IYNI Group Leader (2nd call) Accreditation Scheme

2017/18

Application Form

Please read the Notes for Applicants before completing all sections of this application form.

Please ensure that the Statement of Endorsement & Commitment is attached and signed by your employer.

SECTION 1: CONTACT DETAILS

1a. Applicant Group Leader Details

First name
Surname
Job Title
Organisation
Email
Work & Mobile Numbers

1b. Co-leader Details

First name
Surname
Job Title
Organisation
Email
Work & Mobile Numbers

1c. Manager Details

First name
Surname
Job Title
Organisation
Email
Work address & postcode
Work & Mobile Numbers

SECTION 2: YOUR INCREDIBLE YEARS® JOURNEY

2a. Your IY Training Journey

Please provide details of all Incredible Years training you have received.

Tell us about: the programmes you are trained in, to what level (group leader; peer coach); when you received the training and who delivered it.

IY training received / Date of training / Name of trainer

2b. Your IY Delivery Journey

Please provide details of all Incredible Years programmes you have delivered.

Tell us about: the type of programmes (e.g. Baby; Toddler etc); when you first delivered; the numbers of groups/ deliveries you have successfully completed; your most recent delivery.

IY programme delivered / Dates of first and most recent delivery only / Total number of deliveries

2c. Your IY Supervision Journey

Please provide details of all Incredible Years supervision you have received.

Tell us about: the type of supervision (i.e. peer review; peer coaching; consultation day); when and how frequently it was/is received; who supervised/s you; in what programme/s.

IY supervision received / Date of training / Name of supervisor

SECTION 3: ACCREDITATION GOALS & EXPECTATIONS

3a. Interest and Expectations

Please outline your interest in and expectations of the accreditation process.

Tell us why you are applying to the scheme; what personal and professional expectations you have; think about the opportunities and challenges that might arise.

3b. Strengths & Areas for Development

Please self-identify your strengths as an IY parent group leader and the areas you would like to focus on for development

Tell us about the elements of your practice that you are happiest with; think about the knowledge, skills and experience you bring to that work. Tell us about your development plans as well; what areas you would like to focus on during the accreditation process.

SECTION 4: ELIGIBILITY

4a. IY Pre-school Basic Parent Programme Delivery 2017/18

Please provide details of all the programmes you will be delivering in 2018

* One of these must be Toddler or Pre-school Basic commencing no later than 26 January 2018.

Please include: type of programme/s (i.e. Pre-school Basic and/or Toddler); anticipated start date/s; name of co-facilitator/s; location/s; anticipated numbers; other relevant detail.

4b. Paperwork for previous programme delivery

Please confirm below if you wish to submit paperwork for a previous IY programme delivery.

If you already have a full set of paperwork for one previous delivery of the IY Pre-school basic Parent Programme (minimum 14 weeks) or Toddler Parent Programme (12 weeks), which you wish to submit as part of your accreditation process, please mark (x) in the boxes below:

Pre-school Basic
(x) / Toddler
(x)
Leader Checklist for all sessions
Parent Weekly Evaluation Forms
Final Parent Satisfaction Forms
1 Peer Evaluation checklist
1 Self-Evaluation checklist
Attendance list*

*For your paperwork to be considered for accreditation, 50% of parents must have completed the programme, with a minimum of 6 parents completing.

4c. Peer Coaching Experience

Please provide detail below to confirm that you have availed of a minimum of two peer coaching sessions.

Name of Peer Coach / Number of Sessions

SECTION 5: ENDORSEMENT

Employer’s Statement of Endorsement & Commitment

To be completed by the employer.

Name of Bursary Applicant
Name of Line Manager/Supervisor
Employer Organisation

I confirm that the applicant is supported in their application by their employer.

I endorse this application and, should it be successful, commit to providing the applicant and their co-leader with the following:

  • Adequate time to plan, deliver, peer-review and evaluate their sessions for the 12/14 weeks of delivery. i.e. 1.5 days per week
  • Release from duties for required attendance at: Introduction Session, 2 Peer Coaching sessions and Consultation Day outlined in the activity schedule
  • Means of recording and reviewing session delivery for each of the 12/14 weeks of delivery
  • Means of transferring recorded material to DVD (in a manner that respects consent given by, and confidentiality ground rules agreed with, parents during programme delivery).

If you wish to add a further statement of endorsement for this application, please do so in the space provided below:

Signed:

Dated:

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