In order to help Schools and others wishing to work with artists find out more about you, please fill this registration as best as possible. If you don't understand a specific field, hold the mouse over its label for a few seconds to see an explanation.

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Name: (?)

Date of Birth: (?)

Tel: (?)

Email: (?)

Address: (?)

Town: (?)

Postcode: (?)

Art Form: (?)

Area(s) of Expertise: (?)

Work Locations: (?)

CRB Disclosure Ref: (?)

PLI Cover?: (?) Yes No

Preferred age group: (?) -- Please Select -- 5-10 10-15 15-18 18+ KS1 KS2 KS3 Any

Do you have experience working in a primary school?
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Ever worked with children with special needs/disabilities?: (?)

What do you currently do/would you like to do with schools?:

Teaching certificate?: (?)

Any other training?: (?)

Please tell us what relevant qualifications you have (including where you studied and grades or levels achieved):

About You: (?)

Additional Information: (?)

Please give us a referee from a school or similar project you have worked with previously, within the last 2 years:

Name:

Position:

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Job Description:

Date Undertaken: