NZSL@School Support Application

NZSL@School Support Application

2024-08-26A
Before you begin
By ticking these boxes I confirm that the student in this application meets the Ministry of Education funding criteria.*

Are Deaf/ Hard of Hearing (DHH), andAre enrolled in a mainstream school, kura kaupapa, Māori medium school, or a specialist school other than Ko Taku Reo, andWho best access their learning in NZSL
Please note, Ministry of Education funding criteria is not confirmed until receipt of the following years Resourcing Notice. This occurs approximately towards the end of Term Four, and criteria may be subject to change.
Your Details

For person completing this form
Name *

First NameLast Name
Email*
example@example.com
Your Role*
2023-09-04 OLD Pick which application suits

Current/Existing Student Support ApplicationNew Support Application
Pick which application suits*

Current/Existing Student Support ApplicationNew Support Application
If you would like a copy of your submission sent to you, please email nzslschool@kotakureo.school.nz and someone from our Administration Team will be in touch.

Current/Existing Student Support Application

NZSL@School Support
This application form is for schools who wish to reapply for a student who is currently OR has previously received NZSL@School Support. This service allocation should be co-developed between the parents/whānau, the ākonga (where age appropriate) and the school.

New Application

NZSL@School Support
This application form is for schools who would like to apply for NZSL@School support for a student for the first time. This service allocation should be co-developed between the parents/whānau, the ākonga (where age appropriate) and the School.

Your School or Education Facility details

NZSL@School Support Application
Full Name of school or education facility *
2023-09-04 OLD Is this student a new entrant and not yet on ENROL?

YesNo
2023-09-04 OLD If yes, what is their date for starting school?

DayMonthYear
Date
Principal's Name
Principal's email address
School contact person's name
School contact person's role
School contact person's email address
School contact person's phone number
Current Support

SWIMLANE + NEW NZSL@School New Support Application
2023-08-24 OLD Is this student receiving ORS funded teacher aide support?

YesNo
2023-08-24 OLD If yes, state the number of hours currently received and hourly rate

Current Support

NZSL@School Support Application
Has your student and their parents/whānau received First Signs Support?

YesNo
2024-08-05 OLD Is the student currently receiving other funding to be used to provide in-class access to NZSL?

YesNo
2024-08-05 OLD What is hourly rate received from MoE for this service?
2023-08-24 OLD If yes, state the number of hours currently received
2023-09-04 OLD Hours of NZSL@School Communication/Education Support Worker (C/ESW) support received
2023-09-04 OLD Hours of Educational Interpreter support received

Student Information

NZSL@School New Support Application
What are the students’ areas of need? *
What language does this student use at school? Please indicate receptive language, expressive language and/or any comments *
(eg. NZSL, Spoken English, Te Reo and/or other)
What language does this student use at home? Please indicate receptive language, expressive language and/or any comments *
(eg. NZSL, Spoken English, Te Reo and/or other)
What are observable gains that your student and those supporting them have made as a direct result of the previous year's NZSL@School Funding?
Complete this if the student has previously received NZSL@School Funding.
To support this application please email a current IEP, Audiology report, audiogram, and any recent language assessments to: nzslschool@kotakureo.school.nz

NZSL@School Support Request

NZSL@School Support Application
2023-08-24 TK REPLACED How many hours per week of Communication/Education Support Worker (C/ESW) support are you applying for?
2024-08-26 OLD How many hours per week of Communication/Education Support Worker (C/ESW) support are you applying for?
Total weekly ORS Hours?*
If your student does not receive ORS, please enter Zero.
ORS Funded Students - This funding works on a top-up model. If you are requesting CESW hours, and the number of hours you require exceeds the weekly ORS hours allocation, by how many hours does it exceed?
For ORS funded students. EG. Tane's school wants a CESW in the classroom with him for 17 hours. Tane receives 15 hours per week ORS funding, therefore in this field the school would enter 2 hours (17 CESW hours minus 15 hours ORS, equal 2 hours).
Non ORS Students - How many total weekly hours of CESW support are you applying for?
For non ORS students
2024-08-26 OLD What is the hourly rate you are applying for? *
(GST exclusive)
What is the CESW hourly pay rate you are applying for? *
(GST exclusive)
2024-08-26 OLD Is your student currently receiving ORS Teacher Aide funding?

YesNo
2024-08-26 OLD If yes, state the number of hours currently received weekly
Please indicate any additional hours/support outside of School hours. Please indicate term, purpose, and number of hours for each:
eg. Kapahaka, School camps (4 hours per year allowed for IEP meetings for all students).

Educational Interpreter Support Request

NZSL@School Support Application
Are you applying for Educational Interpreter support?

YesNo
If yes, state the hours per week required
2023-08-24 OLD If yes, state the hours per week required
2024-08-26 Live for less than 1 hour but making OLD. What is the hourly rate are you applying for? Ko Taku Reo provides a maximum hourly contribution of $45 (New Grad), or $55 (Experienced)
(GST exclusive)
What is the hourly rate you are applying for? Ko Taku Reo provides a maximum hourly contribution of $45 (New Grad), or $55 (Experienced). (GST Exclusive)

$45 per hour (New Grad)$55 per hour (Experienced)
What will this be used for?
(Please indicate term, purpose, and number of hours for each)

2023-09-04 OLD Names of the other team member(s) involved in the completion of this form you would like to receive the funding agreement letter.

This application has been co-developed with the student's family/whānau and support team?*

YesNo
I agree to the information provided to be shared with relevant staff within Ko Taku Reo Deaf Education New Zealand*

YesNo
Date*

DayMonthYear
Should be Empty:

Before you begin