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Sequential Training Academy Facilitator Application Form

Personal Details

First Name *

Surname *

Title

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country

Phone Number *

Personal Email Address *

Do you have access to reliable internet access?You will need internet in order to access assessments, learning materials and online classes.YesNo

Do you have a suitable device to conduct online classes, read and/or prepare learning materials and assignements remotely?YesNo

How confident are you in using online tools and applications? *Using systems like Google Meets, Gmail, Google Docs - 1 being not very confident and 5 being extremely confident.

Date of Birth *

ID or Passport Number *0 / 20

Select your Gender

Select your Population Group

Other Population Group

Select your home language

Citizenship *South AfricanOther

Citizenship *

Do you have a disability? *YesNo

Please provide details of your disability and any reasonable adjustments and support you may need to support you?

Next of Kin

Please provide information for your next of Kin or emergency contact.

Next of Kin Name *

Next of Kin Relationship *

Next of Kin Phone Number *

Next of Kin Email Address *

Teaching and Availbility

Do you hold a certificate/qualification as an Assessor? *YesNo

Do you hold a certificate/qualification as a Facilitator/Trainer? *YesNo

Declaration and Terms

I declare that all the particulars supplied by me in this form are true, complete and correct. I accept that incorrect or misleading information could lead to the cancellation of this application.

Signature *

Upload Documents

Please label each document clearly: First Name, Last Name and what the document is.If the below documents are not present, your application will be considered as incomplete.

Upload CV *Copy of your CV

No file chosen

Upload Certified Copy of your ID or Passport *A Certiﬁed Copy of your ID or Passport (Certiﬁcation not older than six (6) months)

No file chosen

Upload a Certified Copy of your Highest Qualification *A Certiﬁed copy of your Highest Qualiﬁcation (Certiﬁcation not older than six (6) months)

No file chosen

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Sequential Training Academy Facilitator Application Form

Personal Details

Next of Kin

Please provide information for your next of Kin or emergency contact.

Teaching and Availbility

Declaration and Terms

I declare that all the particulars supplied by me in this form are true, complete and correct. I accept that incorrect or misleading information could lead to the cancellation of this application.

Upload Documents

Please label each document clearly: First Name, Last Name and what the document is.If the below documents are not present, your application will be considered as incomplete.

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