Teacher Education Refresh Programme Application and Consent Form

TER start date (first workshop day)

Have you applied to the Teaching Council for a new practising certificate?
Yes No

Sector
Primary Secondary

Personal information

Legal surname

Legal first name/s

Preferred first name

Date of birth (DD/MM/YYYY)

Gender
Male Female Other

Residential address

Postal address if different

Have you previously enrolled in a TER programme?
Yes No

Do you have any health issues that may impact your ability to complete the TER programme?
Yes No

Teacher education qualifications
Give details of your teacher education programme and/or other qualifications.

Teaching qualification(s) gained
NZ Overseas

Teaching qualification

Institution

Year awarded

Please attach your NZQA assessment letter
Teaching qualification gained overseas. Please attach PDF file only and size less than 3MB.

Have you met the Teaching Council English language requirements?
Yes No

Are you required to sit IELTS?
Yes No

List your specialist subjects (secondary teachers only)

1st specialist subject (secondary teachers only)

2nd specialist subject (secondary teachers only)

Attach copies of teaching qualifications
Please note that it is your responsibility to obtain verification of your qualifications if you were trained outside of New Zealand. Please attach PDF file only and size less than 3MB.

Please attach a copy of your current Curriculum Vitae
Please attach PDF file only and size less than 3MB.

Please attach a copy of your email confirmation from Teaching Council acknowledging receipt of your new practising certificate application.
Please attach PDF file only and size less than 3MB.

New Zealand teacher registration

Do you hold or have you held New Zealand Teacher Registration?
Yes No

Previous or current NZ registration number

Expiry Date (DD/MM/YYYY)

Current teaching practice

Have you taught in NZ? (This includes full time (FT), long-term relief (LTR) and day-to-day relief (DTD) work).
Yes No

If YES then please give details (starting with most recent teaching position, last 5 years only)

Dates

School

Role type

Referee report

Please be aware of University regulations with regard to plagiarism

Plagiarism is using the work of others in preparing an assignment and presenting it as your own without explicitly acknowledging — or referencing — where it came from. Plagiarism can also mean not acknowledging the full extent of indebtedness to a source. Work can be plagiarised from many sources — including books, articles, the world wide web, and other students’ assignments. Plagiarism can also occur unconsciously or inadvertently. Direct copying is definitely plagiarism. Paraphrasing of another work without attribution is also plagiarism. Submitting someone else’s unattributed or less than fully attributed work or ideas is not evidence of your own grasp of the material and cannot earn you marks.

“The University of Auckland will not tolerate cheating, or assisting others to cheat, and views cheating of course work as a serious academic offence. The work that a student submits for grading must be the student’s own work, reflecting his or her learning. Where work from other sources is used, it must be properly acknowledged and referenced. This requirement also applies to sources on the world-wide web. A student’s assessed work may be reviewed against electronic source material using computer detection mechanisms.

Upon reasonable request, students may be required to provide an electronic version of their work for computerised review.

Students may not translate work from another source without proper acknowledgement and referencing. The use of translation machines to translate and copy texts into the target language of an assignment constitutes academic dishonesty....”

Agree
I am aware of University regulations with regard to plagiarism

Consent to disclosure of information

The Teacher Education Refresh (TER) Programme is being offered by The University of Auckland on behalf of the Teaching Council of Aotearoa New Zealand which owns the TER Programme.

Principle 3 of the Privacy Act 1993 – “Collection of information from subject”
Personal information provided by persons applying to participate on a TER course is being collected for the purpose of determining their eligibility for participation in a course, to enable the Teaching Council of Aotearoa New Zealand to comply with its statutory functions and the requirements of the TER Programme, and for administering participation on that course. The information is being collected by: Kohia Centre, Faculty of Education and Social Work, The University of Auckland, Private Bag 99946, Newmarket 1149, Auckland
All or any part of that information may be held and used by The University of Auckland and Teaching Council of Aotearoa New Zealand, Level 12, 80 Boulcott Street, Box 5326, Wellington

11(a) and (f) of the Privacy Act 1993 – “Limits on disclosure of personal information”
Neither The University of Auckland nor the Teaching Council of Aotearoa New Zealand shall disclose the personal information collected for the TER Programme to a person or body or
agency unless either or both believe, on reasonable grounds:

NZ Driver’s Licence number OR Passport number

I hereby consent to the disclosure by the New Zealand Police, Ministry of Education and the Teaching Council of Aotearoa New Zealand of any information they may have pursuant to this application, to the Faculty of Education and Social Work, the University of Auckland. I understand that any record of criminal conviction I might have will automatically be concealed if I meet the eligibility criteria stipulated in Section 7 of the Criminal Records
Yes

Programme Declaration

I understand:

that to successfully complete the TER programme I must complete all course requirements to the expected standard within the required time frame.
that the professional behaviour described in the Code of Professional Responsibility and Standards for the Teaching Profession is required at all times throughout the course and practicum.
If a school leader or colleague complains about unprofessional behaviour I will be required to leave the programme.

Agree
Yes

On successful submission an email with a summary of these requests will be sent to your email address. If an email is not received shortly after clicking submit then this indicates that there was a technical error saving your requests that you should report to kohia@auckland.ac.nz.

Teacher Education Refresh Programme

Application and Consent Form

Note that an application for a new practising certificate with the Teaching Council of Aotearoa NZ must be made prior to enrolment in a TER programme.