Application to become a Tutor or Trainer

Next (Please print off a copy of this page)

The Educators, 8 Cliff Avenue, Westcliff on Sea, Essex SS0 7AJ 01702 348815

Web www.educators.co.uk Email educators@btinternet.com

APPLICATION TO BECOME A TUTOR/TRAINER/ WITH THE EDUCATORS

PART 1

Surname	First Name		Initials	Status


Date of Birth	Nationality	DfES Number		CRB Ref


Home Address		Postcode

		Email Address

		Telephone Number

		Mobile Number

EDUCATION (PLEASE SUPPLY RELEVANT DATES)

1 LIST SCHOOLS ATTENDED AFTER THE AGE OF 11

2 LIST GCE RESULTS STATING LEVEL AND GRADE OBTAINED

3 NAME OF COLLEGE /POLYTECHNIC/UNIVERSITY ATTENDED

4 STATE DEGREE OBTAINED AND TEACHING QUALIFICATION

EXPERIENCE (PLEASE SUPPLY RELEVANT DATES)

1 LIST YOUR WORK EXPERIENCE SINCE LEAVING COLLEGE OR UNIVERSITY GIVING DATES , NAMES AND ADDRESSES OF EMPLOYERS

2 WHAT EXPERIENCE HAVE YOU HAD AS A TRAINER/TUTOR/ONLINE TUTOR?

3 LIST ANY OTHER RELEVANT EXPERIENCE

STATE THE SUBJECTS YOU ARE PREPARED TO TEACH AND THE LEVEL

STATE THE AREAS YOU ARE PREPARED TO TRAVEL TO

PART 2

We are asking all prospective trainers to complete this form, giving information about themselves, in order to assess their suitability for such work. The information will be kept confidentially by The Educators, unless requested by an appropriate authority.

NAME: ..................................................................................................................................

ADDRESS: (including postcode) ........................................................................................

TELEPHONE NO: Day ..................................... Evening..................................................

How long have you lived at the above address? .....................................................................

If less than 12 months, please give your previous address.

PREVIOUS ADDRESS: ....................................................................................................

................................................................................................................................................

What do you hope to achieve as a trainer ................................................................................................................................................................................................................................................................................................................................................................................................................................................

Please tell us something about yourself - any special interests and skills you have, and any previous experience of working with people -please specify the groups with which you have been involved, and the dates. (If there is not enough space, please continue on a separate sheet).

................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Have you any relevant qualifications or training not previously mentioned? (Please specify) ........................................................................................................................................

........................................................................................................................................

Training is vitally important in equipping tutors to work with people. Are you prepared to undertake some (more) training? YES/NO (Delete where inapplicable)

Do you suffer, or have you suffered from any illness which may directly affect your work with children or young people? (If yes, please give details) ...........................................................

...............................................................................................................................................

REFERENCES

In the space below, please give us the names, addresses and telephone numbers of two people who know you well, and who would be able to give a personal reference. Tell us their relationship to you. If possible, one reference should be from your last school or college (if appropriate).

1. Name ......................................................................... Phone No .....................................

Address ...........................................................................................................................

...........................................................................................................................

2. Name ......................................................................... Phone No .....................................

Address ...........................................................................................................................

...........................................................................................................................

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DECLARATION

You will understand the great responsibility involved in working with people, and the need to ensure their safety. We are seeking to comply with the aims of the Government's Code of Practice entitled "Safe From Harm" (1993), in promoting good safe practice in looking after the people in our care.

We therefore ask you to sign the following declaration. (Please note that the disclosure of an offence need not be a bar to your appointment as a trainer, dependent on the nature of the offence).

Have you ever been convicted of a criminal offence, or are you at present the subject of criminal charges? YES/NO (Delete where inapplicable)

If YES, what was the nature of the offence? ...........................................................................

Date of offence .......................................................................................................................

Signed ................................................................................... Date .....................................

NB All convictions must be disclosed, as the provisions of the Rehabilitation of Offenders Act 1974 do not apply.

I agree to collect from the clients referred to me all money due to THE EDUCATORS and forward that sum promptly each month.

I authorise the disclosure of this information to third parties and accept your terms and conditions

SIGNATURE DATE