Offical use only

OFFICAL USE ONLY

Application Form 2018

Please download form from www.tplt.ac.nz and email to [e-mail]

Privacy Note: the information that you provide on this form is covered by the Privacy Act 1993 and will only be used for the TPDL programme.

Teacher Information

First Name: Preferred Name: Please print Surname: Please print M/F Please circle	Email at school: Personal email: Position at school:
Home address: Home phone/mobile:	Is there anything that could affect your completion or attendance of this programme? (e.g. planned travel, religious affiliation, other commitments) Please note there are three Saturday workshops and two days in the July holidays.
Are you a fully registered teacher? Are you a NZ citizen? Do you have NZ residency?
What is your first language?	How many years have you been teaching?
How did you hear about TPDL?

School Information

School name:	Principal’s name: Principal’s email:
School physical address: School phone no:	School postal address:
Your school has students from: Year_____________ to Year______________	Circle your school region: Northland Auckland Gisborne Hawkes Bay Manawatu/Wanganui Taranaki Wellington	Waikato Bay of Plenty Marlborough Tasman/Nelson West Coast Canterbury Otago- Southland
School roll: _________________ [Maori: ___ Pasifika: ___ Pakeha ___ Other: ___ ]. (in figures or % of total roll) School decile rating:	School GST number: Name of school accounts officer: Email of school accounts officer:
In what way does your application to participate in TPDL form part of a school-wide strategic plan (with annual targets and resourcing) for languages?

Language Teaching and Learning Information

Do you have experience in teaching a language other than English? If so, please state which.

What language(s) will you teach while on TPDL?

What is your level of language proficiency in that language / those languages?

How long have you taught this language/ those languages?

Whom will you teach the language to? (i.e. year level(s)? option class? your homeroom class? other homeroom classes? approximate number of students)

Why do you think it is important to teach this language?

Have you sat a proficiency examination in a language (other than your first language)? If so, please tell us the examination name and level passed.

Describe your background in learning languages other than your mother tongue?

Would you be able to say already what your area(s) of greatest need is and why?

(Answer this question only if you are a native speaker or already highly qualified in the language you teach.) We would like you to study a new language. Do you have a preference? (Chinese, French, German, Japanese, Spanish, Cook Islands Maori, Samoan, Tongan)

Expectations of TPDL participants

Participants will: teach a full year language course to at least one class * be released from class for 90 minute discussions after four lesson observations (one per term) attend all 8 days of the pedagogy component (2 Fri/Sats in Terms 1, 2 and 3 PLUS 2 days in July holidays) study a language (unless exempted*) work towards sitting an international language examination (unless exempted*) accept responsibility for enrolling in the pedagogy and language courses *Contact TPDL National Coordinator Nathalie Bourneville [e-mail] or TPDL Administrator Neena Raniga [e-mail] with any questions.

Expectations of schools

Teachers will be released for 90 minutes after each of four lesson observations Schools cover release cost for one day (3 of 8 ‘pedagogy’ days are in school time. Schools receive 2 TRDs.) Schools pay course fees initially and are reimbursed in Term 4 when teachers complete TPDL

Checklist so we can process your application

I have read the TPDL Information Sheet and the TPDL Agreement Form (please tick)__________ I have discussed this with my principal and have his/her support (please tick) __________

Email completed form to: [e-mail]

or post to: TPDL, UniServices, c/- University of Auckland Epsom Campus, Private Bag 92601, Symonds St, Auckland 1035