Hampshire Learning Tutor Bank

Personal Details:

Full Name
Address
Postcode
Telephone
Daytime Evening
Email

Teaching Specialism(s)

Please indicate the subject areas you are able and qualified to deliver:

Teaching Qualifications

Please indicate with an “x” the qualifications you have achieved and/or are currently working towards / Date achieved / Working towards
PTLLS (C&G 7303)
Level 3 …………..
Level 4 .………....
CTLLS (C&G 7304)
Level 3 …………
Level 4 …………
DTLLS (C&G 7305)
Level 5 …………
C&G 7307 Pt 1 …………
Pt 2 …………
C&G 7407 Pt 1 …………
Pt 2 …………
Certificate in Education
FE / Post 16 ………… School ………….
PGCE
FE / Post 16 ………… School …………
Other teaching qualification(s) (please state)
Skills for Life Specialist qualifications: / Level / Date achieved / Working towards
Literacy - Level 4 or Level 5
Numeracy – Level 4 or Level 5

Membership of Institute for Learning (IfL)

IfL Membership number
Please indicate the Membership Grade awarded by IfL
(Fellow/Member/Associate/Affiliate)

Preferred Location

Please indicate the area(s) you are willing to work in:

Basingstoke and Deane / Havant
East Hampshire / New Forest
Eastleigh / Rushmoor
Fareham / Test Valley
Gosport / Winchester
Hart / Countywide

Please indicate at which Centre(s) you are currently, or have recently been, employed as a tutor.

Data Protection

Thank you for completing this form. Hampshire Learning maintains a database of experienced and qualified tutors in Hampshire who are able to deliver adult and family learning courses. We will use the information you have provided above to update our database so that we hold current information about your qualifications and experience.

We now intend to promote this resource more widely so that we are able to link up tutors with organisations who are recruiting staff to deliver learning programmes.

If you agree to your contact details being shared with providers of adult and family learning in Hampshire, please confirm in the box below.

I agree that my personal details may be shared with Hampshire Learning adult and family learning providers who may be seeking to recruit tutors to deliver programmes of learning within their organisations. Yes / No*

Signed …………………………………………. Date ………………………….

* Please delete as appropriate

Thank you for completing this form.

Please return your completed form to:

Email: or post to: Data Collection Assistant, Hampshire Learning, Hampshire County Council, Children’s Services Department, Mottisfont Court, High Street, Winchester, SO23 8ZF

24 March 2011