Fresh Little Minds Learn To Teach FORM

SECTION 1: Getting to Know you.

We use this section to get to know you in advance of the training.

1. What are your reasons for wanting to train as a Fresh Little Minds Facilitator? (50words approx)*

2. Briefly describe your experience of working with children (if any)? eg How many years and in what capacities.*

3. Briefly describe your experience working as a group facilitator (if any)?*

5. Are you a facilitator for any other agency/franchise/licence?*

Yes
No

If Yes; Name of Programme:

6. How, where and with whom do you hope to deliver this programme?*

SECTION 2: Personal Details

Name:*

First Last

Contact Number:*

Phone Number for Business:

(we will publicise this)

Email: ( we will use for correspondence )*

Enter Email Confirm Email

Email for Business: (we will publicise this)

If different from above

Enter Email Confirm Email

Organisation:

(if any)

Current Job Role?*

eg. Mum at Home, Teacher, Youth Worker, Accountant etc.

Any special assistance?

Any dietary needs?

Anything else we would benefit from knowing in advance of training?

REGISTRATION WITH FRESH LITTLE MINDS

Do you intend to deliver this training within an organisation or within a geographical area?*

Please indicate (we will publicise this)

Do you have a full driving licence and access to a car?*

Yes
No

(We will not publicise this info)

Do you have a criminal record?*

Yes
No

(We will not publicise this info)

Relevant and Recent References

Please supply 2 Relevant and Recent References. (Family references are not acceptable). Include Name, Relationship to you, phone number and email address. (We will not publicise this info)

Reference 1:*

Reference 2:*

SECTION 3: Cancellation Policy

Section 4: Cancellation Policy More than 8 weeks in advance of the training date 100% refund 8 to 4wks in advance of the training date - 50% refundable less than 4 weeks in advance of the training date- non refundable

Please tick below to indicate you understand and accept our Cancellation Policy.*

I understand

SECTION 4: Confirming your place

We will be in contact to confirm your place as soon as possible. Please note Fresh Minds Educations reserves the right to refuse any application.

Please tick below to indicate you understand and accept the above statement.*

I understand

Name

This field is for validation purposes and should be left unchanged.

FLM FACILIATOR TRAINING REGISTRATION FORM