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Membership Application

Name *

Mobile Number *

Gender *

Date of Birth *

Father/Husband Name *

City *

Occupation Qualification Full Address *

Volunteer Application

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Father/Husband Name *

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Occupation Qualification Full Address *

Teacher / Educator Individual Empanelment

For individual teachers, educators, trainers, artists and counsellors.

Home Vidhya Connect Teacher / Educator Individual Empanelment

1. Personal Details

Educator Full Name * Gender * Date of Birth * Mobile Number * Alternate WhatsApp Number Institute / Center Name Address * Locality * PIN Code *

2. Qualification and Profile

Highest Qualification * Institution / University of your Highest Qualification Teaching Mode * Other Teaching Mode Teaching Experience * Specialization *

Educator Profiles *

Own Classes / Center Visiting / Home Visit Online Other

Other Educator Profile For Visiting / Home Classes, distance you can travel? * Other Travel Distance

3. Teaching Preferences

Age Groups *

All Age Group (Age No Bar) Pre Primary upto UKG Primary (Class 1-5) Middle School (Class 6-8) Secondary (Class 9-10) Senior Secondary (Class 11-12) Graduation Post Graduation Other

Other Age Group

Subjects & Learning Programs *

School Curriculum Competitive Exams Spoken English Computer Education Arts & Craft Drawing & Painting Music (Vocal) Music (Instrumental) Dance Public Speaking Vedic Mathematics, Abacus, etc Yoga, Mediation, Zumba, etc Games / Sports (Indoor & Outdoor) Language (Spanish, German, French, etc) Personality Development Career Guidance (In Selecting School, College, Coaching & Others) Career Counselling & Future Planning Other

Other Subject

Preferred Days *

Flexible with Days Week Days (5/6 days a week) Alternate Days (3 days a week) Weekend (Saturday/Sunday) Other

Other Preferred Day

Preferred Time Slots *

Flexible with Time Morning (upto 12 PM) Afternoon (12 to 04 PM) Evening (04 to 08 PM) Other

Other Preferred Time Fee Collection Mode * Other Fee Collection Mode Demo Class Availability *

Kindly upload your Photo, ID Proof, Address Proof, Qualification Certificate, if applicable any Registration of your institute.

Upload up to 10 files. PDF, Word, PowerPoint, JPG, PNG and WebP. Max 100 MB each.

Relevant Documents

I hereby declare that the information provided above is true and correct to the best of my knowledge. I agree to abide by the values and guidelines and maintain professional conduct while interacting with students and parents.

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