NATIONAL STANDARDINSTRUCTOR APPLICATION FORM

Title (Dr, Miss, Mr, Mrs, etc):
Full Name:
Address:
Home telephone:
Mobile telephone:
Email address:
Would we need to make any special arrangements for an interview?
Where did you hear about the role?
1. Do you hold a current driving licence? / Yes No
2. Do you have access to a car? / Yes No
3. Do you have a First Aid qualification? / Yes No
– If yes, please state the type of course and expiry date:
4. Do you have a Child Protection certificate? / Yes No
– If yes, please state the type of course and issue date:
5. Do you have an enhanced DBS certificate less than 6 months old? / Yes No
6. Do you need to disclose anything which would show up on an Enhanced DBS check? / Yes No
– If yes, please state for potential DBS check:
7. Do you have a National Insurance Number? / Yes No
– If yes, please state for potential DBS check:
Employment History
Please give details of all previous jobs (permanent, temporary or volunteer work) in the last 10 years. Please list these in chronological order beginning with your present or most recent post. Please include gaps between employment including the reasons for this. Continue on a separate sheet if necessary.
Company/ Organisation / Start Date (MM/YYYY) / Finish Date (MM/YYYY) / Job Title and Brief Details / Reason for leaving
Your availability:
How often can you work Monday to Thursday (4 days) per month?
Would you have additional availability on Fridays as well?
Do you have experience of teaching/coaching or working with children or adults?
(if yes, please give details or if not please detail why you would like to start teaching/coaching)

Please use the space below to tell us why you want this job and why you think you are a suitable candidate, including further information about any experience you have which is relevant to the post. This might be voluntary work or outside interests/ activities etc.

Referring to the job description, what makes you suitable for the role?
– Please continue on further sheets if necessary
What interests do you have outside of work?
References
Please provide details of 2 references, one of which should be your most current/ most recent employer (please don’t give two refences from the same organisation). Please do not use family relatives:
1. / Full Name:
Address:
Email:
Work Telephone:
Your relationship to this referee: / Current/ Most recent employer
2. / Full Name:
Address:
Email:
Work Telephone:
Your relationship to this referee:
Are you eligible to work in the UK? / Yes No

I understand that any false information given on this application form may make an offer of employment invalid. I confirm that all the information given in this application is, to the best of my knowledge, true.

Signature:
Date:

Please email or post this form with a CV to:or

Outspoken Training, The Bike Depot, 140 Cowley Road, Cambridge, CB4 0DL

The following section is to be completed by applicants who have not completed a National Standard Cyce Instructor course.

NATIONAL STANDARDS INSTRUCTOR COURSE

The National Standard Instructor Course will give you a nationally recognised qualification that you can use anywhere in the country. If Outspoken Training decides you are suitable for the role, Outspoken Training may fund the cost of this course but will expect you to deliver80-hours of training (roughly 6-8 courses) within 6 months of the National Standard Instructor Course. If these hours aren’t completed within the timescales above, new instructors will be liable for the instructor course fee.

During this time, you will be placed on our training support programme and will be supported by instructorswhilst you work towards the second part of the training, your Post Course Assessment. Throughout this period (80-hours), you will be paid £8 per hour which will go up to £12 per hour once the 80-hours have been completed.

DECLARATION

I understand that should I be successful in being chosen, I commit to working for Outspoken Training for at least 80-hours within 6 months of completing the course. If I don’t fulfil this commitment, I will pay the full course fee. I also confirm that I am happy to complete the training support period of 80-hours during which I will be paid £8 per hour.

Signature:
Full Name:
Date:

Please email or post this form together with an up to date CV to Stuart Meadows (Head of Instructor Development):

Outspoken Training, The Bike Depot, 140 Cowley Road, Cambridge, CB4 0DL

Outspoken Training, The Bike Depot, 140 Cowley Road, Cambridge, CB4 0DL

01223 473820