APPLICATION FOR RENEWAL AS PEOPLE’S ASSOCIATION (PA) TRAINER

Important Notes:

1) Your application must reach the PA at least four months before the expiry of your current term, otherwise the PA will allow the current term to expire and your name will be removed from the register.2) The application must be complete. Please attach a recent coloured passport-sized photograph.3) Your application must be accompanied by all relevant certificates and supporting documents, which you have obtained in the past two years. Please send your application to:

People’s Association, c/o Lifeskills & Lifestyle Division, 9 King George’s Avenue, Singapore 208581.

Name _________________________________________ NRIC/FIN # ____________________

Nationality ______________________________________ FIN Expiry Date ________________

Address ______________________________________________________________________

Contact No. __________________(O)____________________(H)____________________(HP)

Email ________________________________________________________________________

Expiry Date of Current Term: _____________________________________________________

Course(s) that I have been approved by the PA to conduct:

(a) ___________________________________________ (b) ______________________________________

(c) ___________________________________________ (d) ______________________________________

(e) ___________________________________________ (f) ______________________________________

Residents’ Committee Centres (RCs) I’ve taught in for the past 3 years(please attach separate sheet of paper if space provided is insufficient)

Name of RC Course Conducted Date [from mm / yy to mm / yy]

(a) _______________________ _____________________________________ _______________________

(b) _______________________ _____________________________________ _______________________

(c ) _______________________ _____________________________________ _______________________

New course(s) that I propose to conduct(I have attached the relevant certificates/supporting documents to the completed form at Annex)

(a) ___________________________________________ (b) _______________________________________

(c) ___________________________________________ (d) _______________________________________

New Qualifications that I have attained in the past 3 years(please attach separate sheet of paper if space provided is insufficient)

Qualification Attained Name of Institution/Examination Board Date [from mm / yy to mm / yy]

(a) _______________________ _____________________________________ _______________________

(b) _______________________ _____________________________________ _______________________

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Please attach RECENT coloured passport-sized photograph

(c) _______________________ _____________________________________ _______________________

MEDICAL & PERSONAL DECLARATION

Please answer the following questions and tick the appropriate box(the information declared will not automatically disqualify applicants from being shortlisted)

1) Have you ever suffered, or are suffering from any medical history of pulmonary, nervousor mental health conditions, prolonged ill health, or impediment in speech or hearing or any physical impairment?

2) Have you ever been charged or convicted in a court of law in Singapore or any country?

3) Have you ever been suspended, discharged or dismissed from the service byany employer?

4) Have you ever applied to be, or have been a PA’s Trainer?

5) Are you an office bearer or member of any of the PA’s Grassroots Organisations?

6) Are you related to any office bearer or member of any of the PA’s Yes No Grassroots Organisations?

7) Are you a pre-qualified private operator of the PA? Yes No If your answer is “Yes” to any of the above, please provide brief factual information and documents (where relevant)

DECLARATION

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Yes

No

Yes No

Yes

No

Yes No

Yes No

I hereby declare that all information provided is true and correct; and agree to abide and be bound by the Terms and Conditions of the PA, Community Club Management Committees, other PA Committees and Organisations amended and updated from time to time and also all legal duties imposed upon me by law whether statutory or common law or otherwise; and authorise the PA to disclose my personal information to its employees, service providers, vendor and affiliated partners and such other person(s) or agency who is reasonably deemed to have a legitimate interest in such information . I understand that if I have suppressed any material fact or given false information, the PA shall have the right to terminate my services as a Trainer without prejudice to any of their other rights for damages and/or losses and/or indemnities against me for my breach of contract or failure to fulfil the full term of their contract as a result of the termination.

I am also fully aware and accept that I would be, from time-to-time, subject to the necessary security screening / audits by the relevant government and / or investigative authorities and / or appointed agencies under the normal procedures and policies of the PA and / or the Singapore Civil Service. I am aware and undertake to comply fully with such necessary screenings and audits and acknowledge that my failure to render assistance in or to clear such screening and audit would be tantamount to me breaching the terms of engagement and PA shall have the right to immediately terminate my services as a Trainer, again without prejudice to any of their other rights for damages and/or losses and/or indemnities against me for my breach of contract or failure to fulfil the full term of their contract as a result of the termination.

I also understand that my services as a PA Trainer will be tied to the validity of my employment status / papers in Singapore and obtaining, if so necessary, the approval from the Immigration and Checkpoint Authority, Ministry of Manpower or all such other relevant government agencies.

Further, I also fully understand and accept that I may be required to commence teaching and / or instructing in and / or continue in the proposed and / or existing course before the information (and / or any updates) provided by me are fully verified by the PA, which may eventually prove adverse and / or unfavourable to me, and / or that the result(s) of such security screening / audits carried out from time-to-time may prove adverse. In such an event or circumstance(s), I fully agree and accept that the PA shall be fully entitled at its sole discretion to terminate the provision of teaching and / or instructional services with immediate effect, without prejudice to any of their other rights for damages and/or losses and/or indemnities against me for my breach of contract or failure to fulfil the full term of their contract as a result of the termination..

Signature of Applicant Date

FOR OFFICIAL USE

Form Received Date: Name & Signature of Processing Officer: Name & Signature of Approving Officer:

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Annex

COURSE PROPOSAL FORM

Note: Please use a fresh form for each course to be offered. Applications will not be considered or will be delayed if a proper typewritten course proposal is not provided.

PROPOSED COURSE DETAILS

Course Title Medium of Instruction Target Group(please state age range for children's courses)

No. of Session(s) No. of Hour(s) per Session No. of Participants per Class

Minimum Maximum

Brief Description of Course (please use not more than 200 words. The information will be used for publicity and marketing purposes) Background and history of the subject

Course Content / Syllabus(please provide separate attachments if necessary) Teaching Methods Materials to be purchased/given

Sample Course Proposal 1Aikido is a modern, non-violent and non-competitive Japanese martial art of self-defense. Besides being a means of work-out and character development, Aikido also emphasises proper etiquette, self-discipline and a spirit of respect for fellow human beings.

There will be a 15-minute warm-up at the beginning of each training session. After the warm-up, the Trainer will demonstrate basic Aikido techniques and student will then partner each other to practise. After some basics, the Trainer may split the class up into the different grades to train related techniques. Towards the end of the class, throw exercises are done in groups for students to practise falling and experience a variety of training partners. Sometimes, free throw exercises are also done to train student’s reaction when being attacked by one or even more attackers. At the end of the class, a breathing extension exercise is usually done in a seating position with a partner.

All-white training jacket and pants with belt is the basic attire for Aikido. As beginners progress, they will change from white belt to various coloured belts to indicate their grades. Sample Course Proposal 2Pilates is a method of exercise developed by German-born Joseph Pilates in the 1920s, which consists of various physical movement programs designed to stretch, strengthen, and balance the body. It is a low-impact exercise which focuses on postural symmetry, breath control, abdominal strength, spine, pelvis and shoulder stabilization, muscular flexibility, joint mobility and strengthening through the complete range of motion of all joints.

A typical 1-hour mat work training session starts with fundamental movements like breathing and gentle spine exercises to warm up the body. This is followed by 40 minutes of mat work movements and finally 5 to 10 minutes of relaxation (warm down) to end the class. The trainer will demonstrate and explain each movement and move among the participants to ensure proper technique and assist as necessary.

While practising Pilates, you will require: (i) A folded towel, blanket or exercise mat of adequate thickness and density to place on the floor for protection of your

spine;(ii) A long towel or stretchy rubber exercise band; and (iii) A flat cushion or small folded towel to place under your head, if necessary.

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Course Proposal (To be typewritten. Please use additional sheets if necessary)

PROPOSED COURSE FEES, MATERIAL FEE & MINIMUM HONORARIUM AMOUNT EXPECTED BY TRAINER Trainers are paid an honorarium for their services. The honorarium is based on a percentage of total course fee collection (course fees charged less GST x no. of participants). The recommended sharing percentage between Trainer / Operator vs PA & CC is 65% vs 35%

The course fees would be negotiated and determined by the CC/ RC, based on the qualifications of trainer, market supply and

demand for courses, as well as local market conditions.

Illustration (for reference only):(a) Total course fee: $100 less 7% GST = $93(b) If a participant uses PAssion ez-link Card, the onePA system will auto-grant the participant 2% discount, ie the participant only needs

to pay $91.14 (c) PA takes 5% levy of $91.14 = $4.56 (d) CC takes the 30% share of $91.14 = $27.34 (e) Trainer takes the remaining share of 65% of $91.14 = $59.24

Proposed Course Fee

Full course fee Per hour course fee

S$ S$

Minimum Honorarium Amount Expected by Trainer

Full honorarium Per hour honorarium

S$ S$

Material Fee (if applicable)

S$

Name Signature & Date

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