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Volunteer application form

Thank you for applying to be an ESOL home tutor with English Language Partners.
Please enter your details, click 'Submit Form' and we will contact you soon.

Email recipient *

First name *

Last name *

Contact phone (home) *

Contact phone (work)

Contact phone (mobile)

Emergency contact

Email *

Preferred mailing address *

Post code

Date of birth

Gender *

Male

Female

Ethnicity *

First language *

Other language(s)

Work status *

Full time

Part time

Student

Homemaker

Self-employed

Retired

Unemployed

Other

Present occupation *

Past occupations

Preferred training course (If centre's 'Teach English' page lists training courses.)

Days/times available

Mode of transport to learner

Life experience (i.e. family, travel, work, qualifications)

Personal interests and preferences (e.g. ethnicity, language level, do you mind if children are present at lessons?)

How did you hear about English Language Partners?

Word of mouth

Website

Connecting Cultures magazine

Local paper

ESOL home tutor

Volunteer centre

Facebook

Other

I agree to provide the names and contact addresses / phone numbers of two people (other than family members) who are able to act as my referees.

Referee 1:

Name

Address

Phone

What is your relationship with this referee?

Referee 2:

Name

Address

Phone

What is your relationship with this referee?

(Tick to agree)

Permission regarding the Privacy Act from 1993 *

I give permission for English Language Partners New Zealand to hold the above information about me in accordance with the Privacy Act, 1993, and understand that some details will be passed on to the National Office for accountability purposes for Government funding and for general communications. I may see any information held about me and amend any errors in that information.

Permission for sending newsletters *

I give permission for my contact details to be used by English Language Partners to inform me of its activities relating to my work as a volunteer home tutor. I understand English Language Partners will not pass contact details to any other organisation.

Declaration about criminal convictions *

I have declared any criminal convictions (not excluded by the Clean Slate Act 2004) and/or any criminal charges pending in New Zealand or any other country.

Understanding that the decision is final *

I understand my application may be declined and that this decision is final.

Confirmation that given data is correct *

I confirm the information I have provided is correct.

Statutory information statement for students required under section 234B of the Education Act: This course may include a fee. Check your centre's webpage for details. No governing members of English Language Partners New Zealand have potential or material conflicts of interest.

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Volunteer application form

Referee 1:

Referee 2: