Please log in before filling out this form by using the blue login/register button and then refresh this page.Contact 1 First Name Last Name Previous Surnames Email Do you hold Qualified Teacher Status (QTS or QTLS)? QTS QTLS No Please enter your Degree information and Certificate here. Name of course Type of course - None -UndergraduatePostgraduateA-LevelCPDINSET Institution Date from Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027 Date to Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027 Qualification / Result Certificate Upload Files must be less than 8 MB.Allowed file types: gif jpg png bmp pdf doc docx odt ppt pptx rar tar zip 7zip 7z jpeg. Transcript Upload Files must be less than 8 MB.Allowed file types: gif jpg png bmp pdf doc docx odt ppt pptx rar tar zip 7zip 7z jpeg. Please enter your Postgraduate Certificate Information and Certificate here. Name of course 2 Type of course 2 - None -UndergraduatePostgraduateA-LevelCPDINSET Institution 2 Date from 2 Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027 Date to 2 Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027 Qualification / Result 2 Certificate Upload 2 Files must be less than 8 MB.Allowed file types: gif jpg png bmp pdf doc docx odt ppt pptx rar tar zip 7zip 7z jpeg. Transcript Upload 2 Files must be less than 8 MB.Allowed file types: gif jpg png bmp txt pdf doc docx odt ppt pptx rar tar zip 7zip 7z jpeg. Please enter your Postgraduate Diploma Information and Certificate here. Name of course 3 Type of course 3 - None -UndergraduatePostgraduateA-LevelCPDINSET Institution 3 Date from 3 Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027 Date to 3 Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027 Qualification / Result 3 Certificate Upload 3 Files must be less than 8 MB.Allowed file types: gif jpg png bmp pdf doc docx odt ppt pptx rar tar zip 7zip 7z jpeg. Transcript Upload 3 Files must be less than 8 MB.Allowed file types: gif jpg png bmp pdf doc docx odt ppt pptx rar tar zip 7zip 7z jpeg. Please enter your Master Degree Information and Certificate here. Name of course 4 Type of course 4 - None -UndergraduatePostgraduateA-LevelCPDINSET Institution 4 Date from 4 Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027 Date to 4 Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027 Qualification / Result 4 Certificate Upload 4 Files must be less than 8 MB.Allowed file types: gif jpg png bmp pdf doc docx odt ppt pptx rar tar zip 7zip 7z jpeg. Transcript Upload 4 Files must be less than 8 MB.Allowed file types: gif jpg png bmp pdf doc docx odt ppt pptx rar tar zip 7zip 7z jpeg. Please enter your PHD Information and Certificate here. Name of course 5 Type of course 5 - None -UndergraduatePostgraduateA-LevelCPDINSET Institution 5 Date from 5 Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027 Date to 5 Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027 Qualification / Result 5 Certificate Upload 5 Files must be less than 8 MB.Allowed file types: gif jpg png bmp txt pdf doc docx odt ppt pptx rar tar zip 7zip 7z jpeg. Transcript Upload 5 Files must be less than 8 MB.Allowed file types: gif jpg png bmp pdf doc docx odt ppt pptx rar tar zip 7zip 7z jpeg. Please enter your PGCE information and Certificate here. Name of course 7 Type of course 7 - None -UndergraduatePostgraduateA-LevelCPDINSET Institution 7 Date from 7 Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022 Date to 7 Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022 Qualification / Result 7 Certificate Upload 7 Files must be less than 8 MB.Allowed file types: gif jpg png pdf doc docx odt ppt pptx rar tar zip 7zip 7z jpeg. Transcript Upload 7 Files must be less than 8 MB.Allowed file types: gif jpg png bmp pdf doc docx odt ppt pptx odp rar tar zip 7zip 7z jpeg. Please enter any other SpLD education Information and Certificate here. Name of course 6 Type of course 6 - None -UndergraduatePostgraduateA-LevelCPDINSET Institution 6 Date from 6 Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027 Date to 6 Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027 Qualification / Result 6 Certificate Upload 6 Files must be less than 8 MB.Allowed file types: gif jpg png bmp doc docx odt ppt pptx odp rar tar zip 7zip 7z jpeg. Transcript Upload 6 Files must be less than 8 MB.Allowed file types: gif jpg png bmp pdf doc docx odt ppt rar tar zip 7zip 7z jpeg. Other Information Copy of or eligibility for AMBDA certificate Files must be less than 6 MB.Allowed file types: gif jpg png bmp pdf doc docx odt ppt pptx rar tar zip 7zip 7z jpeg. Copy of your CCET certificate Files must be less than 6 MB.Allowed file types: gif jpg png bmp pdf doc docx odt ppt pptx rar tar zip 7zip 7z jpeg. Qualifications held Postgraduate SpLD Level 7 Diploma Postgraduate Degree Postgraduate SpLD Level 7 Certificate Undergraduate Degree Postgraduate Certificate in Education (PGCE) Specialist Teaching Qualification Specialist Assessment Qualification Level 5 SpLD Certificate Level 5 SpLD Diploma Postgraduate SpLD Level 5 Dyslexia Action CPD or Adults Pathway HLTA A Level BTEC GCSE GNVQ NVQ ATS/APS AMBDA None Do you currently hold an APC and with who - None -No APCAPC with Dyslexia ActionAPC with PatossAPC with BDA Curriculum Vitae Files must be less than 6 MB.Allowed file types: gif jpg png pdf doc docx odt ppt pptx odp 7zip 7z jpeg. I agree to abide by the Code of Practice. Yes If you meet the requirements, do you wish to be listed in our assessors directory? Yes No CPD Log Files must be less than 6 MB.Allowed file types: gif jpg png pdf doc docx ppt tar zip .7zip.
