Application Form 2014/15 Early Childhood Scholarships for Aboriginal People Personal Information Title: Family Name: Given Name(s): Date of Birth: / / Gender: Male Female Are you an Australian citizen or a permanent resident of Australia? Yes No Are you of Aboriginal and/or Torres Strait Islander origin? Yes No Do you speak a language other than English at home? Yes No No If yes, what language do you speak? Address and Contact Information Postal Address Address: Suburb: State: Postcode: Permanent Address Same as above Address: Suburb: State: Postcode: Home Telephone: Work Telephone: Mobile Telephone: Email Address: Please print clearly as you will be contacted via email Details of Current Employment Current Position Title (e.g. early childhood educator): What is your employment status: permanent full-time permanent part-time contract casual Name of Service: Service Telephone Number: Service Email Address: Service Address: Name and Title of Contact Person at your service (e.g. centre coordinator)
Application Form (cont.) Details of Employment What date did you commence your current position? How long have you worked in your current position? How many hours per week do you work at your current service? Over your entire working history, how long have you worked in the early childhood education and care sector? (number of years and months) Previous Academic Record Please provide a copy of your current contract of employment. What qualifications have you already attained? Please provide copies of academic transcripts for all qualifications you have already attained. Do not submit original documents as they will not be accepted. The Department will only accept copies of documents that have been certified by an authorised person. An academic transcript is an official document which states your course, subject and results. Copies of academic awards will also be accepted. Full Name of Qualification Duration Full Name of Institution State/ Country Date Commenced Study Date Completed Study Full or Part Time (FT/PT) Study Proposal Course Code: Course Title: What is the name of the registered training organisation or tertiary institution at which you will study? What is the commencement date of your course? What is the expected completion date of your course? What is your study load? Full Time Part Time What is your study mode? On Campus External Online What are your course fees for the entire course? $. 1 If you are completing a Certificate III, Certificate IV, Diploma or an Advanced Diploma, provide evidence of the total fees to complete your course in the form of a statement, receipt or letter from the registered training organisation. Application Form Page 2
Application Form (cont.) Employer Form If employed in a Victorian early childhood setting, applicants are required to provide a completed Employer Form. Your employer is required to indicate their support for your participation in the scheme. Applicants not employed in a Victorian early childhood setting are not required to submit an Employer Form. The Employer Form is available at http://www.education.vic.gov.au/about/careers/pages/aboriginal.aspx Other Funding Support Available If applicable, remember to also provide a copy of your current contract of employment. Have you received or applied for funding to complete your Yes No qualification from another source? If yes, please attach details. Have you received financial support from the Department in the past? Yes No If yes, please attach details. The support available to you will depend on the type of qualification you will undertake. Please complete the table below indicating the qualification you will be undertaking. Qualification (tick one only) Certificate III in Early Childhood Education and Care (Previously known as Certificate III in Children s Services) Certificate IV in School Age Education and Care (Previously known as Certificate IV in Outside School Hours Care) Diploma of Early Childhood Education and Care (Previously known as Diploma of Children s Services) Diploma of School Age Education and Care (Previously known as Diploma of Children s Services Outside School Hours Care) Support Available Scholarship (up to $1,500) Scholarship (up to $1,500) Scholarship (up to $3,500) Scholarship (up to $3,500) Advanced Diploma of Children s Services Scholarship (up to $3,500) Early Childhood Teaching Degree Scholarship (up to $12,000) 4 th Year of Early Childhood Teaching Degree Scholarship (up to $6,000) Postgraduate Scholarship (up to $7,500) I agree to have my name used in promotional material about the Early Childhood Scholarships for Aboriginal People. Yes No To the best of my knowledge the information I have provided is true and correct. I have read both the Fact Sheet and the Frequently Asked Questions document. I understand that support is allocated at the discretion of the Department of Education & Training and that the decision of the Department is final. Applicant Name: Signature: Date: Personal Statement Application Form Page 3
In the section below, please provide a personal statement outlining why you are applying for a scholarship. You will also need to demonstrate why you are interested in working in the Early Childhood Education and Care sector. Privacy Statement The personal information provided in this application form will be stored securely on the Department or Early Childhood Australia s property as required by the Public Records Act 1973 and the Information Privacy Act 2000. Please note that this application and any additional documentation will become the property of the Department of Education & Training and may not be returned. Early Childhood Australia are authorised to act as an agent on behalf of the Department to administer this scholarship scheme. The Department and Early Childhood Australia Victoria Branch will access your personal information for the purposes of allocating scholarships and the development of research based policy relating to the early childhood education and care sector. The Department s privacy policy can be accessed at http://www.education.vic.gov.au/pages/privacypolicy.aspx. Early Childhood Australia s privacy policy can be accessed at http://www.earlychildhoodaustralia.org.au/legal_statements/privacy_statement.html The Department may also disclose personal information to the Office of the Minister of Children and Early Childhood Development so that the Minister may congratulate individuals who receive scholarships. The Office of the Minister will treat all personal information in accordance with the Information Privacy Act 2000. Application Form Page 4
Work Obligations Following Completion of Course All scholarship recipients are required to work in a licensed children s or approved education and care service following completion of the course. The work that you do after you have completed the course depends on your qualification type. The table below outlines the position you are expected to secure following completion of the course. Qualification Certificate III in Early Childhood Education and Care Certificate IV in School Age Education and Care Diploma of Early Childhood Education and Care Diploma of School Age Education and Care Length of time required to work following successful completion of the Position to work in following successful completion course of the course An educator in a Victorian licensed children s service or 12 months An educator in a Victorian early childhood setting. 12 months An outside school hours care assistant. 18 months An educator in a Victorian licensed children s service or An educator in a Victorian early childhood setting. 18 months An outside school hours coordinator. Advanced Diploma of Children s Services 4th Year of Early Childhood Teaching Degree Early Childhood Teaching Degree Graduate Diploma in Early Childhood Education 18 months 18 months 2 years 2 years An educator in a Victorian licensed children s service or An educator in a Victorian early childhood setting, or A service coordinator/manager (not required to work directly with children). Early childhood teacher or Pedagogical leader (for example, children s services manager in kindergarten cluster or local government council) in a Victorian licensed children s service, or An early childhood teacher in a Victorian early childhood setting. Postgraduate Qualification 2 years A Victorian early childhood setting includes: A Victorian licensed children s or approved education and care service (this includes Multifunctional Aboriginal Children s services (MACs) and Aboriginal Children and Family Centres (CFCs)) Aboriginal Best Start program Aboriginal Playgroups In Home Support Home Based Learning Child and Family Services in an Aboriginal Cooperative/or corporation Application Form Page 5
Please read carefully before submitting your Application Form CHECKLIST Please tick the box beside each item once completed Complete all sections of the Application Form. Do not leave any sections blank Current contact information, including address, phone numbers and email address is supplied Copies of academic transcripts or awards for qualifications claimed on your application are attached. An academic transcript is an official document which states your course, subject and results. Do not supply original documents Personal Statement is attached Completed Employer Form is attached (if applicable) A signed copy of your current contract of employment or a letter from your employer confirming your employment is attached (if applicable) Other Funding - If you have received other funding for this course or previous funding in the past from the Department please attach relevant documentation Ensure you have supplied evidence of enrolment confirmation in your course from the registered training organisation or tertiary institution at which you will study If you are completing a Certificate III, Certificate IV, Diploma or an Advanced Diploma, provide evidence of the total tuition fees to complete your course in the form of a statement or a letter from the registered training organisation. The following must be stated clearly: a. Your name b. Course code and course name c. The total cost to complete your course d. Course start date and expected course finish date Please note: Your application will not be accepted or processed unless all sections of the Application Form have been filled out correctly and all supporting documentation has been supplied. Submitting Applications Address to: Project Officer Early Childhood Scholarships PO Box 2080 Richmond South 3121 Email to: early.years.workforce@edumail.vic.gov.au All applications submitted via email must be submitted in either MSWord or PDF formats only. Application Form Page 6