Professional Qualification Application Form

Professional Qualification Application Form
Please complete this form if you are applying to complete a PGCE or PGDE teaching placement at DBIS, or if you are a staff member who is looking for support from the school to enrol in professional learning that will lead to a professional qualification. For example a Master’s Degree or NPQSL etc.
Name of Applicant*

First NameLast Name
E-mail*
example@example.com
Do you currently work at DBIS?*

YesNo
Title of the course (Education Institute or Professional Body)*
Name of the course provider?*
Start Date*

DayMonthYear
End Date*

DayMonthYear
Course Information*

Upload PDFInsert course website URL
Browse Files

Cancelof
Insert course website URL
Please provide a brief description of the course*
Have you already been accepted onto the course?*

YesNo
Details of total estimated cost to the school (if any)*
Does the course involve teaching practice?*

YesNo
If yes, which phase?

Early YearsPrimarySecondary
If secondary, which subject/area?
Placement Date 1

MonthDayYear
Date
Number of Weeks
Placement Date 2

MonthDayYear
Date
Number of Weeks
Placement Date 3

MonthDayYear
Date
Number of Weeks
Does the school need to provide you with a Mentor?*

YesNo
If yes, please upload an outline of the responsibilities here:*
How does this training support the development aims from the DBIS School Strategic Plan?
If you are already working at DBIS, please indicate if you are applying for:

Financial support from the schoolRelease from current role to undertake trainingStudy leaveCover during lesson time
If so, please give details
Applicant Signature

Clear
Date of Application

MonthDayYear
Please note: If you are a member of DBIS Staff and you are applying for financial support or a study grant, there is a service bond of no less than one year from the date of completion of the course. Proof of acceptance onto the course is necessary and proof of successful completion may be requested at any time. In the event that the course i not completed, the school reserves the right to recover the financial value of the support given. We recognise the importance of the time teachers spend with their classes, and where a teacher has already been absent from class for 2 or more weeks within the school year, the Head of School will discuss the implications of this when considering approval.
For SLT:

APPROVED BY HEAD OF SCHOOL/PHASE:

Signature: ___________________________

Date: _____________________________
Should be Empty: