Buddy Registration Form
Name
*
First Name
Surname
Email
*
Mobile number
*
Address
*
State / Province
Age
*
Date of birth
*
/
Day
/
Month
Year
Date
Nationality
*
Current job title/employment
*
Main type of employment ie are you working around acting, singing etc?
Academic qualifications (tick all that apply)
GCSEs
BTEC
A levels
Under Grad (still at Uni)
Batchelor's
Masters
Other
Please state your main qualitications here
Do you have an Enhanced DBS?
*
Yes
No
Enhanced DBS Date Issued
/
Day
/
Month
Year
Date
Enhanced DBS Certificate Number
Are you on the update service?
Yes
No
Do we have your permission to check your DBS status on the update service?
Yes
No
Do you smoke?
*
Yes
No
Vape
Social
Do you have a driving licence?
*
Yes
No
If yes, can you drive
Manual
Auto
Do you have your own car?
*
Yes
No
Would you be happy to drive a client's car around London?
Yes
No
Do you have a Work Visa?
*
Yes
No, I don't need one
Visa Expiry Date
/
Day
/
Month
Year
Date
Please provide a brief description of your work (paid or unpaid) experience with children. Please include ages
*
I'm available to work FROM 3pm onwards on;
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
I'm available to work ANYTIME on;
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
School holidays and half terms
I have experience of working with (only tick if relevant);
ADHD
Aspergers
Autism
Dyslexia
Dyspraxia
SEN (general)
Other
I have experience as a:
Teacher
Teaching Assistant
Tutor
Coach
Other
Please select your main interests or skills
*
Football
Rugby
Music
Cricket
Tennis
Cooking
Skiing
Theatre/acting
Cycling
Running/keeping fit
Sailing/watersports
Other
Languages (indicate fluent or conversational)
Instruments played and Grade
Additional qualifications and/or certificates
How did you hear about My Big Buddy?
*
Full name
*
Date
*
/
Day
/
Month
Year
Date
Please check all details are correct before clicking the
Submit Form
button.
Thank you
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