Application for Registration As a Trainer

APPLICATION FOR REGISTRATION AS PEOPLE’S ASSOCIATION (PA) TRAINER FOR COURSESAT COMMUNITY CENTRES /CLUBS (CCs) AND RESIDENTS' COMMITTEE (RC) CENTRES

Note:

1.To help us with your application, please complete the form in full and indicate 'NA' for areas that are not applicable and provide an attachment if space is insufficient.

2Application will not be considered or will be delayed if the following are not submitted.

A recent, coloured passport-sized photograph onto the application form that will be used for issuance of PA Trainer Card

upon successful approval as PA Trainer.Photo to be of 35mm wide by 45mm high without Border and with resolution of

400 by 514 pixels taken with white background.

A photocopy of your NRIC (for Singaporean / Permanent Resident) or FIN Card (for Foreigners)
Relevant certificates and supporting documents as indicated in your application form.
A clearly written profile (Part VI of application form)
A clearly written course proposal form (Annex)

3.Please send the completed application form by post to the People’s Association, c / o Lifeskills & Lifestyle Division, Policy & Administration Section, 9 King George’s Avenue, Singapore 208581

4.We regret thatonlyshortlisted candidates will be notified.

Proposed Course(s) To be Conducted at CC / RC Centre
(e.g. Chinese Calligraphy, Japanese Language, Piano, etc.)
(a) ______
(b) ______
(c) ______/ Please Affix
A Recent
Passport Size Photograph
(Specifications according to
paragraph 2)
IPERSONAL PARTICULARS
Name (as in NRIC or passport, please underline surname) * Dr / Mr / Mrs / Mdm / Ms / Name in Chinese Characters
(if applicable) / Occupation
Date of Birth / Sex
*Male /Female / NRIC No. (*Pink / Blue) / Nationality
Marital Status
*Single / Married / Divorced / Widowed / Separated / Race
*Chinese / Malay / Indian /
Eurasian
Others (please specify) / FIN No. & Expiry Date
Type of Pass
*Employment / Dependent
Others (please specify) / Country of Birth
Residential Address
Postal Code ( ) / Contact Nos.
Home ______
*Handphone ______
E-mail Address ______

* Delete as necessary

IIMEDIUM OF INSTRUCTION

A Trainer can indicate more than one medium of instruction when he or she is highly proficient in more than one language and wants to offer courses using different mediums of instruction, e.g. Abacus (in English), Abacus (in Chinese).
If English is indicated as the medium of instruction, the Trainer must be highly proficient in English and conduct the courses in English only.
Please tick the appropriate box

IIICURRENT EMPLOYER’S DETAILS

Name & Address of Employer
Postal Code ( ) / Office Contact Nos.
Tel. No.
Fax No.

IVDETAILS OF QUALIFICATIONS (please attach relevant certificates / documents)

Academic Qualifications
S / No. / Highest Academic Qualifications Attained
[e.g. Bachelor of Arts, PhD (Finance), etc.] / Name of Institution / Examination Board / Year
From / To

Relevant Professional Qualifications

S / No. / Course Attended (e.g. Yoga Instructor Course) / Qualifications Obtained
(e.g. Yoga Instructor Certificate) / Name of Institution /
Examination Board / Year
From / To
VRELEVANT EXPERIENCE IN TEACHING OR AWARD(S) RECEIVED (please attach relevant certificates / documents)
Relevant Experience in Teaching
(please attach references and comments from previous course participants where possible)
S / No. / Course(s) Conducted
(e.g. Yoga – Beginner, Intermediate and Advanced Level) / Name of Organisation
(CC or RC or other private organisation)
(e.g. YMCA) / From
(mm / yy) / To
(mm / yy)
Relevant Award(s) Received
S / No. / Recognition(s) / Award(s) Received / Name of Event / Organiser / Year
From / To
VIPLEASE PROVIDE A PROFILE OF YOURSELF IN ABOUT 50 WORDS.
(this information will be used at our discretion to market your services to the CCs and RCs, and to the public through our on-linecourse registration services and other marketing purposes)
Important Note : Applications will not be considered or will be delayed if a proper, clearly written profile is not
provided. When writing your profile, please state your

Professional qualification
Experience in teaching
Awards / Accreditation Attained

Sample Profile: Nancy Lee is a well-known trainer in the spa industry. She holds a CIDESCO diploma. She developed her knowledge of spatherapies over the years and is now passionate about the subject, especially on Healing and Water Therapy. She has appeared on Channel NewsAsia and local variety shows to talk about and demonstrate her massage techniques. Her bubbly and warm character enables her to bond with her participants.
Self Profile (to be typewritten)
VIIMEDICAL & PERSONAL DECLARATION
Please answer the following questions and tick the appropriate box

(the information declared will not automatically disqualify applicants from being shortlisted)

1)Have you ever suffered, or are suffering from any medical history of pulmonary, nervous

or mental health conditions, prolonged ill health, or impediment in speech or hearing or

any physical impairment?

2) (a) Do you have a criminal record1 in Singapore ?

(b) Have you ever been charged or convicted in a court of law in any other country?

3) Have you ever been suspended, discharged or dismissed from the service by

any employer?

4) Have you ever applied to be, or have been a PA’s Trainer?
5) Are you an office bearer or member of any of the PA’s Grassroots Organisations?

6) Are you related to any office bearer or member of any of the PA’s Yes No
Grassroots Organisations?
7) Are you a pre-qualified private operator of the PA? Yes No
If your answer is “Yes” to any of the above, please provide brief factual information and documents (where relevant)
______
______
______
1- By this, we refer only to a criminal record of a conviction under the Registration of Criminal Act
VIIIDECLARATION
I hereby declare that all information provided is true and correct; and agree to abide and be bound by the Terms and Conditions of the PA, Community Club Management Committees, other PA Committees and Organisations amended and updated from time to time and also all legal duties imposed upon me by law whether statutory or common law or otherwise; and authorise the PA to disclose my personal information to its employees, service providers, vendor and affiliated partners and such other person(s) or agency who is reasonably deemed to have a legitimate interest in such information .I understand that if I have suppressed any material fact or given false information, the PA shall have the right to terminate my services as a Trainer without prejudice to any of their other rights for damages and/or losses and/or indemnities against me for my breach of contract or failure to fulfil the full term of their contract as a result of the termination.
I am also fully aware and accept that I would be from time-to-time subject to the necessary audits by the relevant government and / or investigative authorities and / or appointed agencies under the normal procedures and policies of the PA and / or the Singapore Civil Service. I am aware and undertake to comply fully with such necessary audits and acknowledge that my failure to render assistance in or to clear such audit would be tantamount to me breaching the terms of engagement and PA shall have the right to immediately terminate my services as a Trainer, again without prejudice to any of their other rights for damages and/or losses and/or indemnities against me for my breach of contract or failure to fulfil the full term of their contract as a result of the termination.
I also understand that my services as a PA Trainer will be tied to the validity of my employment status / papers in Singapore and obtaining, if so necessary, the approval from the Immigration and Checkpoint Authority, Ministry of Manpower or all such other relevant government agencies.
Further, I also fully understand and accept that I may be required to commence teaching and / or instructing in and / or continue in the proposed and / or existing course before the information (and / or any updates) provided by me are fully verified by the PA, which may eventually prove adverse and / or unfavourable to me, and / or that the result(s) of such audits carried out from time-to-time may prove adverse. In such an event or circumstance(s), I fully agree and accept that the PA shall be fully entitled at its sole discretion to terminate the provision of teaching and / or instructional services with immediate effect, without prejudice to any of their other rights for damages and/or losses and/or indemnities against me for my breach of contract or failure to fulfil the full term of their contract as a result of the termination.

Signature of ApplicantDate

FOR OFFICIAL USE

Application Form Received Date / Application ID No.

* Delete as necessaryPA /TD /01 /2003

/ COURSE PROPOSAL FORM / Annex

Note: Please use a fresh form for each course to be offered.

Applications will not be considered or will be delayed if a propertypewrittencourse proposal is not provided.

PROPOSED COURSE DETAILS
Course Title / Medium of Instruction / Target Group
(please state age range for children's courses)
No. of Session(s) / No. of Hour(s) per Session / No. of Participants per Class
Minimum / Maximum
Brief Description of Course
(please use not more than 200 words. The information will be used for publicity and marketing purposes)

Background and history of the subject
Course Content/ Syllabus(please provide separate attachments if necessary)
Teaching Methods
Materials to be purchased / given

Sample Course Proposal 1
Aikidois a modern, non-violent and non-competitive Japanesemartial art of self-defense. Besides being a means of work-out and character development, Aikido also emphasises proper etiquette, self-discipline and a spirit of respect for fellow human beings.
There will be a 15-minute warm-up at the beginning of each training session. After the warm-up, the Trainer will demonstrate basic Aikido techniques and student will then partner each other to practise. After some basics, the Trainer may split the class up into the different grades to train related techniques. Towards the end of the class, throw exercises are done in groups for students to practise falling and experience a variety of training partners. Sometimes, free throw exercises are also done to train student’s reaction when being attacked by one or even more attackers. At the end of the class, a breathing extension exercise is usually done in a seating position with a partner.
All-white training jacket and pants with belt is the basic attire for Aikido. As beginners progress, they will change from white belt to various coloured belts to indicate their grades.
Sample Course Proposal 2
Pilates is a method of exercise developed by German-born Joseph Pilates in the 1920s, which consists of various physical movement programs designed to stretch, strengthen, and balance the body. It is a low-impact exercisewhich focuses on postural symmetry , breath control, abdominal strength, spine, pelvis and shoulder stabilization, muscular flexibility, joint mobility and strengthening through the complete range of motion of all joints.
A typical 1-hour mat work training session starts with fundamental movements like breathing and gentle spine exercises to warm up the body. This is followed by 40 minutes of mat work movements and finally 5 to 10 minutes of relaxation (warm down) to end the class. The trainer will demonstrate and explain each movement and move among the participants to ensure proper technique and assist as necessary.
While practising Pilates, you will require:
(i) A folded towel, blanket or exercise mat of adequate thickness and density to place on the floor for protection of your spine;
(ii) A long towel or stretchy rubber exercise band; and
(iii) A flat cushion or small folded towel to place under your head, if necessary.
Course Proposal (To be typewritten. Please use additional sheets if necessary)
PROPOSED COURSE FEES, MATERIAL FEE & MINIMUM HONORARIUM AMOUNT EXPECTED BY TRAINER

Trainers are paid an honorarium for their services.
The honorarium is based on a percentage of total course fee collection (course fees charged less GST x no. of participants).
The course fees would be negotiated and determined by the CC / RC, based on the qualifications of trainer, market supply and demand for courses, and local market conditions.

Proposed Course Fee
Full course fee Per hour course fee
S$S$ / Minimum Honorarium Amount Expected by Trainer
Full honorarium Per hour honorarium
S$ S$ / Material Fee (if applicable)
S$

Name Signature & Date

ALL INFORMATION PROVIDED WILL BE HELD IN CONFIDENCEDoc. 1 (21March 2017)