Amy Levai Aboriginal Teaching Scholarship – pre-service application

If you have any questions throughout the application process, please call 8226 1456 or email application must be submitted electronically.

Eligibility checklist
☐ / I am enrolled in a teacher education programor have applied to commence in the following year.
☐ / I am a South Australianresident.
☐ / I can provide verification of Australian Aboriginal and/or Torres Strait Islander heritage via a document executed by an Aboriginal or Torres Strait Islander organisation and endorsed with a Common Seal.
*If you are a current Department for Education employee, log on to LearnLink for Tailored Support Package application (includes application for the Amy Levai Aboriginal Teaching Scholarship).

Section 1: personal details

Family name: / Click here to enter text. / Given name: / Click here to enter text. /
Date of birth: / Click here to enter text. / Gender: / ☐ Female☐ Male
Home phone: / Click here to enter text. / Mobile phone: / Click here to enter text. /
Home address: / Click here to enter text. /
Suburb/Town: / Click here to enter text. / Postcode: / Click here to enter text. /
Postal address: / Click here to enter text. /
Suburb/Town: / Click here to enter text. / Postcode: / Click here to enter text. /
Email address: / Click here to enter text. /
/ Attach a copy of your birth certificate.

Section 2: verification of Australian Aboriginal heritage

To be eligible you must be Australian Aboriginal and/or Torres Strait Islander.
Indicate your heritage: / Choose an item. /
/ Attach a copy of your verification of Aboriginal and/or Torres Strait Islander heritage.
Ensure this is a document executed by an Aboriginal or Torres Strait Islander Organisation and endorsed with a Common Seal.

Section 3: academic details

Indicate your current tertiary academic status.
☐I am enrolled in a teacher education program.
☐I have applied to commence in a teacher education program next year.
Insert the teacher education program you are currently enrolled in or the program/s for which you intend to enrol (in priority order).
Program name / Tertiary institution / Expected completion (MM/YYYY)
Click here to enter text. / Click here to enter text. / Click here to enter text. /
Click here to enter text. / Click here to enter text. / Click here to enter text. /
Click here to enter text. / Click here to enter text. / Click here to enter text. /
/ Attacha copy of your SATAC letter (or send when available)
or
Attach copies of all your academic transcripts and professional experience reports to date
Indicate your study load / ☐ Full time ☐ Part time
If part time, indicate how many units/subjects you intend to study per semester. / Click here to enter text.units per semester
I have checked with the Teachers Registration Board of South Australia and confirm my teacher education program will meet the requirements for teacher registration in South Australia. / ☐ Yes

Section 4: level of schooling

Indicate the level/s of schooling you will be qualified to teach as identified by the program you are, or will be studying.
☐Secondary (Year 8-12) / ☐Middle/Secondary (Year 6-12) / ☐Middle School (Year 6-9)
☐Primary/Middle (Year 3-9) / ☐Primary (Year 3-7) / ☐Junior Primary/Primary(Year R-7)
☐Junior Primary (Year R-2) / ☐Early Childhood (B-8 years, inclusive of preschool and junior primary) / ☐Other(please elaborate) Click here to enter text.

Section 5: teaching subjects (secondary and/or middle school)

Complete this section only if you have indicated you will qualify to teach secondary and/or middle school.
  • To increase your employability as a teacher with the Department for Education, it is strongly recommended that your subject major and minor come from two different domains/teaching areas as identified in theteaching subject and skill code.
  • Employability is determined by the way schools describe teacher vacancies, with the most common preference for two different domains/teaching areas.
  • Not all subjects included in teacher education programs correspond with specific subjects taught in schools. While it is good to study subject areas of interest, participation in the scholarship program requires that you maximise your employability. If you are unsure whether your subject choices align with Department for Education teaching subjects, contact 8226 1456 or to discuss.
  • Studying in one domain/teaching area only may influence your scholarship eligibility. Applications will be assessed on an individual basis taking into consideration how your subject choices align with Department for Education teaching subjects.

Indicate below:
  • the subjects you are studying or intend to study in your teacher education course
  • the level of your study in each area and alignment with Department for Education domains/subjects (refer to theteaching subject and skill code)
Major (minimum of 6 x semester courses in a specialist subject) will allow you to teach to Year 12; or
Minor (minimum of 4 x semester courses in a specialist subject) will allow you to teach to Year 10
Domain:Click here to enter text.Subject:Click here to enter text.
☐Major (to Year 12) OR ☐Minor (to Year 10)
Domain:Click here to enter text.Subject:Click here to enter text.
☐Major (to Year 12) OR ☐Minor (to Year 10)
Domain:Click here to enter text.Subject:Click here to enter text.
☐Major (to Year 12) OR ☐Minor (to Year 10)

Section 6: location preferences

In South Australia all Department for Education schools and preschools are grouped under 30 portfolios. Each portfolio consists of 1, 2 or 3 partnerships. Local partnerships are geographical localities consisting of schools and preschools within close proximity.
There are opportunities for employment in metropolitan and country locations.
Employment through the scholarship program requires you to include all metropolitan portfolios in priority order and /or a minimum of 2 country Portfolios (3 if you include Gawler 2)
For example, the preferences displayed from the dropdown list illustrate the portfolio name and then in brackets the partnerships within the portfolio. E.g. “Country - Berri (Berri & Barmera, Renmark Loxton)”.
1 / Click to select preference /
2 / Click to select preference /
3 / Click to select preference /
4 / Click to select preference /
5 / Click to select preference /
6 / Click to select preference /
7 / Click to select preference /
8 / Click to select preference /
9 / Click to select preference /
10 / Click to select preference /

Section 7: employment history

Complete details of previous employment (if applicable).
Employer / Permanent/temporary / Employment dates
Click here to enter text. / Click here to enter text. / Click here to enter text. /
Click here to enter text. / Click here to enter text. / Click here to enter text. /
Click here to enter text. / Click here to enter text. / Click here to enter text. /

Section 8a: referees

Provide details of two referees.
Year 12 students: your referees must be your current secondary teachers.
Other: your referees must be able to provide comment on your capabilities and commitment to becoming a teacher. For current university students this may (if applicable) include a university supervisor or professional experience supervisor.
Your first referee is required to provide a statement in support of your application.
Referee 1 / Referee 2
Name: / Click here to enter text. / Name: / Click here to enter text. /
Position held: / Click here to enter text. / Position held: / Click here to enter text. /
Organisation: / Click here to enter text. / Organisation: / Click here to enter text. /
Relationship to applicant: / Click here to enter text. / Relationship to applicant: / Click here to enter text. /
Telephone: / Click here to enter text. / Telephone: / Click here to enter text. /
Email: / Click here to enter text. / Email: / Click here to enter text. /

Section 8b: referee 1 statement

Please discuss your comments with the applicant.
Provide comments relating to the applicant’s personal skills, ability and commitment to becoming a teacher.
Click here to enter text.
Referee Signature: / Date:
Referee Name: / Click here to enter text. /
For any queries, call8226 1456, or

Section 9: applicant’s supporting statement

Maximum length of one A4 page only.
Please outline your commitment to becoming a teacher in the public education system (include skills and strengths that you would bring to a public school and the local school community).
Click here to enter text.

Section 10: applicant meeting

In support of your application, a meeting will be arranged with you and the project manager.
I accept this requirement / ☐ Yes

Section 11: other information

/ All questions must be answered (YES or NO) in this section.
If you answer YES to any of the below questions, you are obliged to provide comprehensive supporting details, including any relevant documentation. Provide full details, including dates on a separate sheet marked ‘Confidential’. Please note that these are the same questions asked of all teachers seeking employment with the Department for Education.
In the event that any further medical information is required, you may be invited to provide management in Department for Educationwith authority to seek medical information from any treating medical practitioner/s or from an independent medical practitioner/s. You will be personally liable for any cost associated with ascertaining any further medical information.
Please note that answering YES to any question, does not automatically exclude you from being considered for inclusion in an Aboriginal Teacher Employment Program.
  1. Do you currently have any medical condition or disability (including learning disability) which might prevent or impede you from being able to satisfactorily perform any duties or functions that might be reasonably required of you in a teaching role?
Please Note: If yes or unsure, please provide details (include details ofany medications/ assistance/ adjustments that may reasonably berequired so that you can perform the inherent requirements of teaching).Please note: you may be required to participate in a medical and/orfunctional capacity assessment (at your own cost) in order to assist inassessing your suitability to be offered employment in the role andSouth Australian public sector. If you do not agree to participate, you will not be considered for a teaching scholarship / ☐ Yes☐ No
  1. Have you ever been investigated or found guilty of any criminal offence, including any traffic offences not resolved by expiation?
/ ☐ Yes☐ No
  1. Have you ever been the subject of allegations of conduct by you towards a child (Person under 18 years of age) that if proven would have amounted to criminal conduct or would have constituted misconduct in an employment setting?
/ ☐ Yes☐ No
  1. Are you currently facing criminal charges yet to be determined?
/ ☐ Yes☐ No
  1. Has your employment been terminated by any organisation, including a South Australian public sector agency, for any reason?
/ ☐ Yes☐ No
  1. Have you been the subject of allegations or an investigation or any other process relating to alleged unsatisfactory performance or misconduct by you as an employee?
/ ☐ Yes☐ No
  1. Are you currently, the subject of an investigation or any other process relating to suspected or alleged misconduct or other unsatisfactory performance by you?
/ ☐ Yes☐ No
  1. Have you ever received any voluntary early retirement or voluntary separation package from employment in the South Australian public sector, including accepting a ‘Change in Direction’ or ‘Teacher Renewal’ incentive payment?
/ ☐ Yes☐ No
  1. Have you resigned from employment in the South Australian Public Sector or private employer upon the redemption of workers compensation entitlements?
/ ☐ Yes☐ No
Are you currently in receipt of funds from any otherDepartment for Education, State Government or Australian Government scholarship? / ☐ Yes☐ No
If yes, please provide details: Click here to enter text.
How did you find out about the Amy Levai Aboriginal Teaching Scholarship?
Click here to enter text. /

Section 12: applicant declaration

I confirm and declare that to the best of my knowledge, the information in this application is true and correct and acknowledge that any wilful suppression or inaccuracy may render me ineligible for consideration or inclusion in thescholarship program.
I understand that information provided by me will be available to Department for Education staff for the purpose of identifying successful applicants.
If I am successful, I agree to abide by the contractual agreement and accept that any employment gained following the successful completion of a teacher education program, will be in accordance with employment conditions stated in relevantDepartment for Education policies and procedures.
Applicant’s signature: / Date://
Parent/Guardian
(if under 18 years) / Date://
Please provide any additional comments in support of your application.
Click here to enter text.
APPLICATION CHECKLIST
☐ / I have completed all sections of the application including the Supporting Statement (Section 9).
☐ / My first referee has provided a statement in support of my application (Section 8b).
☐ / I have advised both referees they may be contacted.
☐ / I have retained a copy of this application for my records.
DOCUMENT CHECKLIST
/ It is essential ALL relevant paperwork is attached to your application.
☐ / Birth certificate
☐ / Verification of Aboriginal and/or Torres Strait Islander heritage (document endorsed with a Common Seal by an Aboriginal or Torres Strait Islander Organisation).
☐ / SATAC letter (this relates to your official acceptance into a teacher education program and can be submitted once you have been accepted into a program).
Please indicate your status if this is not attached.
Click here to enter text.
☐ / SATAC results and/or academic transcripts of all current and completed studies
☐ / Professional Experience reports (for students who have undertaken professional experience placements experience/s as part of their teacher education program).

Applications can be submitted at any time; however, students applying for the scholarship in their final year of an initial teacher education program must submit an application by 30June of that year.

Complete and forward your application, along with scanned attachments .

Further information direct enquiries to:

Phone:8226 1456

Email:

1| Amy Levai Aboriginal teaching scholarship application | August 2018