Expression of Interest

INSTRUCTIONS FOR COMPLETING FORM

1. Download the Expression of Interest form and save the form to your desk top.
2. Enter information as required into the shaded fields.
3. Check the boxes, as required.
4. Ensure that your Principal/Manager/RNL completes the Statement of Support section.
5. Email: bastow@edumail.vic.gov.au – enter [Program/Module Name] in the Subject line.
Note: Hard copies of the Expression of Interest form will not be accepted.
1. ELIGIBILITY
To be eligible for selection in this program/module, the applicant must satisfy all the following criteria:
Current on-going employment with a Victorian Government School
Availability to participate in all workshops and program/module activities
Ability to meet any deposit/co-contribution costs
2. PROGRAM/MODULE SELECTION
Please select the program/module you are applying for:

LEADING PEOPLE: Developing Effective Communication

3. PERSONAL DETAILS
Record No: 01589730 Name: Leslee Surname: Rees
Edumail Address: rees.leslee.l@edumail.vic.gov.au Other Email Address: laisy2@gmail.com
AH/Mobile Number: 0439148887 Gender: Female
No. Years Service in Education Sector: More than 20 Years
Current Substantive Classification:

Leading Teacher Specify Other... No. of years in current substantive position: Please Select...
4. SCHOOL DETAILS
School Number:       School:      
School Address:      
School Phone Number:       Region: Please Select... Network:      
Principal/Manager/RNL:            Email: @edumail.vic.gov.au
School Category: Please Select... Specify If Other Selected... National Partnerships School: Yes No
5. HOW DID YOU FIND OUT ABOUT THE PROGRAM/MODULE?
Please Select... Specify If Other Selected...
6. ALIGNMENT WITH YOUR INDIVIDUAL PERFORMANCE AND DEVELOPMENT PLAN (max 250 words)

Describe how your participation in this program/module aligns with your personal and professional development plan, and your
aspirations for future leadership roles. The Developmental Learning Framework for School Leaders and iLead 360 Survey can
assist you to identify and articulate your capabilities and areas for growth.
     
7. CURRENT LEADERSHIP CHALLENGES (max 250 words)
Describe a current leadership challenge in your workplace, and how the knowledge, skills and dispositions you expect to
develop through this program/module will assist you to address this challenge.
     
8. ALIGNMENT WITH SCHOOL STRATEGIC PLAN AND IMPROVED STUDENT OUTCOMES (max 250 words)

Describe how your participation in this program/module aligns with the school strategic plan, the annual implementation plan
and the whole school professional development plan, and how it will contribute to high quality instructional practice as
identified in the e5 Instructional Model.
     
 Expression of Interest
9. KEY SELECTION CRITERIA (max 250 words)

Applicants will be selected based on:

 demonstrated leadership capabilities
 potential for future school leadership roles
 demonstrated commitment to the development of self and others
 enthusiasm and readiness for undertaking this program as part of personal and professional learning and system
leadership.
Use this section to provide any further evidence as to how you meet these selection criteria.
     
10. APPLICANT’S STATEMENT OF COMMITMENT
Applicants must read and agree to the following terms and conditions for their Expression of Interest to be considered.
I       have considered the scope of this program/module.
If selected for this program/module I agree to:
 participate in all aspects of the program/module, including workshops, project work, assessment and evaluation
activities
 complete self assessments and feedback tools as required and use the data to improve my capabilities
 conduct workplace-based learning activities during the program/module and between workshops with support from
program facilitators
 share my learning with my employer, with other staff and with others in my professional community
 practise my leadership skills, and
 provide thoughtful feedback through evaluation processes for the improvement of the program/module.
I agree to the conditions of participation set out above. Date      
11. PRINCIPAL/RNL’S STATEMENT OF SUPPORT
Principal or Regional Network Leader needs to endorse this Expression of Interest. (Please check all the boxes below).
Name:       Position:      
Email:       Phone:      
I       have read information related to this program/module and confirm that:

the applicant is a competent teacher practitioner

the applicant demonstrates strong leadership capabilities

the applicant demonstrates a willingness to engage in critical reflective practice

the applicant demonstrates an ability to contribute to school and system-wide improvement

the professional learning aligns with the applicant’s development plan and the school and/or network priorities.

I will ensure the applicant is provided with opportunities to:

o complete all activities associated with the program/module
o practise his/her leadership capabilities.

I agree to the conditions of participation set out above. Date      

PRIVACY STATEMENT
The personal information which is provided in this application form will be stored securely on Department of Education and
Early Childhood Development property in accordance with the requirements of the Public Records Act 1973 and the Information
Privacy Act 2000. It will only be accessed by the Department of Education and Early Childhood Development for the purposes of
participant selection, compilation and reporting on participation statistics, and to inform the development of leadership policy
for the school and early childhood workforces.
Expression of Interest