If you are already qualified as an instructor please use this form, If you wish to train as instructor then please go Here
If you have already started your application and saved it as draft enter the reference you were given here:

Contact Details

Instructor Name    


Enter your work postcode and select correct postal address from the list provided:
Postcode


Organisation
Street
Town/City
County
Telephone
Mobile
Fax
Email

Personal Details
Date of Birth
Gender
Emergency Contact Name
Emergency Contact Number
Are you in Good Health?

If you answer no, Please tell us more about this in the Anything Else box

Can you deliver the National Standard Bike Adjustments?



Password
(for access to your records)

Confirm Password

Instructor Certificates...

If you do not have electronic copies of your certificates please fax them to Cycling Instructor.

Do you have insurance to cover your work as an instructor?
Insurance Number.
Insurance cert.
Details
Insurance Expiry Date

Cycling instructor cert.
Instructor Number
Trained by
Provisional Course Dates
Details

CRB Number
CRB cert.
Details
CBR Issue Date

First aid cert.
Details
Issued Date

ITO registration Number

Instructor CV details

Attach CV

Cycling CV
Work History
Qualifications
Cycle Training Experience
Personal Specification

First Reference
First Name
Last Name
Organisation
Street
Town/City
County
Telephone
Mobile
Fax
Email

Second Reference
First Name
Last Name
Organisation
Street
Town/City
County
Telephone
Mobile
Fax
Email

Are you Available for work

Days available for work at school and group courses
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Do you want to provide private Lesson
(Trainee will pay you direct)


Additonal Details
(Anything Else)