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Personal Information
Please complete this personal information form, taking care to provide accurate information.
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Personal Information
Nationality, Identity and Right to Work
Role
Languages
Lived Overseas
Safeguarding training
Enhanced Disclosure Checks
Criminal Record History
Disqualification by Association
Name
Title
*
Mr.
Mrs.
Ms.
Miss.
Mx.
Dr.
Prof.
First Name
*
Surname
*
Date of Birth
*
Email Address
*
Phone number
*
National Insurance number (to work in the UK), Personal Public Service number (to work in Ireland)
*
Current Address
Address 1
*
Address 2
Address 3
City
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Post Code / EIR Code (Ireland)
*
Country
*
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua & Barbuda
Argentina
Armenia
Aruba
Ascension Island
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia & Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Canary Islands
Cape Verde
Caribbean Netherlands
Cayman Islands
Central African Republic
Ceuta & Melilla
Chad
Chile
China
Christmas Island
Clipperton Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo - Brazzaville
Congo - Kinshasa
Cook Islands
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czechia
Denmark
Diego Garcia
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard & McDonald Islands
Honduras
Hong Kong SAR China
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR China
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territories
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé & Príncipe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia & South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
St. Barthélemy
St. Helena
St. Kitts & Nevis
St. Lucia
St. Martin
St. Pierre & Miquelon
St. Vincent & Grenadines
Sudan
Suriname
Svalbard & Jan Mayen
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad & Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks & Caicos Islands
Tuvalu
U.S. Outlying Islands
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis & Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
When did you move into this address?
*
Have you lived at this address for more than 5 years?
*
Yes
No
Please provide your address history covering the past 5 years
*
Previous Address
Date moved into this address
Date left this address
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What is your nationality?
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UK
Republic of Ireland
Other
Please tell us your nationality?
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How are you able to prove your right to work in the UK or Ireland?
I have EU Settled Status
I have a UK or Irish VISA giving me the right to work
I am an EU citizen planning to work in Ireland
Other
Please provide your Share Code
*
Please upload a copy of your Right to Work VISA
*
Please provide more details - We will need to see evidence of this in due course
*
Do you have a valid passport?
*
Yes
No
Please upload a photograph of your passport, showing your picture and passport number.
*
Do you have a current driving licence?
*
Yes
No
Please upload a photograph of your driving licence.
*
Do you have a birth certificate?
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Yes
No
Please upload a photograph of your birth certificate
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Please upload a copy of a Utility Bill dated within the last 3 months, showing your current address (for example, Gas, Electricity, Water, Broadband) or a current Council Tax bill. Please note: Mobile Phone bills must not be uploaded.
*
Please upload evidence of your National Insurance number (to work in the UK), or Personal Public Service number (to work in Ireland). For example - Letter from government, screenshot of tax account, photo of NI or PPS card or letter)
*
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Are you applying to set up your own La Jolie Ronde language classes (you will have signed a marketing agreement), or are you applying to work with an established Tutor?
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I plan to set up my own La Jolie Ronde classes
I plan to work with an established tutor
Which established Tutor do you plan to work with?
*
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Which Language(s) are you planning to teach?
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French
Spanish
French & Spanish
Please tell us about your language knowledge
English - Spoken
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Native
Fluent
Good understanding and knowledge
Basic understanding and knowledge
None
English - Written
*
Native
Fluent
Good understanding and knowledge
Basic understanding and knowledge
None
English - Reading
*
Native
Fluent
Good understanding and knowledge
Basic understanding and knowledge
None
French - Spoken
*
Native
Fluent
Good understanding and knowledge
Basic understanding and knowledge
None
French - Written
*
Native
Fluent
Good understanding and knowledge
Basic understanding and knowledge
None
French - Reading
*
Native
Fluent
Good understanding and knowledge
Basic understanding and knowledge
None
Spanish - Spoken
*
Native
Fluent
Good understanding and knowledge
Basic understanding and knowledge
None
Spanish - Written
*
Native
Fluent
Good understanding and knowledge
Basic understanding and knowledge
None
Spanish - Reading
*
Native
Fluent
Good understanding and knowledge
Basic understanding and knowledge
None
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Have you lived outside of the UK or Ireland for more than 3 months in the past 5 years?
*
Yes
No
Please provide details of which country / countries and the exact dates you lived there.
*
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All La Jolie Ronde Tutors are required to undertake Safeguarding Children Training prior to starting with the company and then every two years. Please select from the following options:
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I have completed Safeguarding Children training within the past 2 years and can provide a copy of my certificate
UK Residents - I will source my own Safeguarding Children training and will provide a copy of the certificate to the company in due course
UK Residents - I would like to purchase Safeguarding Children training from La Jolie Ronde at a price of £18
Irish Residents - I will complete the Irish Government TUSLA training - please send me approriate details
Please upload a copy of your certificate
*
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All La Jolie Ronde Licensees and Tutors are required to hold current enhanced disclosure checks with the relevant national body. Please select from the following options:
*
England, Wales and Northern Ireland - I will need a new enhanced DBS check (We will set you up for a check)
England, Wales and Northern Ireland - I have an existing non voluntary enhanced DBS check for the child workforce and have joined the update service
Scotland - I will need a new PVG check (We will set you up for a check)
Scotland - I am a PVG member, working with childen (We will set you up to link your PVG to La Jolie Ronde)
Ireland - I will need a new Garda vetting check (We will set you up for a check)
Ireland - I have a garda vetting check dated within the last 2 years
Please upload a copy of your existing Garda vetting certificate
*
Please upload a copy of the DBS certifcate that is attached to your DBS Update membership
*
Please provide your consent for La Jolie Ronde to check your membership of the Update Service
*
I consent to La Jolie Ronde checking my membership of the update service
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Have you been cautioned or convicted of any offences against a child?
*
Yes
No
Have you been cautioned or convicted of any violent or sexual offences against an adult?
*
Yes
No
Have you been barred from working with children by the Disclosure and Barring Service (England and Wales), Disclosure Scotland (Scotland), Access NI (Northern Ireland) or Garda Vetting (Republic of Ireland)?
*
Yes
No
Have your children been taken into care?
*
Yes
No
Not applicable - I do not have any children
Are your children currently, or in the past, the subject of a child protection order?
*
Yes
No
Not applicable - I do not have any children
Has a court order been made in respect of a child under your care?
*
Yes
No
Have you been refused registration or had registration cancelled in relation to childcare or a children’s home or have you been disqualified from private fostering?
*
Yes
No
You have answered Yes to one or more of the above questions. Please provide further details.
*
I agree that I will inform La Jolie Ronde if my situation changes in the future with regard to my answers to these questions.
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Are you planning to teach from home (either online or in person), now or in the future?
*
Yes
No
Has anyone else living in your household been cautioned or convicted of any offences against a child?
*
Yes
No
Has anyone else living in your household been cautioned or convicted of any violent or sexual offences against an adult?
*
Yes
No
Has anyone else living in your household been barred from working with children by the Disclosure and Barring Service (England and Wales), Disclosure Scotland (Scotland), Access NI (Northern Ireland) or Garda Vetting (Republic of Ireland)?
*
Yes
No
Does anyone else living in your household have children that have been taken into care?
*
Yes
No
Has anyone else living in your household been the subject of a child protection order?
*
Yes
No
Has anyone else living in your household had a court order made in respect of a child in their care?
*
Yes
No
Has anyone else living in your household been refused registration or had registration cancelled in relation to childcare or a children’s home or has anyone been disqualified from private fostering?
*
Yes
No
You have answered Yes to one or more of the above questions. Please provide further details.
*
I agree that I will inform La Jolie Ronde if my situation changes in the future with regard to my answers to these questions.
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