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Applicant Name
Email Address
Mobile phone number
Street Address
Suburb
State
Postcode
Please attach your resume and copy of tertiary qualifications here. (PDF)
Do you have a current Blue card or Blue Card Exemption? YesNo
Do you have a current QCT or relevant organisation registration? With whom? QCTSpeech TherapyOccupational TherapyNoOther
This is not a requirement
Other registration (This 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
Do you have specialist training as an instructor or facilitator in any of the following programs? Sounds WriteUFLI FoundationsMultiLit - MiniLIt, MacqLitPLDRead3Talk for Writing or ReadingCracking the ABC CodeOrton-Gillingham/MSLLittle Learners Love LiteracySpelling MasteryMaths U See/Maths AustraliaMath Mastery
Please attach any course certificates here
Provide a recent example of how you have used this program successfully.
Do you have training or experience in any other specialised literacy or mathematics intervention program?
Please provide your ABN
Are you GST registered? YesNo
This 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)
What year levels are you comfortable teaching? P-3Year 4 - 6Years 7 - 9Years 10 - 12Adult learnersOther
What areas are you happy to support? Literacy interventionNumeracy interventionGeneral Curriculum EnglishGeneral Curriculum MathsOther
How will you work with your students? In my home/officeLibrary/OtherStudent HomeSchoolOnline
How many hours per week? 2 - 4 hours a week5 - 10 hours a week10 or more hours a week
Referee 1
Referee 2
How frequently do you check your emails? 1 - 2 times a weekOnce a daySeveral times throughout the day
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. Put the condition for consent here.
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