NTS Alliance Training Partner Application

PLEASE COMPLETE THIS FORM IN FULL AND RETURN TO

Organisation:
Address:
Website:
CEO or Managing Director:
Work Ph: / Mobile:
Email:
Name of Trainer:
Work Ph: / Mobile:
Email:

This Application Covers

Advanced Brief Intervention

Pregnancy, Post Partum

Ensure you have reviewed the competencies developed for this area.

The competencies can be found at or by emailing

Do you have any specific expertise in this area?

YesNo

If yes, please list and describe.

Do you have any qualifications related to this area?
Yes No
If yes, please list below – when, where and what level e.g. Secondary School, Cert or Bachelors
Are you a Stop Smoking Practitioner?
Yes No
If yes, how long for?
<1 year >1 year
Have you completed the NTS Stop Smoking Practitioner Programme?
Yes No
Have you had any previous experience as a trainer?
Yes No
If yes, please list examples
Years as a trainer?
Have you studied -
  • how to design and deliver effective, engaging face to face training?
Yes No
  • how to ensure learning happens and is assessed in your sessions?
Yes No
  • the principles and theories of how adults learn?
Yes No
If yes, please list the training or qualifications you have related to training/educating.
Have you reviewed the NTS “Training Essentials” related to designing and delivering effective learning sessions and ensured that your training meets these criteria?
Yes No
Note: All trainers without formal education in how to train adults will need to review this. It’s been designed as a quick overview of training essentials.
Training Essentials can be found at

Please attach a copy of your CV and the phone and email details of two referees:

  • One referee must be able to validate your knowledge and skill in your area of expertise.
  • One referee must be able to validate your knowledge, skill and ability to deliver engaging, effective training in which demonstrated learning is measured.

☐I hereby declare that the above information presented is true to the best of my knowledge

☐I have the support of my employer to be an NTS certified trainer for this organisation and will work under the guidance and framework of the organisation.

Applicant’s Signature:______

Date:______

CEO’s or Managing Director’s Signature:______

Date:______

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