| 1. First Name * |
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| 2. Last Name * |
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| 3. Gender * |
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| 4. Your Date of Birth (You must be 18 yrs or above to volunteer as instructor) |
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| 5. Current Employment Status * |
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| 6. Your Mobile Number * |
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| 7. Email * |
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| 8. Suburb you live in * |
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| 9. Education * |
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| 10. Time available for supporting this program (per week) |
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| 11. General Work Experience, Skills, and other supporting comments: |
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| 12. How many classes (30 mins each) can you teach per week? |
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| 13. Do you have experience teaching Islamic studies or other subjects? |
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| 14. If so, do you currently teach Islam or Islamic Studies at a Victorian public school (primary or secondary)? |
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| 15. Do you have any preference in terms of teaching a particular age group (for example, primary school age or high school age)? |
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| 16. Do you have transport to travel to schools? |
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| 17. Would you consider travelling more than 20 mins to teach Islamic education in public schools every week? |
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| 18. If you answered No, would you consider travelling more than 20mins to teach a class if the situation arose from time to time? |
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| 19. Do you have a valid ‘Working with Children’ (WWC) card? (Issued by the Department of Justice, Victoria) OR are you a registered teacher with the Victorian Institute of Teaching? |
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| By completing and submitting this Islamic SRI Instructor Registration Form, I agree to completing over time all of the requirements for Instructor accreditation as advised by Arkan Toledo, including formal Accreditation Training and successful application for a WWC Card. I'm aware that SRI classes are held during standard school hours. I further agree to make myself available to teach Islamic SRI classes once I have been approved to do so. * |
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| How did you hear about Islamic SRI or Arkan Toledo? |
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