These Can Be Provided Later, Directly to Your Exchange Partner

Commonwealth Teacher Exchange Programme

2015 – 2016

INFORMATION

Please do not include any additional information (leaflets or booklets) about your school or area.

These can be provided later, directly to your exchange partner.

You need to supply a two-page photomontage of your home (or other accommodation). This should comprise digital photos onno more than 2 sheets of A4.

A copy of the floor plan of the exchange accommodation.

A photomontage or your school/classrooms – no more than 1 sheet of A4.

Copies of your qualifications to teach such as your PGCE qualification, university degree, any diplomas etc.

A profile picture of yourself.

Email the complete application form to needs to reach CYEC/RCS by Friday 16th January 2015 in order to meet the recommended first round of matching – submit your application as soon as you are ready. A second application round will close in mid-March 2015.

Please also send by post a hard copy of the signed, completed application form and include a cheque for the non-refundable registration fee - your £100 cheque should be made payable to ‘Royal Commonwealth Society’. Please also post both the application form and your cheque to:

Commonwealth Teacher Exchange Programme

c/o The Royal Commonwealth Society, Award House

7-11 St Matthew Street, London SW1P 2JT

EXCHANGE DESTINATION: AUSTRALIA OR CANADA OR EITHER?

If you have a preference for a particular province/state in Canada or Australia please indicate. However, please note that restricting your destination preferences reduces the possibility of gaining an exchange placement.

1st Choice
2nd Choice
Duration

Please tick preference for locality of exchange:

Metropolitan City Rural

If you already have located a potential exchange counterpart, please provide details:

Name: / State, Country, School:

PERSONAL DETAILS (Please ensure that your name is exactly as it appears on your passport)

Teacher Registration Number:
Citizenship:
Title: / First Name: / Middle Name: / Surname: / DOB:
Home Address and Post Code:
Local Authority: / Home Number: / Mobile Number:
Email (one that is checked regularly):
Marital Status: married/Civil partnership single other
Religious Affiliation(some overseas denominational schools will only consider exchange participants of a particular faith or denomination):
Locality of your home: Central city Suburb
Country town Rural
Number of bedrooms in your home: / Number of bedrooms required:

Details of Accompanying Spouse/Partner and Children:

Name as Appears on Passport / Relationship to You / Date of Birth / Occupation

SCHOOL INFORMATION

School Name:
Address: / Classification (primary, secondary, special etc): / Status (state, independent, church,etc): / Local Authority:
Telephone: / Fax Number: / Website:
Headteacher Name: / Headteacher email: / Head of Department:
Number of students: / Number of teaching staff: / Number of support staff: / Number of staff in department:

Please give the term dates for your school or institution for the exchange period (generally Sept-Sept for exchanges to Canada and Jan-Jan for exchanges to Australia).

Term 1
Term 2
Term 3

Date of the most recent OFSTEAD/HMI inspection:

Has OFSTED rated your school as being in:

Special measures
Serious difficulties
Given ‘notice to improve’

Do you expect your next OFSTED report to result in any of the above categories? YES/ NO

Is an HMI inspection due in the anticipated exchange period? (Scottish applicants only)

SUMMARY CURRENT POSITION DETAILS:

Current position title:
(classroom teacher, deputy head teacher, principal etc)
Subject(s)you currently teach/description: / Year Group/Exam Level (as applicable):
Student Age Range:
Subject/s you are willing to teach (if different from above): / Year Group/Exam Level (as applicable):
Student Age Range:
Subject/s the exchange partner will be expected to teach: / Year Group/Exam Level (as applicable):
Student Age Range:
Summary explanation of your current position to assist in understanding of your role:

Do you hold any positions of responsibility or any extra-curricula roles? If yes, will your exchange partner be expected to take on this role(s)?

CHILD PROTECTION

Have you ever been convicted of a criminal offence or are there any proceedings pending against you?

Yes / No

If yes, please specify the nature and date of the conviction/s and sentence/s:

What was the date of your last police check or Disclosure and Barring Service/Disclosure Scotlandcheck? Please give reference number, results of check or disclosure below:

All exchange participants must obtain a clear DBS/Disclosure Scotland check that is no more than five months old upon arrival in the exchange country. Exchange participants should apply for this once their exchange has been fully confirmed.

Does your school have any current or previous international links? Please give details:

Have you or anyone in your school previously participated in a CYEC, LECT, Fulbright or British Council programme or undertaken work overseas? Please give details:

EMPLOYMENT HISTORY (please start with current position)

Institution / Position / Subject / AgeRange / Dates

ACADEMIC AND PROFESSIONAL QUALIFICATIONS (please start with most recent and include CPD as appropriate)

Qualification / Course / Subjects / Institution / Awarding Body / Dates

ACCOMMODATION DETAILS

It is a condition of exchange that you must agree either to exchange your own accommodation or provide alternative rented accommodation for your exchange partner and their accompanying family members for the duration of the exchange period. It is essential that your exchange partner has sole occupancy of accommodation and that the property is clean and suitably equipped.

I wish to exchange my current home with my exchange partner

I will not exchange my current home with my exchange partner but will find appropriate accommodation in the locality

Type of Accommodation (please tick):

Detached house Semi-detached house Terraced house

Flat/apartment Owned Rented

Is the accommodation shared?Yes / No

If yes, will alternative accommodation be arranged if your exchange partner will not accept shared accommodation?

Kitchen Dining room Living room Family room

Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4

double/single double/single double/single double/single

Study Laundry Bathroom 1 Bathroom 2

Other, please give details:

Description of Appliances (please tick):

Stove / grill Oven Microwave Fridge

Freezer Dishwasher Washing machine Tumble dryer

Television Radio Video/DVD Stereo

ComputerInternet/Broadband Other:

Please describe the facilities for water and heating:

Special Conditions (please delete as necessary):

Are you or anyone accompanying you a smoker?Yes / No

If yes, would you be prepared to refrain from smokingYes / No

in a non-smoking household?

Would you be prepared to have smokers living in your home?Yes / No

Do you have any pets requiring care from your exchange partner?Yes / No

If yes, please give details:

HOME LOCATION

Distance of your accommodation from the nearest major city (miles & km):

Distance from your workplace (miles & km):

How do you travel from your accommodation to your workplace and what is the approximate weekly cost?

Please give details of local schools likely to be attended by an exchange partner’s children, including distances from your accommodation:

Personal/Family Profile

Provide details to help your prospective exchange partner to form a picture of the sort of person/family you are. Include community/cultural or recreational interests and relevant abilities or disabilities that may need to be catered for during the exchange period:

Professional Profile (continue on a separate sheet if necessary)

Use this space to provide a detailed explanation of:

a)Your current position (to assist your exchange school/partner in understanding your role)

b)Your particular skills and abilities as a teacher

c)Your professional interests, membership of professional organisations, any extra-curricular involvement etc.

(Remember that this is like a job application and will be assessed by your prospective Principal overseas).

School Profile (continue on a separate sheet if necessary)

Provide information about:

a)Percentage of students with English as an additional language

b)Socio-economic profile

c)How students are grouped for teaching and pastoral care

d)School facilities

e)Daily organisation of school

f)School philosophy

SUPPORTING STATEMENT

Please describe your expectations for undertaking an exchange, including:

a)How you expect the visit to benefit your professional development and your school

b)Any special interests you wish to pursue whilst overseas

c)How you intend to prepare for the exchange

d)How you intend to disseminate your learning within and outside your institution

Please give details of the exchange locality

a)Estimated population

b)Geography

c)Access to airports and other transport methods

d)Useful/informative websites

Emergency Contact

Please nominate an individual who is authorised to act on your behalf in any emergency while you are overseas. Ideally s/he should live close to your home.

Name:
Relationship to You:
Home Address:
Telephone and Mobile:
Email:

MEDICAL DECLARATION

I confirm that I am not aware of any medical issues concerning myself or my accompanying family members that may have an impact on the exchange.

(If you are not able to sign this declaration, and either you or members of your family have medical issues which may impact on the exchange, please give details on a separate and in confidence sheet which you may enclose in a sealed envelope).

(please tick)

Please note that immigration authorities may require applicants and accompanying family members to undergo a medical examination with a nominated doctor before issuing visas. There is a charge for this (up to £200 per adult and £50 per child).

APPLICANT’S DECLARATION

Please sign the application form below. Your signature should be witnessed by your Headteacher by signing the declaration of support.

I have read and understood ALL of the information in the Commonwealth Teacher Exchange Guidance Notes and Teacher Exchange Application Form 2015/16. I agree that:

The information I have supplied in my application is accurate.
I have been teaching for at least five (5) years and I am still currently working.
I am of good character.
I make a firm commitment to completing any exchange I accept.
I will not be eligible to apply for leave, transfer or promotion, once an exchange has been confirmed and accepted by me, which would prevent the exchange commencing or continuing. (Note: leave, transfers or promotions will only take effect upon return from an exchange).

During the exchange, I remain an employee of my school in the UK, retaining normal rights, privileges and obligations.

Upon my return from the exchange, I will resume duty with my school in the UK and work for at least one school term.
Where spouses/partners apply for exchange, the success of one application does not automatically ensure the success of the partner.

I understand that to participate in an exchange I must be in satisfactory health. I will undergo a complete medical at my own cost, if I am requested to do so prior to the exchange.
I am responsible for all health and medical expenses, and any medical insurance required for me and dependants whilst I am on exchange.
My employing school will pay my salary for the exchange period with any usual contributions or authorised deductions continuing during the exchange (subject to the continuation of satisfactory service).
I am responsible for all expenses involved in the exchange.
I will be covered by Employer’s Liability Insurance whilst on the exchange.
During the exchange, I will work full-time under the conditions of the host authority and abide by the instructions of the host Principal in matters relating to school management.
I will be entitled to recreation/holiday leave according to the normal provisions of the host authority. I will be entitled to all other leave according to the agreement between the host authority and the Department.
I understand that I can only take leave during the designated vacation/holiday periods of the host school.
The duration of the exchange is a one year period (unless agreed otherwise), commencing and concluding on the dates specified by the respective education authorities. Extensions will not be approved.
I must remain in the exchange school for the entire duration of the exchange.
If I return to the UK prior to the completion of the exchange (with or without approval), I will not be able to return to my substantive position or accommodation until the agreed arrangement with my exchange partner is completed.
If I do not complete the exchange, I will be responsible for any expenses incurred by myself or the host school as a result.

It is my responsibility to negotiate a mutually satisfactory arrangement in regard to accommodation with my exchange partner.
I am responsible for all travel arrangements for myself and dependants and associated costs.
I have a responsibility to plan and organise appropriate professional and personal support for my exchange partner.
Prior to departure, I will attend the compulsory Pre-exchange meeting, arranged by the Commonwealth Youth Exchange Council (CYEC)/Royal Commonwealth Society.

I will notify CYEC/RCSof any change that may affect my application, e.g. employment location, accommodation, marital status, health etc.
I will inform CYEC/RCS of any matters/issues relating to my confirmed exchange as they may arise. This includes maintaining regular contact during the exchange via email and updating contact details etc.

Signed:Date:

HEADTEACHER’S DECLARATION OF SUPPORT

I, ______Headteacher of ______endorse the application of ______

I confirm that I have read the supporting information and am in full support of the applicant’s participation in the exchange programme, and:

affirm to their suitability to represent the school while on exchange;

confirm that I have read and discussed with the applicant the Commonwealth Teacher Exchange Guidance Notes 2015/16;
agree to accept on staff, a suitable exchange replacement during the term of the exchange;
agree to provide the school support required for the incoming exchange teacher for the duration of the assignment;
agree to provide the incoming exchange teacher with the same level of professional learning and support as applies to all other teachers/staff within the school, including relief where necessary;
agree to provide a substitute/supply teacher for:

the release of my school’s outgoing exchange teacher to attend the CYEC/RCS’s pre-exchange meeting; and

the release of the overseas incoming exchange teacher to attend the CYEC/RCS’s induction meeting.

agree to liaise with CYEC/RCS on allexchange teacher related matters, including performance issues before and during the exchange.

Name:

Signature:Date:

Application checklist

Applicant to check () all sections to ensure completion and attach this checklist to the front of your application.

() / Item / Action
Programme Information and Guidelines / Read carefully and understand all requirements. Check with the Commonwealth Youth Exchange Council/RCS (if necessary).
Application details / Completed accurately and fully; preferably word processed or typed.
Duration and location preferences / Indicate preferences clearly and do not indicate a location that you are not willing to exchange to.
Photographs / Take and attach photographs of your accommodation on no more than 2 A4 sheets. DO NOT SEND LOOSE PHOTOS.
Attach a passport-sized photo of yourself.
Floor Plan / Attach a sketch of your accommodation floor plan. Please give approximate dimensions.
Applicant declaration of agreement / Ensure that you have read and fully understood the Commonwealth Teacher Exchange Guidance Notes2015-16before signing the agreement.
Head Teacher’s endorsement / Discuss the endorsement with your Headteacher and ensure that it is signed.
Application form / Email the completed application form to . It needs to reach CYEC by Friday 16th January2015for the first matching round – submit as soon as you are ready. A second round will close in the middle of March 2015, but you are advised to submit as early as possible.
Please send by post a hard copy of the completed application form and include a cheque for the non- refundable registration fee - your £100 cheque should be made payable to ‘Royal Commonwealth Society’. Please post both the application form and cheque to:
Commonwealth Teacher Exchange Programme
c/o Royal CommonwealthSociety(RCS)
Award House, 7-11 St Matthew Street
London SW1P 2JT

CYEC/RCSSurvey Sheet

We would be grateful if you would complete this survey sheet to assist us in monitoring equal opportunities. The information in this form will be detached from the rest of your application and will not be used in any selection process. Please tick applicable boxes.

1. How did you find out about the Commonwealth Teacher Exchange Programme?

Previous participantCYEC Website RCS Website Web research

Local Authority Colleague Other (please state):

Please look at the descriptions of race or ethnic origin listed below and tick the one box that most accurately describes you. If you tick one of the 'other' boxes, please specify.

WHITEBLACKASIANMIXED HERITAGE

English Caribbean Indian White/Black Caribbean

Scottish African Pakistani White/Black African

Welsh Bangladeshi Chinese White/Asian

Irish Other Japanese Other

Other: Other

Other Ethnic Group:

3. Please indicate your gender.

Male Female

4. To which age bracket do you belong?

22-25 26-35 36-4546-55 Over 55

5. How many years teaching experience do you have?

6. Do you consider yourself to have a disability?

Yes No

7. Please indicate the area in the UK where you are employed:

EnglandScotlandWalesNorthern Ireland

Thank you for your assistance in completing this survey sheet.