Contact Details First name Last name Email address Phone number Personal Background Can you tell us a bit about yourself and your experience delivering activities to children? Why do you want to become a cycle instructor? Qualifications & Training Are you trained to deliver Play on Pedals/ Play Together on Pedals? Yes No Are you First Aid trained ? Yes No What kind of training did you complete? Are you able to complete this within the next 3 months if Cycling UK cover the costs? Yes No Protection of Vulnerable Groups Regulated roles are roles that meet certain criteria. They often involve work with children or protected adults, or positions of power or influence over these groups. The Protection of Vulnerable Groups (PVG) membership scheme helps to ensure people who are unable to work with children and protected adults cannot do regulated roles. Disclosure Scotland continuously checks members' criminal history information. It also keeps lists of people barred from regulated roles. A PTOP Instructor delivers regulated work and as such, all PTOP Instructors are required to undergo a PVG check. Are you happy for us to carry out a PVG check through Disclosure Scotland? Yes No We require each instructor to have their own insurance – is this something you are happy to obtain if successful in this process to become a PTOP Instructor? Yes No PTOP Instructors are required to complete Child Protection and Safeguarding training. Is this something you have recently obtained? Yes No When did you complete your training Are you able to complete this within the next 3 months if Cycling UK cover the costs? Yes No Experience Are you currently in employment? Yes No Please tell us about your position, responsibilities and contracted hours. Do you have experience in working with children in early years setting? Yes No Please tell us about your experience of this. Can you tell us about your current delivery experience which you feel is relatable to this role? Availability & Commitment What times and days are you generally available to deliver PTOP? Are you able to start training and delivery from October? Yes No SubscribeFor more than 140 years, Cycling UK has been inspiring people to ride. With your help, together we’re bringing about a real change. We’d like to keep in touch about the difference you’re making, our campaigning, cycling projects and volunteering opportunities, as well as events, marketing, and fundraising work. If you’re happy to hear from us please opt in. Subscribe to Cycling UK emails Data Protection Statement Your details will be kept safe and secure, only used by us, or those who work for us, and will not be shared with anyone else. we analyse information you provide about how you’ve helped us, to decide what communications will be of interest to you and to help us understand our supporters. We also use this information to run our charity’s operations, e.g. if you become a member, place an order or make a donation, we’ll need your details to process those. If you would like to know more or understand your data protection rights, please take a look at our general privacy policy.