School Counsellor Scholarship Program Page 1
Last name:
Suburb: State: Postcode:
Permanent full-time
Permanent part-time
I am currently working in a non-government school
School code:
2022 School Counsellor Sponsorship Application Form
Department serial number:
Title:
First name:
Middle name:
Date of birth:
Residential house number and street:
Contact number:
Current engagement with the NSW Department of Education:
Yes
No
Prefer not to answer
I am an approved:
Infants/Primary school teacher
Secondary school teacher
School leader/Executive
Temporary
Casual
Current position: Name of school:
for example: LaST, classroom teacher, assistant principal etc.
The university where I will be completing or have completed my three year sequence of APAC approved psychology:
Evidence of enrolment must be provided
Name of qualification I am enrolled in (as appears in university communication):
I am applying for the following sponsorship pathway:
Psychology Sponsorship Program (three year sequence of psychology won't be completed by the end of trimester 3, 2021)
School Counsellor in Training Program, honours and masters pathway (I will have no more than two undergraduate psychology subjects to
complete by trimester 3, 2021)
School Counsellor in Training Program, masters pathway (I have completed or will be completing my honours year by the end of trimester 3, 2021)
I confirm I will complete my three year sequence of APAC approved psychology studies or honours year studies by:
For example: end of semester 2, 2021 or end of trimester 3, 2021.
Course requirements must be completed within the maximum one year study period for the psychology sponsorship program.
*
A person of Aboriginal descent or Torres Strait Islander descent who identifies as such and is accepted as such by the community in which they live.
Department email address: (Communication will only be sent via this email address)
Confirm department email address:
Are you an Aboriginal person or a Torres
Strait Islander*:
select one of the following:
Service Commitment Areas:
You must be willing to accept an appointment to a NSW public school in an agreed Service Commitment Area.
Please indicate below the locations in which you are prepared to work as a school counsellor following successful
completion of the relevant sponsored studies.
OR
I am prepared to teach anywhere in the state.
I am prepared to teach in one or more of the following rural or remote priority areas: (If you select from this list you may also choose to select
from any of the below areas)
Bourke (308)
Broken Hill (309)
Deniliquin (313)
Griffith (317)
Moree (323)
Orange (328)
AND/OR
In three or more of the following priority areas: (If you did not select an area from the above list you must select a minimum of three priority areas before selecting from the
additional areas below)
Albury (301)
Armidale (302)
Bankstown (303)
Batemans Bay (304)
Bathurst (305)
Blacktown (306)
Bourke (308)
Broken Hill (309)
Campbelltown (310)
Central Coast (311)
Clarence/Coffs Harbour (312)
Deniliquin (313)
Dubbo (314)
Fairfield (315)
Granville (316)
Griffith (317)
Lake Macquarie (319)
Lismore (320)
Liverpool (321)
Maitland (322)
Moree (323)
Mount Druitt (324)
Muswellbrook (325)
Newcastle (326)
In addition to one of the above selections, I am also prepared to work in one or more of the following areas: (You may
only select from this list if you have selected from the above areas)
Sutherland (337)
Tweed Heads/Ballina (340)
Bondi (307)
Hornsby (318)
Northern Beaches (327)
Port Jackson (331)
St George (336)
Teaching in rural and remote NSW offers exceptional opportunities for both experienced and beginning teachers. It is a rewarding lifestyle choice that can give you numerous
opportunities to get involved in the wider community.
The NSW Department of Education offers a range of incentive benefits to teachers who accept positions in rural or remote schools. Depending on the school location, these
may include additional training and development days, one week of additional summer vacation for schools in the western areas of NSW, rental subsidy of up to 90% in the
most isolated locations and 70% in some other isolated locations, and a number of locality allowances such as a climatic allowance, an isolation from goods and services
allowance, vacation travel expenses, reimbursement of certain expenses related to medical or dental t
reatment and an allowance for dependents. The allowances are paid in
addition to your salary.
The benefits vary from school to school. The online benefits calculator provides additional information about allowances and incentives for individual schools and school
education areas.
School Counsellor Scholarship Program Page 2
Queanbeyan (333)
Taree (339)
Orange (328)
Parramatta (329)
Penrith (330)
Port Macquarie (332)
Queanbeyan (333)
Ryde (334)
Shellharbour (335)
Tamworth (338)
Taree (339)
Wagga Wagga (341)
Windsor (342)
Wollongong (343)
Muswellbrook (325)
Please comment on the applicant's communication and interpersonal skills. Provide an example of when the applicant has used their communication and interpersonal
skills to work collaboratively with students, parents and staff (limit 100 words).
Principal supporting statement for
Describe the applicant's personal and professional suitability to work as a school counsellor (limit 100 words).
School Counsellor Scholarship Program PagePage 3
Date:
Date:
Principal's name:
School:
Principals delegate's name:
School:
Please comment on the applicant's interest and involvement in student wellbeing initiatives in schools. Provide an example of the applicant's involvement in wellbeing
initiatives (limit 100 words).
Please comment on the applicant's ability to build rapport with individual students and make adjustments for their needs (limit 100 words).
Section 10.5.2 of the Code of Conduct 2021 enables employees to issue references. The department’s policy on providing references is available from the website
on https://policies.education.nsw.gov.au/policy-library/policies/pd-2004-0020/pd-2004-0020-01.pdf
Please comment on the applicant's sensitivity to the diverse cultural backgrounds of students (limit 100 words).
A delegate is the Principals nominated representative with authority to provide a
reference.
Principal Certification
I certify that this applicant (teacher/executive) has a current Performance and Development Plan based on the Australian Professional Standards for
Teachers and is participating in the performance and development cycle.  I confirm that this applicant (teacher/exec) is meeting the Australian Professional
Standards for Teachers. The (teacher/executive) is not receiving individualised support in relation to performance concerns.
Note: Individualised support requires that specific performance concerns have been raised, explaining which of the Australian Professional Standards for
Teachers are not being met, based on work examples.
click to sign
signature
click to edit
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signature
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Referee supporting statement for
Describe the applicant's personal and professional suitability to work as a school counsellor (limit 100 words).
Please comment on the applicant's interest and involvement in student wellbeing initiatives in schools. Provide an example of the applicant's involvement in wellbeing
initiatives (limit 100 words).
Please comment on the applicant's communication and interpersonal skills. Provide an example of when the applicant has used their communication and interpersonal
skills to work collaboratively with students, parents and staff (limit 100 words).
School Counsellor Scholarship Program PagePage 4
Referee's details
Name:
Position:
School:
School contact number:
Mobile contact number:
Date:
Section 10.5.2 of the Code of Conduct 2021 enables employees to issue references. The depa
rtment’s policy on providing references is available from the
website on https://policies.education.nsw.gov.au/policy-library/policies/pd-2004-0020/pd-2004-0020-01.pdf
Please comment on the applicant's ability to build rapport with individual students and make adjustments for their needs (limit 100 words).
Please comment on the applicant's sensitivit
y to the diverse
cultural backgrounds of students (limit 100 words).
Any further comments (limit 50 words).
click to sign
signature
click to edit
Applicant supporting statement
What
is your
understanding
of
t
he key
a
spects of the school counsellor role? Which aspects have motivated you to apply for this scholarship and why? (limit 100 words).
Give
a
n example of when you have
use
d your communication and interpe
rsonal sk
ills to work collaborati
vely with students, parents and staff to achieve an outcome (limit
100 words).
Please describe in detail your demonstrated interest and experience in wellbeing initiatives in schools and/or the community (limit 100 words).
School Counsellor Scholarship Program
Page 5
Please give an example of when you have utilised your skills as an educator to assist the wellbeing of an individual student (please do not name the student) How would
these skills carry forward to
the school counsellor role? (limit 100 words).
Please describe in detail your demonstrated sensitivity to the diverse cultural backgrounds of students (limit 100 words).
Please describe a positive experience you have had working with a school counsellor (please do not name the counsellor) (limit 100 words).
Applicant's signature:
Date:
I certify that the information I have provided on this form is accurate and complete.
In applying, I acknowledge that personal information about me will be used by the NSW Department of Education in the interests of the proper and prudent management
of the School Counsellor Sponsorship Program. Consistent with NSW Government policy (Premier’s Department Circular 2004-03), any person who falsifies their record of
academic and/or professional qualifications to gain employment may be dismissed and/or prosecuted.
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signature
click to edit
School Counsellor Scholarship Program Page 6
CHECKLIST
Please note that al
l required documentation should be submitted with your application.
When submitting your completed application, please ensure your supporting documents are electronically scanned
(as a pdf). Your application is not able to be submitted as a scanned copy. Your application and supporting
documents must be emailed to sponsoredtraining@det.nsw.edu.au.
Please ensure that all relevant boxes below have been ticked before submitting your application.
Sponsorship terms:
If I am successful in attaining a sponsorship under the Psychology Sponsorship Program:
I will have completed all psychology subjects by the end of the 2022 academic year.
I will maintain the required GPA of 5.5 as per CSU's method of calculation.
I understand I will need to meet CSU entry requirements to progress my studies into the fourth and fifth year of
the School Counsellor in Training academic program.
I understand that the sponsorship pays my universi
ty course fees.
I acknowledge RFBA will be applied to Psychology Sponsorship recipients for the period they are completing
their third year level psychology subjects and that this may impact eligibility for other Commonwealth benefits
and obligations.
I have read and understand the Frequently Asked Questions in relation to the School Counsellor
Sponsorship Program.
I understand and meet the requirements of the School Counsellor Sponsorship Program
(including Psychology Sponsorship and School Counsellor in Training Sponsorship).
I acknowledge that the School Counsellor Sponsorship Program is driven by the demand for school counsellors
in specific geographic locations. Any appointment will be in line with my nominated Service Commitment Areas.
I understand that if successful at being offered a scholarship, I will be committing to remain an employee of the
department for two years following the completion of my studies.
I understand that I will be required to meet Charles Sturt University's (CSU) academic requirements to progress
through the fourth and fifth academic year program.
I am willing to accept an appointment to a NSW public school in an agreed Service Commitment Area as
outlined in the Sponsorship Agreement and acknowledge there will be a financial liability for not accepting an
appointment.
If I am successful in attaining a sponsorship under the School Counsellor in Training Program:
I have informed my principal and referee that they may be contacted.
Principal supporting statement completed using specific examples and signed.
Referee supporting statement completed using specific examples and signed.
Completed all sections of the application form, including my supporting statement that includes specific examples.
I have provided a photo identity card issued by the Australian Government or a state or territory government
(this may take the form of a Working with Children or Vulnerable People card or a government
issued
occupational licence) to verify my identity at interview.
I will have completed all psychology subjects by the end of the 2021 academic year.
I will maintain the required academic standard through my fourth year of studies enabling entry into the fifth
year of academic studies.
I understand I will need to meet CSU entry requi
rements to progress my studies into the fourth and fifth year of
the School Counsellor in Training academic program.
I understand the course costs will be paid by the Department.
Written Application:
I acknowledge that:
School Counsellor Scholarship Program Page 7
Privacy Notice
The information provided by the applicant is being obtained for the purpose of the administration of the
School Counsellor Sponsorship Program by
the NSW Department of Education.
It will be used by the NSW Department of Education for consideration of the applicant’s admission to the
Program and the applicant’s ongoing participation in the Program.
Reasons for the coll
ection and disclosure of information are for the purposes of consideration of the
applicant’s application to participate in the Program, the applicant’s participation in the Program and
other purposes relevant to the proper and prudent management of the NSW Department of Education
School Counsellor Sponsorship Program.
The information is
provided as part of the applicant’s applying voluntarily to participate in the Sponsorship
Program.
The information will be stored securely.
If the applicant does not provide
all or any of this information then the application will not be considered by the
NSW Department of Education.
Should you be offered a sponsorshi
p, you may be required to provide documentation verifying your identity in
order to conduct a nationally coordinated criminal history check.
Please note that a scanned copy of your application form will not be accepted. Only writable electronically
submitted forms will be reviewed.
School Counsellor Sponsorship Program
Emai
l your completed electronic application and supporting documentation to
sponsoredtraining@det.nsw.edu.au
Closing date of applications is Sunday, 18 July 2021
SUBMIT FORM