East Region ITO  
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east region ITO - Application for Membership
Please fully complete the application form before submitting.  
Fore name
Last name
Address
Post Code
email address
Telephone Number
NSI Number
(if you cannot locate yours, contact 020 7910 5000 and ask for the cyclist training team)
Original Training Provider/Organisation
Last Monitoring Date // (dd/mm/yyyy)
Number of courses you trained within the last 12 months
As lead trainer
 As assistant trainer
Please list CPD courses attended within the last 12 months (date, title and provider)
Please indicate the Local Authorities within the East Region you would be prepared to work with
Cams Beds Borough Central Beds
Luton Southend Peterborough
Essex Suffolk Herts
Info...
Membership of the East Region ITO entitles members to a number of benefits:
  • Inclusion in the East Region Local Authorities’ database of cycling instructors.
  • Access to CPD courses across the East Region.
  • An invitation to attend an annual conference within the East Region.
  • A newsletter update on a termly basis.
  • A membership card.
Membership of the ITO runs from April to March and costs £25 per annum.
Photo
A current, passport style, photograph of the applicant will be required for creating the membership ID card. It is preferred that the image is provided as an electronic file in JPEG format and should be of high enough resolution to clearly identify the applicant. This file should be attached to an email giving the applicant's full name and marked as 'east region ITO application'. The email should be addressed to:
ito@5th-enigma.co.uk

Conditions
Our full 'Conditions of Membership' can be viewed here:
east region ITO conditions
By submitting this application you are agreeing to these conditions.
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