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Tutor Application Form
If you are interested in teaching a class with Southland Education, please fill in the form below.
For position of tutor in
Date
Your Address
Number and Street
Floor or Building
City
Postcode
Relevant Qualifications / Experience
Recent Teaching / Tutoring Experience
Recent Employment
Employer
Position
Dates from and to
Liaison with other community groups
Tell us about “you” the tutor (include other areas of expertise)
Referees (at least two)
Referee #1
Referee's Name
Referee's Email
Referee's Phone/Mobile
Number & Street
Building or Floor
City
Referee #2
Referee's Name
Referee's Email
Referee's Phone/Mobile
Number & Street
Building or Floor
City
Please attach brief CV for our confidential information
Title and Brief Description of your proposed course
Personal Information
First Name
Last Name
Email
Work Phone
Home or Mobile Phone
Do you have permanent residency in New Zealand
Yes
No
If not, are you legally entitled to work in New Zealand?
Yes
No
Do you have any criminal convictions or court action pending?
Yes
No
Have you ever been charged with a crime, or are you currently being investigated?
Yes ↓
No
If Yes:
The declaration of an offence may not preclude your application from being considered. However, non-disclosure of relevant matters may be seen as misrepresentation and will be dealt with accordingly. If you are in doubt as to whether or not to declare something, please declare it. It is not necessary to declare parking fines or speeding tickets unless they resulted in a sentence of disqualification or otherwise.
Do you give us permission to carry out a police check?
Yes
No
SUbmit application
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