Expression of Interest in the Graduate Certificate in Tertiary Education

Expression of interest in the Graduate Certificate in Tertiary Education

Thank you for your interest in applying for the Graduate Certificate in Tertiary Education(ATHE) at Victoria University. Please email this completed Expression of Interest form to the Course Coordinator, Kaye Cleary, .

Section A – Personal Information

Title: / First name: / Last name:
Gender? / Male / Female / Date of birth: / Aboriginal or Torres Strait Islander? / Yes / No
Staff ID: / Student ID (if known):

Residency Status

Please note: if you hold a Student Visa, we are unable to accept you into this course.

☐ / Australian citizen / ☐ / New Zealand citizen / ☐ / Permanent resident
☐ / Visa holder (Please attach a scanned copy of your visa/passport)

Section B – Contact Information

Work phone: / Mobile phone: / Non-VUEmail address:

Mailing Address

No. and Street: / Suburb: / State and Postcode:

Section B – Teaching Role at VU

Please provide a 200-500 word statement of describing your current VU teaching role, (e.g. teacher, coordinator, tutor, demonstrator, guest lecturer, or other).

Please indicate how long you have had a teaching role in this sector.

Section C – Education Overview

What was the highest level of study prior to this course?

☐ Complete Higher Ed postgraduate level course
☐ Complete Higher Ed bachelor level course
☐ Complete Higher Ed sub-degree level course
☐ Incomplete Higher Ed postgraduate level course
☐ Complete VET award course
☐ Other qualification complete or incomplete / Year completed (or last year attempted):
Please list the award name and awarding institution,
e.g. Master of Business (Victoria University)

Section D – Additional Information and Lodging an Expression of Interest in the ATHE

For more information or to lodge an Expression of Interest, email the Course Coordinator, Kaye Cleary,.