IOSH Working safely & NDT Penetrant Testing Level 1

NDT level 1

☐ IOSH Working safely & NDT Magnetic Testing Level 1

☐ IOSH Working safely & NDT Visual Testing Level 1
☐ IOSH Working safely & NDT Ultrasonic Testing Level 1
☐ IOSH Working safely & NDT Penetrant Testing Level 2
☐ IOSH Working safely & NDT Magnetic Testing Level 2
NDT level 2

☐ IOSH Working safely & NDT Visual Testing Level 2

☐ IOSH Working safely & NDT Ultrasonic Testing Level 2
☐ IOSH Working safely & NDT Radiographic Film Interpreter Level 2
3.0 ☐ IOSH Working safely & CSWIP Visual Welding Inspector
☐ IOSH Working safely & BGAS-CSWIP Site Coatings Inspector
Site skills

☐ IOSH Working safely & BGAS-CSWIP Painting Inspector Grade 2

☐ IOSH Working safely & Welder Training
IOSH Working safely & Please name below the training of your choice.
other

Candidates who hold an international or national certificate in safety, may be exempt from ‘IOSH Working
Safely’ training.

To gain exemption, please attach the copy of your certificate to this enrolment form.

Why did you select the particular training (selected above)?

Please select up to a maximum of 3 options

☐ To support my career progression 1

☐ To improve my chances for promotion 2

☐ To increase my flexibility and value in the labor market 3

☐ Because it is affordable 4

☐ Because my employer asked me to 5

☐ Other reason – please specify 6

SEASEP Ph.2 enrolment (rev.5) Page 3 of 8

Why did you decide to access the training through SEASEP?
Please select up to a maximum of 3 options

☐ Because my company is seeking internationally recognized certification 7

☐ Because it is difficult to access internationally recognized H&S and Inspection training 8

☐ Because the training is being offered locally 9

☐ Because it is affordable because of the subsidy 10

☐ Because my employer wants to support the SEASEP project 11

☐ Other reason – please specify: 12

Was advice given to you on course selection and from where?

Please select up to a maximum of 3 options

☐ Yes, Employer advised and selected the course for me 13

☐ Yes, I was advised by TWI 14

☐ No, I decided on the course type myself 15

☐ Yes, Friends and/or colleagues helped me to decide 16

☐ Other source of information (please describe below) 17

SECTION 3: EDUCATION, QUALIFICATION AND OCCUPATION RECORD

Please describe your current experience within the subject of your training (if any)

18

Please list the education you completed in chronological order, starting from the highest.
Results
School / College / Year
Level Subject (grades / bands
Awarding body Taken
or GPA)

Please list your current qualifications relevant to your current employment (if applicable)
Qualification level Certificate expiry
Qualification name Awarding body
(if applicable) date (if applicable)

19

SEASEP Ph.2 enrolment (rev.5) Page 4 of 8

Are you currently employed?

Employed: ☐ Unemployed: ☐ Self-employed: ☐ Student: ☐ 20

Please list your occupational (work) history in chronological order (if applicable)

Positon: Company Name: From - To: Monthly Income:

☐ 0 – 3 mil Rp

☐ 3 – 5 mil Rp

☐ 5 – 10 mil Rp

☐ 0 – 3 mil Rp

☐ 3 – 5 mil Rp

☐ 5 – 10 mil Rp

☐ 0 – 3 mil Rp

☐ 3 – 5 mil Rp

☐ 5 – 10 mil Rp

Please answer the following questions related to your current occupation:

Note: the data provided in these sections are collected for the SEASEP project purpose only and will be
treated highly confidentially.

Following questions are based on workplace hazards.

Please choose the most appropriate answer options.
Once Every 6 Every 3 Every
How often do you …. ? Never
a year months months month
NA

31 Manually push or lift items that are more than 20 kg ☐ ☐ ☐ ☐ ☐ ☐

Do repetitive movement with your hands for at least

32 ☐ ☐ ☐ ☐ ☐ ☐
3 hours during the day

33 Perform tasks that you are not familiar with ☐ ☐ ☐ ☐ ☐ ☐

34 Interact with chemicals or inflammable substances ☐ ☐ ☐ ☐ ☐ ☐

Work in awkward positions (bend, twist, heavy

35 ☐ ☐ ☐ ☐ ☐ ☐
manual labour)

36 Work at a height that is more than 5 meters ☐ ☐ ☐ ☐ ☐ ☐

37 Work in high decibel levels ☐ ☐ ☐ ☐ ☐ ☐

38 Stand for more than 3 hours a day ☐ ☐ ☐ ☐ ☐ ☐

SEASEP Ph.2 enrolment (rev.5) Page 5 of 8

The following questions are based on workplace policies and procedures.
Please choose the most appropriate answer options.
Strongly Strongly
Disagree Neutral Agree
disagree agree

39 Everyone receives compulsory health and safety training ☐ ☐ ☐ ☐ ☐

40 Management is extremely particular about the certification ☐ ☐ ☐ ☐ ☐

41 Systems are in place to identify and deal with hazards ☐ ☐ ☐ ☐ ☐

Workplace health and safety is considered extremely
42 ☐ ☐ ☐ ☐ ☐
important
43 There is an active health and safety committee ☐ ☐ ☐ ☐ ☐

44 An incident report is filed with due diligence ☐ ☐ ☐ ☐ ☐

45 Health and safety procedures are clearly communicated ☐ ☐ ☐ ☐ ☐

Following questions are based on workplace health and safety awareness.

Please choose the most appropriate answer options.
Strongly Strongly
Disagree Neutral Agree
disagree agree

46 I am clear about health and safety regulations at work ☐ ☐ ☐ ☐ ☐

47 I have been certified by proper authorities ☐ ☐ ☐ ☐ ☐

48 I know I can refuse to work in an unsafe environment ☐ ☐ ☐ ☐ ☐

49 If I notice a workplace hazard I am obligated to report it ☐ ☐ ☐ ☐ ☐

I help my teammates understand the importance of health
50 ☐ ☐ ☐ ☐ ☐
and safety

Please tell us, which skills you believe you need to gain / your company believes you
need to gain)?
Please select up to a maximum of 4 options (from each column)
I believe I My company
need believes I need
Attention to detail ☐ 61 ☐ 71

Knowledge of engineering and technology ☐ 62 ☐ 72

Improve English language ability ☐ 63 ☐ 73

Knowledge of design and drawings ☐ 64 ☐ 74

Ability to use testing equipment ☐ 65 ☐ 75

Ability to follow written instructions ☐ 66 ☐ 76

New and Improved Inspection skills ☐ 67 ☐ 77

Ability to produce better reports ☐ 68 ☐ 78

Better understanding of health and safety ☐ 69 ☐ 79

SEASEP Ph.2 enrolment (rev.5) Page 6 of 8

How did you hear about the SEASEP project?

81

SECTION 5: PERSONAL STATEMENTS OF CANDIDATE

Please include why you are applying for this training, and how this training will positively
transform your career whilst improving safety in the work place.

82

Bursary Eligibility
Please tick the boxes to confirm:

☐ I confirm that I am a national of Indonesia.

☐ I agree to:
(i) participate in marketing, promotion and similar activities in relation to the scholarship.

(ii) the use of my personal data by TWI to fulfil its legal and contractual obligations including the
sharing of my personal with third parties for this purpose, and
(iii) being contacted by TWI or third parties for or on behalf of TWI to access impact of the
training

Cooperation on study-case
We may contact you to ask you for case study on behalf of TWI or Lloyds register. Please could you confirm
we have your consent with this?

Yes, I will participate ☐ No, I wish to be excluded ☐ 83

Candidate’s Declarations
I do agree that I will participate on the follow up surveys and interviews as required by programme
☐ (represented either by TWI and/or Lloyds register foundation).

I confirm that the information given in this form is true, complete and accurate and no information requested
or other material information has been omitted. I give my consent to the processing of my data by TWI as
provided for herein.

Applicants Signature: Date

SEASEP Ph.2 enrolment (rev.5) Page 7 of 8

SECTION 6: EMPLOYER’S STATEMENTS (only if you are employed)

Please tell us, what is/are your main motivators to get your personnel upskilled?
Please select up to a maximum of 4 options

91 To improve staff skills and knowledge ☐

92 To develop staff to take on additional responsibilities ☐
93 To improve the overall safety culture of our workplace ☐
94 To ensure our inspectors are qualified to international standards ☐
95 To strengthen the company portfolio to take on additional contracts ☐
96 To comply with contract requirements for qualification ☐
97 To offer an improved service to our clients ☐
98 To take advantage of affordable training ☐

Employer’s Declarations
I do agree that I will participate on the follow up surveys and interviews as required by programme
☐ (represented either by TWI and/or Lloyds register).

Employer’s Signature: Date

TWI is collecting this information to help assess and process your Lloyd’s Register Foundation
Scholarship eligibility and to undertake marketing, legal or contractual obligations concerning
the scholarship. The information will be held on file by TWI. This application form is also used
to collect data for third parties. Access to the information you provide will be restricted to a
limited number of authorised TWI Ltd and third party staff. If unsuccessful your application
form will remain on file and be destroyed after one year.

Your information will be processed and stored (by means of a computer database or otherwise) as described
above for a duration to fulfil the statutory and recommended retention periods and as required by any
contractual obligations of TWI. If you have any concerns about your personal information please contact
[email protected].

The granting of a Lloyd’s Register Foundation Scholarship bursary and the amount of said bursary is at the
discretion of TWI. No correspondence relating to the bursary will be entered into. Applications from
candidates who do not meet the minimum level of qualification to undertake the course to which a bursary
application has been made will be ineligible to receive a bursary. TWI shall have the right, at its sole
discretion and at any time, to change or modify the terms and conditions of the Lloyd’s Register Foundation
Scholarship, such change shall be effective immediately upon posting to its webpage
(www.twiindonesia.com).

TWI shall mean as appropriate: TWI Technology (S.E.Asia) Sdn. Bhd. (Reg. No. 247037-X) - No. 1, Jalan
Utarid U5/13 - Section U5, 40150 Shah Alam, Selangor Darul Ehsan, Malaysia; TWI Ltd, Granta Park, Great
Abington, Cambridge CB21 6AL, United Kingdom and/or PT. Teknologi Weldim Indonesia, Mutiara Building,
3rd Floor, Room 301, Jl. Mampang Prapatan Raya No. 10, Jakarta Selatan, 12790, Indonesia.

FOR TWI INTERNAL USE ONLY

Discount Code:

Processed by: Signature: Date:

Reviewed by: Signature: Date:

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