<p>February 2013 Page 1 of 2 TE RAKI PAE WHENUA NORTH SHORE PLAYCENTRE ASSOCIATION INC</p><p>REQUEST FOR A PAID CO-ORDINATOR to be completed by the centre </p><p>Centre</p><p>Title of the session</p><p>Session day & time The session above is included on the centre’s current license Yes No</p><p>Hours of work  This is the total number of hours that the _____ hours from ______to ______centre agrees to pay the employee for the session. Rate of pay  The rate of pay can be described as an hourly rate or a per session rate The rate of pay should be the gross amount before tax is deducted. Date for Paid Coordinator to commence employment Name and contact details of applicant that the centre recommends for the position of Paid Coordinator.</p><p>Does the Centre feel that the applicant fulfils the requirements and has the knowledge and experience to fulfil the role. Please provide more than a yes/no answer. Are there any special conditions that the centre would like to offer to in relation to the employment of the applicant? Please provide details.</p><p>Are there any variations to the NSPA generic job description that are requested by the centre. Name of person, phone number and centre Name: position of the person responsible for orientation of and provision of ongoing Phone No. support for Paid Co-ordinator Centre Position:</p><p>On behalf of ...... Playcentre I confirm that: </p><p>The Request for a Paid Coordinator was discussed and agreed to at a Centre Meeting held on </p><p>………………………………………(date) Name of person/s completing the application: ______</p><p>Signed by: ______(Name)______President</p><p>Completed forms should be sent to Headquarters, one week prior to Management Team Meetings.</p>