TEACHERS PROFESSIONAL EXCHANGE PROGRAM

TEACHERS PROFESSIONAL EXCHANGE PROGRAM APPLICATION FORM Use the guidelines Teachers Professional Exchange Program to help prepare this application. Your application needs to be received by School Recruitment, People and Careers by end Term 3 to ensure it is finalised in Term 4 of the year preceding the exchange. Both teachers applying for exchange will need to complete this form. The principal of each teacher will need to endorse the application. The Director of Public Schools, NSW will need to endorse the application. If another principals network group is involved, both Directors will need to endorse the application. PART 1: APPLICANT DETAILS TEACHER 1 DEC ID Title Mr Mrs Ms Other, please specify Family name Given name/s Current school appointed Name of Principal For new scheme teachers only: Professional Competence was achieved Current teaching load and school responsibilities Reason for seeking exchange Include information about how this professional exchange would benefit your professional development Declaration I certify that the information I have provided on this form is accurate and complete. In applying for this professional exchange I accept the conditions of exchange described in the program guidelines. Applicant s signature 1

PART 2: APPLICANT DETAILS TEACHER 2 DEC ID Title Mr Mrs Ms Other, please specify Family name Given name/s Current school appointed Name of Principal For new scheme teachers only: Professional Competence was achieved Current teaching load and school responsibilities Reason for seeking exchange Include information about how this professional exchange would benefit your professional development Declaration I certify that the information I have provided on this form is accurate and complete. In applying for this professional exchange I accept the conditions of exchange described in the program guidelines. Applicant s signature 2

PART 3: PRINCIPAL S ENDORSEMENT FOR TEACHER 1 I confirm that in my professional judgement, this teacher s current teaching load and school responsibilities as described are accurate. I confirm that this teacher meets the criteria for a one year teacher professional exchange. Principal s comment on the suitability of the teacher to undertake a one year professional exchange Principal s printed name Principal s signature PART 4: PRINCIPAL S ENDORSEMENT FOR TEACHER 2 I confirm that in my professional judgement, this teacher s current teaching load and school responsibilities as described are accurate. I confirm that this teacher meets the criteria for a one year teacher professional exchange. Principal s comment on the suitability of the teacher to undertake a one year professional exchange Principal s printed name Principal s signature 3

PART 5: DIRECTOR OF PUBLIC SCHOOLS, NSW CONFIRMATION OF EXCHANGE I confirm that the teachers named above meet the criteria for a one year teacher professional exchange. I endorse the exchange to take place for the school year. Director s comment Director's printed name Director's signature Complete this section if the exchange is to take place in more than one principals network group PART 6: SECOND DIRECTOR'S CONFIRMATION OF EXCHANGE I confirm that the teachers named above meet the criteria for a one year teacher professional exchange. I endorse the exchange to take place for the school year. Director s comment Director's printed name Director's signature To the Director: Please return this form to Teacher 1 after keeping a copy for your records. Teacher 1 will forward a copy to: Teacher 2 each principal the other Director (if applicable), and a scanned copy to SchoolRecruitment@det.nsw.edu.au Attention: Geetha Sivaramakrishnan 4

CHECKLIST FOR PRINCIPALS Before confirming this application, please ensure that you: review the guidelines Teachers Professional Exchange Program to ensure the applicant meets the criteria review the applicant s description of teaching experience at your school against your records check that if the applicant is a new scheme teacher, they have achieved Professional Competence in their initial teaching area return the application form to the teacher after completion so that both principals involved have the opportunity to complete the form inform the Director of Public Schools, NSW of the application and forward it to the Director if asked to do so advise the applicant to make copies of their final completed application: one for each teacher; one for each principal; one for the Director of Public Schools, NSW; one for the other Director (if applicable); and a scanned copy to: SchoolRecruitment@det.nsw.edu.au Attention: Geetha Sivaramakrishnan CHECKLIST FOR APPLICANTS In submitting your application, please ensure you: use the guidelines Teachers Professional Exchange Program to ensure that you meet the criteria seek the support of your principal by discussing your intention to apply well before submitting the form clearly and comprehensively describe your teaching experience and expertise ensure that the confirmed application is forwarded to the Director of Public Schools, NSW make a copy of your completed application for your own records make copies of the completed application and ensure that both teachers, both principals and the School Education Director/s has a copy forward a scanned copy of the completed form to SchoolRecruitment@det.nsw.edu.au Attention: Geetha Sivaramakrishnan 5