NZSL@School Support Application

NZSL@School Support Application
Version 2 created on - 19/08/2025

Version 1 used for 2024
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 year's Resourcing Notice. This occurs approximately towards the end of Term Four, and criteria may be subject to change.
Student Name (As per Ministry of Education enrolment)*

First NameMiddle Name (If none, insert N/A)Last Name
Your Details

For person completing this form
Name *

First NameLast Name
Email*
example@example.com
Your Role*
Please confirm you are authorised to complete this application on behalf of the Principal/Board*

Yes, I confirm.
Pick which application suits*

Existing Student Support ApplicationNew Support Application

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.

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.
Please attach a current IEP, Audiology report, audiogram, and any recent language assessments below:
Please attach your files here.

Cancelof

ORS Other Criterion

NZSL@School Support Application
What criterion are you applying under?*

LearningVisionPhysicalLanguage use and social connection
What is the ORS level?*

HighVery High

NZSL@School Support Request

NZSL@School Support Application
Total weekly ORS Hours?*
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).
Does your student attend NZSL Immersion Hub?*

YesNoUnknown

Please detail any other school activities your student may require NZSL support for e.g. School Camp

Type of Support Request

NZSL@School Support Application
What support is this application for?*

Educational Interpreter SupportCommunication Education Support Worker (CESW)
If applying for CESW Support you will receive NZSL tutor support

Educational Interpreter Support Request

NZSL@School Support Application
In class hours per week requested
In class hours per week requested
This funding works on a top-up model. If you are requesting EI hours, and the number of hours you require exceeds the weekly ORS hours allocation, by how many hours does it exceed?
What is the hourly rate you are applying for? Ko Taku Reo provides a maximum hourly contribution of $47 (New Grad), or $57 (Experienced). (GST Exclusive)

$47 per hour (New Grad)$57 per hour (Experienced)

CESW Support Request

NZSL@School Support Application
Total hours per week requested?
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?
Total hours per week requested?
Total hours per week requested (including ORS hours)?
What is the CESW hourly pay rate you are applying for? *
(GST exclusive)

NZSL Tutor Support Request

NZSL@School Support Application
Who will NZSL tutor support be for?

StudentClassmatesFamily/whānauC/ESW
If your student attends primary school, are you applying for NZSL Language Model support?*

YesNo
A Language Model follows the student through their day-to-day classroom activities, providing real-time NZSL support, immersing the student in NZSL and Deaf culture. Sessions are either a morning or afternoon for up to 3 hours. For more information please see FAQs section on our website: www.kotakureo.school.nz/educators/nzsl-services

Confirmation
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:

Your Details