Become a Specialist Teacher - Speld Queensland

Applicant Name *

Email Address *

Mobile phone number *

Street Address *

Suburb

State

Postcode

Please attach your resume and copy of tertiary qualifications here. *

Do you have a current Blue card or Blue Card Exemption? *YesNoThis is a requirement. You can apply for a free exemption card with QCT registration.

Other registrationThis is not a requirement

Recent classroom teaching or intervention experience *

Recent Tutoring (or 1:1 teaching) experience *

Number of years working with students as Teacher/Tutor/Professional *1 - 3 years3 - 9 years10 or more years

Do you have experience working with students with SLD's? *YesNo

Please attach any course certificates here *

Provide a recent example of how you have used this program sucessfully. *

Do you have training or experience in any other specialised literacy or mathematics intervention program? *

Please provide your ABN *

Are you GST registered? *YesNoThis is not a requirement, however we suggest you investigate the current laws for further clarification.

Do you provide tuition under a registered business name? *YesNo

What is your business name? (if applicable)You may be operating as a sole trader, company or trust. Please indicate only a business or company name if it is registered with ASIC.

What areas are you happy to support? - Other

How will you work with your students? *In my home/officeLibrary/OtherStudent HomeSchoolOnlineThe minimum requirements for tutoring from your home include: safe, distraction free environment tidy, clean and clutter free space no smoking or eating whilst students are present

How many hours are you available for taking students from Speld QLD Referrals? *2 - 4 hours a week5 - 10 hours a week10 or more hours a week

Referee 1 *Please provide the name, position, phone and contact email for your first referee

Referee 2 *Please provide the name, position, phone and contact email for your second referee

How frequently do you check your emails? *1 - 2 times a weekOnce a daySeveral times throughout the dayWhen we refer new students, we will do so via email. Let us know how often you typically check your emails.

I certify that my answers are true and complete to the best of my knowledge. If this application leads to registration, I understand that false or misleading information in my application or interview may result in my removal and deregistration by Speld QLD. *Yes

Today's date *

Become a Specialist Teacher/Tutor

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