PRIVACY:The Department of Education,Training and Employment (DETE)iscollecting personalinformation onthisform tofacilitatemanagementofpotential conflictsofinterest from secondaryemploymentin accordance withthe DETE Standard ofPractice.Theinformation willbe collected andsecurelystoredincompliance withtheInformation PrivacyAct2009withintherelevantCentralOffice,RegionalOffice,DistrictOffice or school.Theinformation maybe disclosed tothird partiesincluding GovernmentSuperannuation Office,Australian Taxation Office,Queensland College ofTeachers,Departmentof Justice and Attorney-General, Industrial organisationsorotherentitiesin accordance with orwhererequested bylaw orindustrialinstrument.
New notification Changeof existingnotification
(A new notificationisalsorequired upontransfer to anotherlocation within DETE)
Thisformmustbecompletedwithin14calendardaysofundertakingotheremployment(i.e.anyadditionalpaidemploymentperformed byapublicserviceemployeewithinthepublicserviceorelsewhere)shouldengagingin theotheremploymentlessenorhavethe potentialtolessenpublicconfidencein theintegrityofpublicadministration;or
  1. beorhavethepotentialtobe,aconflictofinterest, realorapparent,in relationtotheemployee’semploymentwithinDETE; or
  2. impactorhavethepotentialtoimpactadverselyontheemployee’sability,healthorwell-beingtosafelyandeffectivelycarry-out theirofficialdutieswithinDETE;or
  3. compromiseorhavethepotentialtocompromisetheintegrityoftheemployingdepartmentorto reflectseriouslyandadversely onDETE;or
  4. resultin orhavethepotentialto resultin themisuseofinformation,intellectualorphysicalproperty,orotherpublicresourcesof DETE.
Employeesaretonotifythedepartmentofanyneworactualchangein thenatureofanyotheremploymentin whichtheyareengaged within14calendardaysif thatnewormaterialchangeiscoveredbytheprinciplesabove.
Shouldit becomeknownthatanemployeeisengagedin otheremploymentandhasfailedtonotifythedepartmentin accordancewiththe above;theemployeemaybedirectedtodeclaredetailsoftheotheremployment.Theemployeeisthenrequiredto resolvetheconcernsin favourofthedepartmentwithin14calendardays.
Penaltiesfornon-disclosuremayresultin disciplinaryaction.
Public ServiceAct 2008
Code of Conduct fortheQueenslandPublic Service
DETE Standard of Practice
EMPLOYEE DETAILS:
Employee Number: / Title: (e.g. Mr/Mrs/Ms/Miss/Dr)
Surname: / Given Names:
Date of Birth:// / Telephone Number:
Address:
Post Code:
DETE-EMPLOYMENT DETAILS
Position Title: / Numberof hours perweek:
Position Location: / Location Code:
Hours of Work: (e.g. 9am– 2pm)Permanent/Temporary/ Casual
Off WeekPay Week
Mon / Tue / Wed / Thu / Fri / Mon / Tue / Wed / Thu / Fri
OTHER EMPLOYEMENT DETAILS:
Position Title: / Location Code:
Position Location: / Location Code:
Hours of Work: (e.g. 9am – 2pm)
Off Week / Permanent / Temporary / Casual
Pay Week
Outline the nature of employment and duties to be performed:
(attach additional page if required)
Period of Employment: from / / to / / or Continuous 
EMPLOYEE CERTIFICATION:
I certify that the above information is correct. Regardless of any commitments to other employers, it is expected that I will be able to perform my job in DETE efficiently and effectively.
Employee’s signature: ______/ Date: ______
Employee’s name: ______/ Employee’s position title: ______
MANAGER / PRINCIPAL / DIRECTOR VALIDATION:
 Other employment is not considered a conflict of interest. If you have ticked this box, no further assessment or action is required.
 Other employment is considered a conflict of interest.
Reason: (record what action has been taken, including strategies agreed upon to manage the conflict of interest)
(Original form is to be kept on a file register in the relevant Unit, School, District or Region with a copy to be given to the employee and reviewed annually or sooner if required. The Ethical Standards Unit does not require a copy of this form unless further advice or assistance is required.)
Public ServiceAct 2008
Code of Conduct fortheQueenslandPublic Service
DETE Standard of Practice
Manager/Principal/Director signature: ______/ Date: ______
Manager/Principal/Director name: ______/ Position title: ______
ETHICAL STANDARDS UNIT
Please contact the Ethical Standards Unit ONLYif further advice or assistance is required to determine appropriate management action, or if the matter is to be escalated and assessed as possible misconduct.
 / Other employment is considered a conflict of interest. Ethical Standards Unit advice and assistance is required to determine the most appropriate management action.
Ethical Standards Unit advice to assist with management decision: ______
 / Escalated to the Ethical Standards Unit for further assessment of potential misconduct.
Signature: ______/ Date: ______
Name: ______/ Position title: ______