Teacher Registration form and Agreement This form allows teachers to register their interest in working with Progressive Home Tutors. Form IDSalutation*MrMrsMsMissDrName* First Last Street Address*Address Line2City/Suburb*State*Please Choose . . .ACTNSWNTQLDSAVICWAPostCodeDate of birth Date Format: MM slash DD slash YYYY Home Phone*Mobile Phone*Email* Please give us a passport style photo of yourself. Drop files here or Accepted file types: jpg, png, pdf, tif, tiff. Are you able to take students further than 15km from your home (e.g.. near work)?YesNoYour present occupationAre you a registered teacher?*YesNoDo you have your own transport?*YesNoSubjects you can supportSUBJECTLevels (lowest)Levels (highest) RefereesNameContact Please supply copies of your qualifications.Accepted file types: jpg, gif, png, pdf.Give Brief details of any special aspects which may assist in selecting suitable students for you.Add any further points in favour of this submission you would like to include here.WWCWorking With Children CheckTRBTeacher Review Board RegistrationQCOTQueensland College of Teaching Registration numberNational Police CheckState the name of your nearest relative (not living at the same address First Last Phone of nearest RelativeTerms of Service*I, ('the Teacher') in consideration of PROGRESSIVE HOME TUTORS ('the Agent') agreeing to refer the Teacher to persons desirous of engaging the Teacher as Tutor for themselves and/or their dependants (such persons being called jointly and severally 'the Client') agree with the Agent as follows:- 1. The Agent his servants and agents shall not be under any liability whatsoever whether at common law or by Statute and the Teacher agrees to indemnify the Agent against any claim whatsoever which may arise out of or be connected with any damage or injury which may occur to the Teacher or his servants or agents connected with or arising from such referral and the parties hereto expressly negate a relationship of master and servant. 2. The Teacher will charge the rates to the Client as indicated on the Agent's current rate card, such payments being made directly from the Client to the Teacher with the exception that the first three lessons will be prepaid to the Agent by the Client. 3. The Teacher accepts that the prepayment of lessons by the Client to the Agent represents the Agents Commission for referring students to the Teacher. 4. The Agents commission entitles the Teacher to tutor the student for up to twelve months. Where tutoring extends beyond any twelve month period a further Agents commission of two lessons will be paid by the Client to the Agent. 5. The Teacher agrees with the Agent: (a) Within twenty four (24) hours of being notified of the referral: (i) to give oral notification to the Agent of his acceptance or refusal of the referral and in the event of acceptance, (ii) to contact the Client to effect an introduction and to make arrangements for the commencement of lessons. (b) To notify the Agent upon any Client terminating or ceasing to require the services of the Teacher. (c) To suspend the provision of services to any Client upon the request of and for such period stipulated by the Agent in its absolute discretion provided however that such a request is not made capriciously or without reason. (d) To give not less than 21 days notice to both the Agent and the Client if for any reason the Teacher wishes to terminate the provision of services to the Client. (e) To refer any enquiries or application for tuition and teaching by (i) Any past or present student who has been referred by the Agent OR (ii) Any other person who is associated with or recommended by any past or present student to the Agent and only upon receiving the consent shall the Teacher accept or engage any such student or person. 6. Delegation. A teacher may delegate to another teacher the tuition of any student provided such delegated teacher is properly qualified to undertake the tuition but at all times subject to the provision that the Agent may direct that the delegated teacher is not an appropriate replacement. 7. Either party may terminate this agreement by giving to the other forty-eight hours notice in writing of his intention to do so but any termination shall not affect any existing liabilities or other warranties herein. The Teacher warrants and guarantees that the information endorsed hereto is correct. I agree to the Terms of Service Please scroll to the bottom AND agree to the Terms of Service before hitting the submit button.PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.