Expression of Interest to provideProfessional Learning design and delivery to FKA Children’s Services

Please return this form and any supporting documentation to

Part One: Applicant details

Applicant’s name / Please enter
Company name / Please enter
ABN / Please enter
Is the company registered for GST? / Yes
No
Address / Please enter
Postal address
(if different from above)
Phone / Please enter
Mobile / Please enter
Email / Please enter
Website / Please enter

Part Two: Referee details

Please provide the details of two professional referees

First referee / Second referee
Referee name / Please enter / Referee name / Please enter
Company name / Please enter / Company name / Please enter
Phone / Please enter / Phone / Please enter
Mobile / Please enter / Mobile / Please enter
Email / Please enter / Email / Please enter

Part Three: Product details

Target audiences

Please indicate which services you can provide professional learning design and delivery for:

FKA Children’s Services
Professional Learning Expression of Interest January 2016Page 1 of 2

Long Day Care Services

Family Day Care Educators and Providers

Outside School Hours Care Educators and Providers

Kindergarten Teachers and Educators

Other Early Childhood Education and Care agenciesPlease list here

Professional learning details:

  • include details of how you meet the selection criteria
  • include brief details of proposed professional learning (up to 250 words)

Enter details here

Pricing

  • Clearly detail your complete pricing structure and terms, inclusive of any GST

For example, include costing for session development, session delivery, travel

Enter details here

Part Four: Mandatory Requirements

Please confirm that you meet the following mandatory requirements:

Qualifications

The applicant named on this EOI holds aCertificate IV in Training and Assessment or has demonstrated adult training experience.

The applicant named on this EOI holds qualifications or expertiserelevant to the topic of professional learning

Insurance

The applicant named on this EOI has Public Liability for not less than $10,000,000

The applicant named on this EOI has Professional Indemnity for $5,000,000

Note: Evidence of insurance must be attached to this application. Sole traders may wish to negotiate insurance coverage with FKA Children’s Services

Conflict of Interest

The applicant named on this EOI has no perceived, real or potential Conflict of Interest, or;

The applicant named on this EOI has a perceived, real or potential conflict of interest and a Conflict of Interest Management Plan is attached

Part Five: Declaration

I confirm that I am the applicant or am authorised by the applicant to complete and sign the form on behalf of the applicant and that all information provided is true and complete

I confirm that the applicant (and all its employees) will abide by the Sub-contract agreement with FKA Children’s Services

Please return a signed copy of this form.

SignatureDate

NamePlease enter

PositionPlease enter

CompanyPlease enter

FKA Children’s Services
Professional Learning Expression of Interest January 2016Page 1 of 2