2015 Application for Accreditation As an Experienced Teacher

2015 APPLICATION FOR ACCREDITATION AS AN EXPERIENCED TEACHER

Pilot Action Research Project

ELECTRONIC APPLICATIONS ONLY WILL BE ACCEPTED

Eligibility

·  It is important that before you begin completing this application form that you check your eligibility. Eligibility requirements are detailed in the Experienced Teacher Information Brochure.

Closing Date for applications

·  The closing date for this application form is:

Friday 11th April 2014

·  Application forms must be scanned as a PDF and emailed to the ISTAA Office:

Joanne Chislett

Processing of your Application Form

·  Incomplete application forms will not be processed. Use the checklist to make sure you have completed the form correctly.

·  Do not send the application fee with your application form.

·  Your eligibility will be checked by the ISTAA Office. If there are any discrepancies, the ISTAA Office will contact you for further clarification regarding your employment history or qualifications.

If you are eligible:

·  Once your application form has been processed, you will be sent an email confirming your eligibility. Contained in this email will be your ISTAA number. It is important that you keep this in a safe place.

·  This email will also provide details of the Professional Support Session. Details of when and where the session is being held and how to register will be included in the email. Supervisors will also be required to attend.

If you are not eligible:

·  Your application form will be returned to your Head of School indicating the reason/s for your ineligibility.

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2015 APPLICATION FOR ACCREDITATION AT EXPERIENCED TEACHER LEVEL

Pilot Action Research Project

Complete this checklist before you submit it to the ISTAA Office.

I have carefully read and understand the Eligibility Requirements section of the Information Brochure.

I have provided Alternate Contact Details so that the ISTAA Office can contact me if I change schools.

My principal has sighted my academic qualifications and attested to my suitability to undertake a classroom based action research project to achieve accreditation at Experienced Teacher.

My principal has nominated and provided email and telephone contact details for a supervisor to support my accreditation at Experienced Teacher.

Relevant to NSW teachers who have completed Accreditation at Proficient Teacher
I have attached a completed copy of the final page of my Accreditation report for Professional Competence (Section 2).

I have provided all details of my employment as a teacher in the Teaching Employment History section.

I have provided my NSW Institute of Teachers number (if I have one) in Section 7.

I have provided my ISTAA number (if I have one) in Section 8.

I have provided my TQI number (if I have one) in Section 9.

I have signed and dated the Applicant’s Signature and Declaration section.

I have discussed my application with my Head of School and obtained their signature in the Head of the School’s Acknowledgement section.

Please include this checklist as the first page of your application.

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Office Use Only

ISTAA Number:______– ____

INDEPENDENT SCHOOLS TEACHER ACCREDITATION AUTHORITY

Application for accreditation as an Experienced Teacher 2015

Pilot Action Research Project

1.  NAME

Title: / Mr / Mrs / Ms / Miss / Dr / Reverend / Other:
Surname / Family Name:
Given Name:

2.  SCHOOL

Name:
Address:
Phone: / Fax:
Your School Email:
Name of Head of School:

3.  Alternative contact details

Residential Address:
Postcode:
Postal Address: / Postcode:
Phone: / Alternative Email:

4.  QUALIFICATIONS

Academic qualifications:

Institution/s / Qualification/s / Teaching Methods or Major/s / Year Commenced / Year Completed

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5.  TEACHING EMPLOYMENT HISTORY

Your eligibility for this level of accreditation is determined based on the number of years of teaching experience.

Please be specific in detailing your teaching employment history in schools only.

·  Part-time of casual teaching experience must be expressed as a fraction of the week

o  Eg: Four days per week would equate to .8

Happy Valley Grammar School / Lane Cove NSW / Music teacher / .8 / January 2008 / December 2008

·  Where you have been employed as a casual teacher directly for a school or on behalf of a school through an agency, the number of casual teaching days must be specified in the teaching load column

o  Eg:

Protocol Teachers / London, United Kingdom / Casual (Supply) Teacher / 62 days / 3 September 2009 / 19 December 2009

·  Where specifying the commencement and end dates for positions, please be as accurate as possible.

o  Eg: Date from – Beginning of Term 1, January 2010 Date to – End of Term 2, July 2010

Happy Valley Grammar School / Lane Cove NSW / Year 5 classroom teacher / Full-time / 27 January 2010 / Friday 2 July 2010
School Institute or
Employing Authority / State or Country / Position / Teaching Load
(Full-time or Fraction per week) / Date from
(Commencement date) / Date to
(End date)

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6.  CURRENT TEACHING ALLOCATION IN YOUR SCHOOL

It is important to be as specific as possible when detailing the subjects and classes you teach.

Primary ______

Early Stage 1 Stage 1 Stage 2 Stage 3 Subject Specific

Secondary

Stages 4 & 5 Subject/s taught ______

Stage 6 Subject/s taught ______

7.  BoSTES/NSW Institute of teachers

Please select:

I do not have a BoSTES/NSW Institute of Teachers number (Please proceed to section 9)

I do have a BoSTES/NSW Institute of Teachers number (Please complete details below and proceed to section 9):

Accreditation Number:
Date of Accreditation at the level of Professional Competence: / /
NB: This is the date your BoSTES/NSWIT Accreditation Report for Professional Competence is signed by the Head of School / dd/mm/yyyy
Last date of accreditation renewal: / /
dd/mm/yyyy

8. ACT TEACHERS ONLY

My TQI number is ______

9.  independent schools teacher accreditation authority

Please select one of the two options:

I do not have an ISTAA number

I do have an ISTAA number (Please complete details below):

ISTAA Number:
Date of Accreditation at the level of Proficient Teacher: / /
dd/mm/yyyy
Last date of accreditation renewal: / /
dd/mm/yyyy

Applicant’s signature and declaration

I, / (Full name of applicant)
declare that the information I have provided in this application is true to the best of my knowledge and belief.
Applicant’s signature: / Date: /
dd/mm/yyyy

head of school’s Nomination

I, / (Full name of Head of School),
being the Head of the School at / (School)
declare that / (Applicant Name)
is currently teaching at the aforementioned school and I am aware that he/she is applying to undertake the process of accreditation for Experienced Teacher as part of the 2015 pilot project.
The applicant has demonstrated initiative and time management skills and has the capacity and commitment to conduct an action research project. I have discussed the pilot project with the applicant and he/she has agreed to participate.
I confirm I have sighted the applicant’s qualifications and they match the list on page 2 of this application
I nominate (Name of supervisor) ______who will support the applicant through the accreditation process. The supervisor will attend all of the nominated professional support sessions.
Email contact: ______Telephone contact:______
I understand that the application fee for (name of teacher) will be covered by the Experienced Teacher 2015 Pilot Project school grant.
I acknowledge that if the applicant transfers to the mainstream Experienced Teacher process or withdraws and then reapplies for accreditation at a later date, the application fee will need to be paid to ISTAA.
Head of School’s signature: / Date: /
dd/mm/yyyy

Applications should be scanned and emailed to Joanne Chislett

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