STUDENT APPLICATION PACK
PART A – APPLICATION FORM (Tip: Please save this application form to your computer hard-drive to complete electronically) The Premier’s Anzac Prize 2018 will give eight students a once in a lifetime opportunity to experience the Anzac tradition firsthand. The prize includes a tour to the United Kingdom (London), Belgium and France in April–May 2018 and includes travel, group travel insurance, accommodation and meals. Students will attend ceremonies marking Anzac Day at Villers-Bretonneux in France and across the Western Front as well as experience many of the tourist attractions. For further information about the itinerary, please refer to the 2017 tour page for an example itinerary: http://education.qld.gov.au/students/grants/scholarships/anzac/2017.html. Two chaperones will be selected to lead and accompany the selected students. The application package has six parts [A-F].
Privacy Notice The Department of Education and Training (the Department) is collecting personal information on this form, including names, contact details, photographs and medical information for the purpose of administering The Premier’s Anzac Prize 2018, assessing applications for The Premier’s Anzac Prize 2018, verifying information provided and contacting applicants, parents and endorsing principals/teachers where necessary (for example, to request further information). The information submitted on this form will be made available to employees of the Queensland Government involved in administering The Premier’s Anzac Prize 2018. Entries will be shortlisted by an evaluation committee comprising of employees of the Department and other persons (for example, the chaperones selected for the tour, non-state school teachers and representatives from universities across Queensland). A selection panel, including a serving member of the Australian Defence Force and an Anzac descendant will review the shortlisted entries to determine the winners. The evaluation committee and the selection panel will be provided with the applicant’s name, school and multimedia presentation only. In relation to shortlisted entries (finalists) - Some of the information provided by these applicants (including name, school, year level, photographs and responses to background information below), will be used to create a short biography about each finalist. In relation to the winners The biography referred to above will be disclosed to the Minister of Education (‘the Minister’), the Premier, and their staff and made public. For example, the biography will be put in a media release, given to media organisations and may be put on the internet. Student/parent/guardian contact details may be provided to the Minister and the Premier and their staff and Members of Parliament, for the purpose of them contacting the winners about the Prize. Parent/guardian contact details may be provided to media representatives for the purpose of them contacting the parents/guardians about the students and the Prize. The parent/guardian will always be the first point of contact for the media representative. A parent/guardian holds the decision of whether to allow the media to directly communicate with the student. The winning multimedia presentations may be provided to the Minister, the Premier, their staff, the chaperones and the Department staff involved in administering The Premier’s Anzac Prize 2018. The personal information provided will be used for planning and organising The Premier’s Anzac Prize 2018 tour (which is the prize), obtaining travel insurance, making arrangements to cater for special requirements (where possible) and for the purpose of assisting the Department and chaperones to fulfil their duty of care. This information will be given to supervising staff and chaperones accompanying the overseas tour. Some of the information provided will be disclosed to insurance organisations, tour operators, airlines, travel companies, accommodation providers and other external parties involved in providing services to the group as part of the tour. Relevant information will be given to medical professionals in the event the student requires medical attention on the tour or while in the care of the Department. The personal information and copyright material will also be dealt with in accordance with the Consent Form (Part D). The information will not be used or disclosed for any other purpose without your consent unless the use or disclosure is required or authorised by law. If you have any questions or concerns about the collection, storage, use or disclosure of the information, please contact the Senior Project Officer on 3513 5747. 1. Student details (the applicant) As per your passport or birth certificate. Surname: PASTE Given names: PASSPORT PHOTO Sex: Male Female HERE Date of birth: Day Month Year (or a recent photo of Citizenship: Australian citizen Australian permanent resident yourself) New Zealand citizen residing in Australia
Please note, the Department may request more information regarding your residency status. Do you have a current passport with validity up to 31 December 2018? Yes No Successful applicants can organise the required passport when they are notified they are a winner My multimedia presentation is in the following format: mov mp4 wmv
Multimedia references: I have attached a list of references
2. Contact Details Home address:
Postal address:
(if different from above) Home phone: Mobile (student): Parent 1 name: Parent 2 name: Mobile (parent 1): Mobile (parent 2): Work phone (parent 1): Work phone (parent 2): Email (parent 1): Email (parent 2): Email (student):
3. School details (if home educated, please complete Question 6 below) I am currently enrolled (in 2017) as a student in: Year 8 9 10 11 Name of school: Full address of school: School phone: School type: State Catholic Independent Other Endorsing Teacher’s name: Teacher’s phone: Teacher’s email: Principal’s name: Principal’s phone: Principal’s email:
4. Teacher’s endorsement 2 Teachers, please consider the student’s school attendance record, behavioural and discipline history, contribution as a member of the school community and the student’s multimedia presentation when providing your endorsement for their application to represent your school and Queensland in The Premier’s Anzac Prize 2018.
[Teacher to insert own comments here]
Furthermore, I have viewed the student’s presentation. Teacher’s signature: Date:
5. Principal’s signature (please note: each school may nominate up to two students)
I am aware only two applications from my school will be accepted and I support this student’s application.
Principal’s signature: Date:
6. Home educated students (only required for home educated students) Please indicate your year level (as recorded in the Home Education Unit database, based on your age not the content of the home education program): Year 8 9 10 11
Referee’s report Please provide a statement of endorsement. This endorsement must be provided by someone over the age of 18 years who has known the applicant for at least 12 months and is not a member of the applicant’s immediate or extended family. The referee must be in a position to attest to the applicant’s character.
[Referee to insert own comments here]
How is the applicant known to you? Name of referee: Contact no.: Signature of referee: Date: Signature of parent: Date:
OFFICE USE ONLY Home Education Registration - Confirmation The Department will confirm with Manager, Home Education Unit, that applicant is registered for home education and the year level of the student. Registered for home education Year level confirmed
7. Special requirements Please consider the information you have provided and all information about the tour and provide details of any special requirements you may have for the tour if your application is successful. For example: adjustments for impairment; mobility aides or assistance; religious requirements; medical conditions; dietary requirements (such as allergies, halal, vegetarian, gluten free); any special requirements for air travel or accommodation. If you do not have any special requirements, please indicate N/A below. Further information may be requested to assess if and/or how your special requirements can be accommodated on the tour.
8. Do you identify with any of the following groups Aboriginal, Torres Strait Islander or non-English speaking background? No Yes Please provide details:
9. Background Information: (please answer all questions and provide relevant detail)
3 Do you have any family links to Anzac or the Australian Defence Force?
What is your inspiration for entering The Premier’s Anzac Prize 2018?
Have you been to the United Kingdom (London) or the Western Front before?
What are your hobbies or interests?
What is your career goal?
Do you participate in any community activities? (Please detail)
Is there any event or experience that has shaped your perception of Anzac Day? (Please detail)
What would you hope to learn from a tour to the United Kingdom (London) and the Western Front?
How would you use the Premier’s Anzac Prize experience to influence your local community?
I declare that: I have read and understood the privacy notice on page 1 of this application form I have read, understood and agree to the conditions of entry [Part B] I have read and understood the tour rules [Part C] and if I am selected for the tour I agree to comply with the tour rules I have read the Student Code of Conduct [Part D] and if I am selected for the tour I agree to abide by the code [Part D] I have read, understood and signed the consent form [Part E] I am an Australian citizen, permanent resident of Australia, or New Zealand citizen residing in Australia The presentation I submit is my original work and has not been professionally developed or edited by any other person My presentation does not contain material owned by other people (e.g. music) without their permission All information provided in this application form is true and accurate to the best of my knowledge I am available to travel in April and May 2018 I am medically fit to travel and will inform the organisers if my health changes such that I am not medically fit to travel I am not a previous recipient of The Premier’s Anzac Prize (Queensland).
4 ______Applicant signature Date
5 PART B - CONDITIONS OF ENTRY
Who can enter? The Premier’s Anzac Prize is open to all eligible Year 8–11 Queensland students. For students registered for home education, their year level is the year level recorded in the Home Education Unit database, based on their age, not the content of the home education program. Year 8–11 Queensland students are eligible if, at the time of application and at the time of travel (April and May 2018) they are: an Australian citizen, a permanent resident of Australia or a New Zealand citizen residing in Australia and either: o a student at a Queensland state school or accredited Queensland non-state school who has been nominated by their school or o registered for home schooling in Queensland. Each state school or accredited non-state school may nominate up to two students only. Entries must be from individuals and not groups.
How do students enter? Students are invited to submit a multimedia presentation addressing the following key question:
Students are asked to refer to evidence of the Anzac spirit from Australia’s involvement in wars and conflicts from Gallipoli through to the present day, and to relate those experiences to positive values and activities in everyday life. Students are encouraged to source material from interviews, experiences of friends or relatives, media resources and individual research. All sources must be acknowledged and referenced. The presentation must include a list of references which acknowledges all of the material students use. The multimedia presentation must be between three and five minutes long, in one of the following formats: mov, mp4 or wmv. Other formats will not be accepted. Multimedia files will not be accepted unless they are less than 100Mb in size (preferably less than 10Mb). If students need to reduce the size of the file to be less than 100Mb, consider using a software program that enables reduction of the file size (e.g. Xilisoft Video Converter, Camtasia etc)
When can students enter? Applications open on 18 April 2017 and must be received by the Queensland Department of Education and Training (the Department) by 5pm, 15 September 2017. Late applications will not be accepted. Early lodgement is welcome. Winners will be announced by the end of the 2017 school year.
Entry procedures Students must submit the following: a multimedia presentation with a list of references a completed and signed application form [Part A] a completed and signed consent form [Part E] (this form must be signed by the student and parent) a completed and signed parent’s agreement [Part F]. Entries that do not include all the above components will not be considered. The multimedia presentation must be submitted on USB. Save the signed and scanned documents onto the same USB Include original hard copy of application form in envelope with USB.
6 7 The USB must be sent to: The Premier’s Anzac Prize Department of Education and Training International Services PO Box 15050 CITY EAST QLD 4002
Judging criteria and process Entries will be assessed against the following criteria: addresses the key question effectively adheres to the set time limit of three to five minutes includes one or more examples of Australia’s involvement in conflicts to illustrate the Anzac tradition argues a point of view effectively while recognising changes in people’s approaches to historical events over time uses a range of historical sources and evidence to support ideas evaluates historical sources in the inquiry uses the features of the medium to communicate the argument and the analysis effectively and purposefully includes references in presentation. Applications will be shortlisted by an evaluation committee comprising employees of the Department and other persons (for example, non-state school teachers and/or representatives from universities across Queensland). A selection panel including a serving member of the Australian Defence Force and an Anzac descendant will determine the final eight students. The eight winners will be announced by media release.
The prize The prize includes flights, accommodation, travel insurance, meals, visas and transfers (students located within reasonable driving distance to Brisbane will be responsible for their own transfers to and from Brisbane). Personal expenses, passport application, spending money, mobile/phone charges, vaccinations and any excess payable for claims made against the travel insurance policy are covered by participants.
Multimedia presentations The presentation must not be copied from another person. The presentation must not be developed or edited by any person other than the applicant. Students must ensure that their entries do not infringe another’s copyright and/or other intellectual property rights. Where an applicant uses someone else’s work in their entry, they must ensure they have permission to include the work, have the presentation submitted as an entry for the prize, and subsequently used as stipulated by the consent form. If a presentation features another living person (e.g. by including them, their picture/image or talking about them), then the applicant must have that person’s permission to: include the person in the presentation submit the presentation as an entry for the prize and use the presentation as stipulated in the consent form.
Other conditions Successful applicants must be prepared to feature in media and promotional activities — see consent form [Part E] which must be completed, signed and submitted at the time of entry. Entrants may revoke their consent at any time, as per the provisions of the consent form, however they will no longer be considered for the prize and tour. If a winner revokes their consent, their participation in further aspects of the prize and travel may be terminated by the Department. In such circumstances the prize winners will not be awarded substitute prizes. Successful applicants from previous years’ prizes (in Queensland) are not eligible to apply for the 2018 prize. Previous winning submissions from this or any similar competitions in any state or territory will not be accepted as new entries. Applicants may only enter once.
8 The judges’ decision is final and given the large number of entries, individual feedback to students will not be available. The prize cannot be exchanged and is not redeemable for cash. At the Department’s discretion, the tour/prize is subject to change in itinerary and/or cancellation in the event of unforeseen circumstances e.g. safety concerns such as may be raised from time to time by the Australian Government through its Smart Traveller website (see http://smartraveller.gov.au/countries/Pages/default.aspx). In the event a prize winner is denied a visa or passport, they will not be able to travel or may not be able to enter particular countries and will need to return home. In these circumstances the prize winners will not be awarded substitute prizes. Successful applicants must have a passport with validity up to 31 December 2018. Successful applicants may organise their passport validity when they are notified they are a winner. No responsibility will be taken for incomplete, late, misdirected, damaged or lost entries. These conditions of entry may be altered where necessary, and any changes will be notified at www.education.qld.gov.au/anzac-prize/. The Department reserves the right, at any time, to verify the validity of an entry or disqualify an entry that is not in accordance with these conditions of entry. Entries (i.e. the USB) will not be returned unless specific arrangements are made. Please let the Department know at the time of submitting the entry. If the USB is returned the Department will keep a copy of the presentation. Further information Further details regarding the tour and the inclusions can be found at: www.education.qld.gov.au/anzac-prize/.
9 PART C - TOUR RULES (for students selected for The Premier’s Anzac Prize 2018)
Before the tour I agree to: ensure that my school is aware of my application for the Premier’s Anzac Prize obtain a passport that is valid up to 31 December 2018 and ensure there are no restrictions on me travelling to the tour destinations (United Kingdom (London), Belgium and France) and any stopover countries (Singapore). Visas will be arranged and paid for by the Department of Education and Training (the Department) seek medical advice about and pay for any vaccinations disclose to the Department all pre-existing medical conditions and medications that I take supply the completed Student Medical Information and Authorisation Form when requested (a sample form, which is indicative of what will be sent to the winners, is available for viewing at www.education.qld.gov.au/students/grants/scholarships/anzac/resources.html) undertake research upon request or respond to media requests, including attending events (where reasonable) promptly advise organisers of any changes to information supplied on the application form and any issues which may affect my participation in the tour (for example, a change to my health, family situation, financial circumstances, Australian passport or visa validity, school, or a need for any special requirements or assistance on the tour) comply with all reasonable requests by the organisers for any additional information or documentation for the purposes of organising the tour (including but not limited to arranging and booking transport, insurance, tours and accommodation) participate in all pre-tour program briefings have my selection in the tour revoked if: o I do not comply with the conditions of entry [Part B] o I am suspended or excluded from school o I do not have and maintain a school attendance record and behaviour that is satisfactory to the Department o I, or my parents, revoke the consent given in The Premier’s Anzac Prize 2018 [Part E] (because the tour will involve many media and promotional activities) o I am unable to obtain the necessary passport/visa o the Department is unable to obtain an appropriate level of travel insurance coverage for me (‘appropriate’ will be determined by the Department in its absolute discretion). The Department is not responsible for any loss or damage to persons or property if my selection for the tour is revoked.
On the tour I agree to: abide by the Student Code of Conduct [Part D] my parents being given information about me, including (but not limited to) my behaviour on the tour and any health or wellbeing issues or concerns the supervising staff and chaperones immediately dealing with any breach of these Tour Rules or the Student Code of Conduct by imposing appropriate consequences, including notifying parents. In serious cases my school will also be notified (with additional consequences imposed by the school under the school’s Behaviour Management Plan) and I may be sent home (under supervision) at my own/my parents’ expense being sent home at my own/my parents’ expense if I, or my parents, revoke the consent given in The Premier’s Anzac Prize 2018 [Part E] (because the tour will involve many media and promotional activities). The Department is not responsible for any loss or damage to persons or property if I am sent home in accordance with these rules make tour reports (including photos, videos, research and journal entries) which will record my experiences and feelings during the tour.
After the tour I agree to: record my reflections of the tour in my tour report
10 make presentations about the tour to schools and communities if requested participate in all post-tour briefings and complete a questionnaire about the tour.
Please note that these tour rules may be updated if the need for additional or varied rules arises. If you are notified of any updates to the rules, you must follow the revised tour rules.
PART D: STUDENT CODE OF CONDUCT The aim of this Student Code of Conduct is to maintain the safety and wellbeing of all students during all stages of the tour and to promote harmony within the tour group. Students and parents are required to read this document and acknowledge that they agree to this Student Code of Conduct.
Overall Students must be subject to the authority and care of the supervising staff and chaperones and follow all lawful and reasonable directions of their supervising staff and chaperones. Students must be punctual at all times. Students must be courteous to and respectful of supervising staff, chaperones, other participants, tour guides, transport and accommodation providers and all other persons involved in the tour. Students must be considerate of the general public at all times and respect local customs and values. Students must obey all laws of Australia and the countries they visit and take responsibility for their own behaviour. Students must, at all times, while on the tour, behave in a manner which upholds and promotes, as representatives of the State of Queensland, the highest standards of integrity and dignity. Students must only depart from their chaperones in The Premier’s Anzac Prize 2018 tour group if they are in group of three of more and if prior permission is obtained. Students must take reasonable care to protect their own safety and the safety of the others in The Premier’s Anzac Prize 2018 tour group at all times. Students are not permitted to have sexual contact, smoke or consume alcohol at any stage during the Tour. Provided that a medical authorisation form has been completed for the relevant non-prescription drug, students may request from their chaperones non-prescription drugs such as Panadol or Imodium or carry their own – chaperones will monitor and record use of such non-prescription drugs that they issue. All students must attend and participate in the planned activities throughout the tour unless they have the express permission of one of the lead chaperone not to do so. Reasons not to participate in the planned activities may include, but are not limited to, injury and illness (after consultation with the first aid chaperone). Students must attend any arranged meetings of the tour group (e.g. each morning, to receive information and instructions regarding the day’s activities). Students must show absolute respect for the property, facilities and staff (including bus, tour company, hotel, tourist sites, aeroplanes and people) which they may utilise or engage with during the tour. Students must ensure they carry with them at all times the emergency contact cards and whistles (to alert the chaperones in the event that they are lost, in danger or in a difficult situation that needs urgent attention). Students must not use the whistles at any other time.
Digital Devices Students may take digital devices on the trip at their own risk. Students are expected to follow instructions, related to the use of their digital devices, given by people of authority (i.e. chaperones, Tour Leaders, Airline and Airport staff). Students will email (preference) or text family members at an appropriate time such as in their hotel room in the evening and will refrain from emailing or texting during meal times/meetings/cemetery or memorial visits. No responsibility for global roaming, Wi-Fi, or data charges will be accepted by the chaperone or the Department (responsibility for payment of such charges remains entirely with the student and / or parent). Students are to use digital devices in an appropriate manner that doesn’t disrespect other members of the tour group or the broader community. Students are reminded that it may not be appropriate to use digital devices at specific times such as at monuments of cultural significance or in places of religious significance. In some cultures, particularly where covering up with clothing is part of the culture, the taking of photos without permission is considered highly insulting. Close up photos of any individuals or small groups must only be taken with the express permission of the subjects in the photo. 11 Airport Students must get a chaperones permission to leave the tour group. If leaving the group, students must be in groups of three or more, have a watch or phone set on the time at the airport and check in with chaperones at the departure gate at the designated time. Chaperones will monitor the departure and return of students. Students are responsible for their own luggage. Students must not leave bags unattended unless specifically directed by the tour leaders or airport authorities. Students must ensure that their luggage conforms to the dimensions and weight in line with their ticketing / airline arrangements or the limits imposed by the Department. Lead chaperone will carry a portable bag scale which students can access when necessary to check luggage weight. Students are responsible for the safe keeping of their passports, visas and other travel documentation whilst in transit in a passport wallet/lanyard (supplied by the Department) to be worn around their necks. Students must keep a photo copy of their passport information in a location separate to their passport (e.g. back pack – it is also recommended that students scan key documentation such as passports and email a copy to themselves). Lost documents must be reported at the first available opportunity to the chaperone.
Transport Students, on tour, must wear seatbelts, life jackets and safety helmets when/if provided. Students must remain on the bus they are allocated to and notify their chaperone at the first available opportunity of any missing student/s from their chaperone group.
Accommodation Students must not venture outside the precincts of their accommodation unless as part of the official tour or with the permission from chaperones. Chaperones will advise bed/lights out time each night. Students can socialise in common areas (dressed appropriately e.g. no pyjamas or bare feet) in the hotel as long as chaperones are present. Students must not enter the rooms of students of the opposite sex at any time. There is to be no more than 4 students in a room at any time and noise and music must be kept to a minimum. Students must not order room service, take items from the mini bar (hotels will be requested to remove mini bar items during the tour) or use the phones in their rooms other than to contact their chaperones (or the chaperones on duty at night time) if required. Students must not take souvenir items from their accommodation such as towels, coat hangers. Consumables such as soap and shampoo are acceptable to keep. Students must not deface or graffiti any item in their accommodation. Students are not to invite any visitors (outside the tour group) to meet them at the hotel, unless prior approval received from the lead chaperone. Students must check for any damage to premises on arrival and notify supervising staff or chaperones. Students must attend toilets and shower facilities in pairs where they are located away from sleeping areas. Students must keep their room tidy
Meals Students are responsible for managing any food allergies at meal times. Students with serious food allergies should ensure that they are seated adjacent to one of their chaperones at meal times. Students with serious food allergies must also travel with devices such as Epipens, and alternative supplies of sustenance if supplied meals are unable to be consumed. Chaperones will be informed of any food allergies within their group and be trained in the use of the Epipens.
Touring Students must wear the appropriate standard of dress/uniform as directed by supervising staff or chaperones. Students must wear appropriate clothing when visiting religious sites - o Female students should wear slacks or a dress or blouse and skirt (at least below the knees), preferably with elbow-length or longer sleeves (no bare shoulders or upper arms) and must wear a headscarf (or hooded jacket) when instructed to do so by their chaperone, or tour company representative. They must also be prepared to remove their shoes if entering a mosque.
12 o Male students should wear long trousers and a sleeved shirt. They must also be prepared to remove their shoes if entering a mosque. Students must not damage, vandalise (including graffiti or putting initials on any object) or remove any artefacts from tourist sites even if they appear insignificant or worthless. Students must obey all conditions of entry at the various tourist sites visited while on tour. Students must remain as a group, or with their chaperone group, while touring. Students must first seek the permission of a chaperone to depart the group and then partner with two or more other students or a chaperone to accompany them. Students must report back to the same chaperone when they return back to the tour group. Students must be responsible for bringing their own spending money and covering the cost of their personal expenses, any excess baggage fees and any excess payable for claims made against the travel insurance policy.
Dawn Service Students must wear the tour uniform supplied by the DET International at the Dawn Service, morning tea and Le Hamel Service. Students must adhere to the directions of local authorities such as police, military, at all times when in any country visited throughout the tour. Any dialogue between students and local authorities should occur in the presence of a chaperone and a chaperone must be contacted immediately by the students in this situation.
Health/Wellbeing/Safety Students must be monitored by supervising staff or chaperones in the use of all medication. Students must, so far as is reasonable, disclose to the chaperones any matter which might adversely affect their health, wellbeing or safety at any point during the tour. This includes immediately reporting any accidents, illness, security issues or risk to chaperones. Any difficulties of a personal, financial or social nature must be communicated to one of the tour leaders or chaperones so that they can be addressed. Students should, where possible, look out for the health, wellbeing and safety of fellow students (and in particular their room-mate/buddy) and report any concerns immediately to the tour leaders or chaperones.
Communications and Media Students and their families must not make adverse comments to the public or media (including through social media) about the tour. Any issues should be addressed to the lead chaperone or DET International to respond to. Students are not to speak to the media under any circumstances during the tour unless authorised by and in the presence of a chaperone. Note: In an emergency the Department of Foreign Affairs and Trade is the designated spokesperson on all matters and all communications must be directed through them. Students must wear their supplied jacket or polo shirt for all media photo opportunities and remove all headphones, non-tour clothing and any other items requested by the lead chaperone (which may include hats and sunglasses).
13 PART E: CONSENT FORM
The Premier’s Anzac Prize Consent Form (applications 2017, travel overseas in 2018) Consent to use copyright and personal information
What is this consent for? This Consent Form authorises the Department and the State to use the Student’s personal information and copyright material, together with information about the Student’s participation in Departmental and State initiatives, for the purposes specified in the Consent Form particularly in Section 5. For further information, please refer to Section 8 below.
1. I GIVE CONSENT On behalf of the student identified in Section 6 of this Consent Form (the Student), the person or persons signing this Consent Form (the Signatory)* grant consent to and license the Department of Education and Training(the Department) and any other Department or Agency of the State of Queensland (the State) to use, record and disclose the Student’s: name, image (e.g. a photo or video of the Student), voice, biographical details and other identifying information and any other personal information specified in Section 5 of this Consent Form (personal information); and copyright material, including their written, artistic or musical works or video or sound recordings, created in connection with The Premier’s Anzac Prize (including, but not limited to the examples identified in Section 5 of this Consent Form) (Student work). The consent is given in relation to personal information and Student works whether created before, on or after the date of signing this Consent Form. The Signatory also irrevocably and unconditionally consents to the Student being attributed or not attributed as the author of the Student work in a form and manner acceptable to the Department or the State. The Signatory consents to the Department disclosing my personal phone number and/or email address to media representatives for the purposes of interviewing the Student with regards to their participation in the prize. *Note: If the Student is under 18 years of age, the Signatory must be a parent or guardian of the Student. The Student must also sign if he or she is under 18 and able to give and understand the consent.
2. FOR THE PURPOSE OF This consent applies to the Department and the State using, including recording or disclosing, the Student’s personal information and/or Student work, and permitting other persons to do so, for: the purposes identified in Section 5 of this Consent Form; the purposes of public relations, promotion, advertising, media, commercial and educational activities concerning The Premier’s Anzac Prize (in 2018 and future years), including via the Internet generally (e.g. on the Department and State’s websites), iTunes U and the Social Media Websites identified in Section 5 of this Consent Form; and where the material is uploaded to iTunes U, a Social Media Website or other website: o any purposes, commercial or otherwise, required by operators of the websites as a condition of uploading the personal information or Student work; and o transfer of the personal information outside of Australia in the course of the operation of the website.
3. FOR THE DURATION OF This consent will continue until the Student and/or Signatory revoke consent by providing written notification to the contact officer nominated in Section 7 of this Consent Form. Despite the above, if, at the time the Student and/or Signatory revoke consent: the winners have not yet been selected, the Student will no longer be considered for the prize and tour; the Student is a prize winner and selected for the tour, the Student’s further participation in the tour may be terminated, as the Prize will involve many media and promotional activities (this may mean that the Student may not be able to travel overseas or continue travelling overseas with the other winners); and the Department, the State or another person permitted by them to do so is using the Student’s personal information or Student work, or has entered into contractual obligations in relation to that material, the consent
14 will continue in relation to that material until the use is complete or until the contractual obligations come to an end. The Signatory acknowledges that where material is uploaded to a Social Media Website or other website: 1. the use and the contractual obligations may be perpetual and irrevocable; and 2. it may not be possible to ensure that all copies of the material are deleted or cease to be used, and the Department and the State will not be responsible for doing so.
4. I UNDERSTAND THAT ‘Use’ includes: - to create, make copies of, reproduce, modify, adapt or retain in any form, including by camera, video, digital recorder, webcam, mobile phone or any other device; and - to distribute, publish or communicate in any form, including in Australian or overseas newsletters, print media, television and via the Internet (e.g. Department and State websites), iTunes U and Social Media Websites, in whole or in part, and to permit other persons to do so. The Signatory or the Student will not be paid for giving this Consent or the use of the Student’s personal information or Student work This Consent Form does not revoke other consent forms (e.g. individual school consent forms) in relation to the use of the Student’s personal information or Student work by the Department and the State in The Premier’s Anzac Prize. If there is an inconsistency between this Consent Form and other consent forms in relation to The Premier’s Anzac Prize then this Consent Form will prevail to the extent of any inconsistency. This Consent Form is a legally binding and enforceable agreement between the Signatory and the Department or the State. Nothing in this Consent Form limits the rights that the Department or the State reserve in relation to the use of the Student’s personal information or Student work, copyright or other intellectual property under any other law. The ‘Department’ and the ‘State’ include the officers and employees of the Department and the State engaged in performing services for the Department and the State. ‘Social Media Website’ includes any website operated by a third party which facilitates the uploading and sharing of user generated content, including social and professional networking websites, web forums, blogs and wikis. The definition includes (without limitation) the following websites for accounts currently used by the Department: - Facebook: https://www.facebook.com/pages/Queensland-Department-of-Education-Training-and- Employment/136384799716300 - YouTube: http://www.youtube.com/user/DETQueensland - Twitter: http://www.twitter.com/QLDDETE (or any replacements to the above). In relation to Social Media Websites, this consent only extends to the Social Media Websites specified in Section 5 of this Consent Form. ‘iTunes U’ is an online digital content download service operated by Apple Pty Ltd or its affiliates for the purpose of enabling educational institutions to make educational materials and other content available through Apple’s iTunes software. The definition includes (without limitation) the following iTunes U Site currently operated by the Department: - DETE 2 Go: [http://itunes.apple.com/institution/department-education-training/id413610423] This consent extends to the Department and the State: - disclosing the Student’s personal information and Student work to the Department’s and the State’s agents, contractors and volunteers for the purpose of performing services for the Department and the State; and - permitting those persons to use, record and disclose such material to the same extent as the Department and the State are entitled to deal with the Student’s personal information and Student work.
15 5. PROGRAM/PROJECT/EVENT DETAILS Name and description of program/project/event: The Premier’s Anzac Prize (with applications occurring 2017 and travel 2018). The Premier’s Anzac Prize includes the entry processes, the selection of the winners, the awarding of the prize to go on the tour, the tour/travel in or about April and May 2018, lead up activities in 2017 and 2018 and post-tour/travel events in 2018 and includes promotional activities before and after the tour. Further promotional activity may occur using the Student’s personal information and Student work for promotional purposes in future years beyond 2018. Further details are available from The Premier’s Anzac Prize website at: www.education.qld.gov.au/students/grants/scholarships/premiers-anzac-prize.html (or any replacement website).
Description of what is to be made, used, retained or reproduced: Student’s copyright material Student’s name Student’s image and voice Student’s recording Description of image, copyright material or other personal information: In addition to the Student work and personal information described generally in Section 1 of this Consent Form: photographs of the Student; film/video footage and audio which includes the Student’s image, voice and/or performances; biographical information (e.g. the Student’s school, year level, age and the names/relationships to any relatives, e.g. soldiers the Student has researched); film/video footage, audio (including music), text made and/or produced by or contributed to by the Student (e.g. tour reports); speeches made by the Student (in print or audio version) or films of the Student making the speech; written material made by the Student about The Premier’s Anzac Prize; multimedia presentations made by the Student (including the entry for The Premier’s Anzac Prize); film/video footage and print and audio versions of answers to questions made by the public/other students/others; text and artwork in travel diaries and journals kept by the Student for The Premier’s Anzac Prize (e.g. daily journal entries made on the tour). Description of the purpose for which the personal information or Student work is required, and the medium of reproduction (e.g. paper, electronic or other form). Will it be made, used, retained or reproduced, and will it be distributed, published or communicated to the public (e.g. on the Internet)? In addition to the general purposes stated in Section 2 of this Consent Form: audio-visual presentations that may be presented at The Premier’s Anzac Prize post events; web conferences with school students and teachers within Queensland. Description of the timeframe during which the Student’s name, image or Student work is required (e.g. Is it for one-time use? For what date or dates?): Ongoing from date of signature, unless revoked in accordance with Section 3 of this Consent Form. Please note however if consent is revoked this may impact upon the Student’s continuing involvement in The Premier’s Anzac Prize if the Student is selected for the tour. (This may mean that the Student may not be able to travel overseas or continue travelling overseas with the other winners). Note: publicity and promotion may occur pre-tour in 2017 and post-travel in 2018 and future years. Name that should be used in association with the Student or the Student’s image or Student work: First name, last name and any abbreviations (please note at a minimum, first name and surname must be specified below) [Insert Name here] Will the Student’s personal information or Student work be published on a Social Media Website or the iTunes U site (i.e. permanently published to the public) by the Department? Yes No
16 If yes, which Social Media Website below will the student’s personal information or Student work be published on by the Department: The Student’s personal information and Student work will be published by the Department on: Facebook page: www.facebook.com/pages/Queensland-Department-of-Education-Training-and-Employment/136384799716300 The Department’s Facebook page is publicly accessible by all Internet users. The Department may share information, photographs and videos related to the Department’s programs, activities and initiatives (including The Premier’s Anzac Prize) with users through its Facebook page. YouTube channel: http://www.youtube.com/user/DETQueensland The Department’s YouTube channel is publicly accessible by all Internet users. The Department may share videos related to the Department’s programs, activities and initiatives (including The Premier’s Anzac Prize) with users through its YouTube channel. The Department does not permit users to download its videos uploaded to its YouTube channel. However third party applications may be used to overcome the Department’s settings. Also, please note that people may embed videos from the Department’s YouTube channel into other websites.
Twitter profile: http://www.twitter.com/QLDDETE The Department’s Twitter profile is publicly accessible by all Internet users. The Department may share information, photographs and videos related to the Department’s programs, activities and initiatives (including The Premier’s Anzac Prize) with users through its Twitter profile and stream. iTunes U Site: http://itunes.apple.com/institution/department-education-training/id413610423 The Department’s iTunes U Site is a dedicated store on iTunes U which provides online digital educational materials and other content for download. It is publicly accessible by all internet users who have established an iTunes account. The Department may share information, photographs and videos related to the Department’s programs, activities and initiatives (including The Premier’s Anzac Prize) with users through its iTunes U Site. Other: Provide a short description: In addition to Social Media Websites, the Department may publish personal information and the Student’s work on websites (such as http://deta.qld.gov.au and http://education.qld.gov.au, the Learning Place: http://www.education.qld.gov.au/learningplace/, EdTube: http://www.youtube.com/user/DETQueensland and State websites such as http://www.qld.gov.au/, http://www.premiers.qld.gov.au/). Most websites are publicly accessible by all Internet users.
6. STUDENT DETAILS
Name of Student: Address of Student:
Name of the school (at which the Student is enrolled):
Signature of the Student: Date: //
Name of signing parent or guardian: Address of signing parent or guardian:
17 Signature of the parent or guardian (required if the Date: Student is under 18 years of age): //
18 7. NOTE The Department will use its best endeavours to ensure the person signing this Consent Form is authorised to do so, but takes no responsibility for circumstances in which it is misled as to the identity or authority or ability of a person to provide consent. If you require a copy of this signed Consent Form, or if you wish to revoke this consent, please contact the Senior Project Officer (The Premier’s Anzac Prize), DET International, Phone: (07) 3513 5747.
8. INFORMATION What is this consent for? This consent covers the entire or partial use of the Student’s personal information, as per Section 5 and copyright material in conjunction with other words and images. For example, the Student’s personal information and copyright material may appear in school newsletters, magazines, websites (including iTunes U and Social Media Websites) and other school, departmental or State publications, as well as in television advertising, videos, brochures, forms, public relations displays, annual reports, press advertising, internal documents such as manuals, websites, certificates, strategic plans, posters and other promotional material. There may also be occasions on which the Department may approve the media, such as local newspapers and television stations, using information and copyright material in relation to the Student (for example, announcing winners in The Premier’s Anzac Prize, publishing biographies, attendances at award ceremonies). Websites and Social Media Websites Students and the Signatory should be aware that publication of a Student’s personal information and Student work on websites, including iTunes U and Social Media Websites is similar to publication in newsletters, magazines, brochures, etc; however publication on websites is generally publication of that material to the world at large. Students and the Signatory should be aware that the publication of a Student’s personal information and Student work, by the Department or the State, on a website typically constitutes a permanent and publicly available record of that material. This means that anyone may be able to copy and use an Individual’s personal information and Student work that has been published on a website for any purpose and without the consent or knowledge of the Department, the State or the Student. Students or the Signatory should not grant their consent to the Department or the State to use a Student’s personal information or Individual work in connection with a website if the Student or the Signatory does not agree to the material being permanently available to the public. If a Student’s personal information or Student work is published on a website, that material will be governed by the privacy policy and terms of use of the relevant website. The Department or State cannot reasonably control how a Student’s personal information or Student work is used by or affected by the conduct of third parties once the material has been published on a website which is not under the direct control of the Department, for example, iTunes U and Social Media Websites. What is copyright material? A Student’s copyright material may include written work (e.g. stories and poems), paintings, pictures, drawings, designs, photographs, videos, films, music, performance, recordings, computer programs, websites, sculptures, multimedia presentations made by them or to which they contributed. The Department understands that students generally own the intellectual property rights in the material they create and that this Consent Form is not meant to transfer the Student’s ownership of the intellectual property in their copyright material. What is personal information? Personal information includes information or opinions, whether true or not, about an individual whose identity is apparent or can reasonably be ascertained from the information or opinion. This includes the Student’s name, recording, video, sound recording or image. It may also include the Student’s health information, where such information may enable the Student to be identified. What happens to the Consent Form once it is completed and signed? The Consent Form is retained by the Department and it will be stored on file. The Student or Signatory may request a copy of the signed form by contacting the contact officer nominated in Section 7 of this Consent Form. What if I give my consent and later change my mind? The consent will be in effect from the date the Consent Form is signed. The Department and the State from that point may start using the Student’s personal information and Student work to create material incorporating the Student’s personal information and Student work and may enter into contractual obligations in relation to that material.
19 If you wish to later modify or revoke this consent, the Student or the Signatory should send a notice in writing to the officer nominated in Section 7 of this Consent Form. After that notice is received, the Department and the State will take all reasonable steps to stop using and disclosing the personal information and Student work. The Department and State will not take actions such as destroying any existing printed matter but will, for example, refrain from producing any new material and will remove material from websites under the Department and State’s control.
Note also: If the Student and/or Signatory revoke consent and the Student is selected to go on the tour, the Student’s further participation in The Premier’s Anzac Prize and tour may be terminated, as the tour will involve many media and promotional activities. (This may mean that the Student may not be able to travel overseas or continue to travel overseas with the other winners). Where the Department or another person uploads material to iTunes U, a Social Media Website or other website, it may need to accept contractual obligations that are perpetual and irrevocable. In that case, it may not be possible to ensure that all copies of the material are deleted or cease to be used, and the Department and the State cannot undertake to do so. Privacy The consent to the recording, use and disclosure of the Student’s personal information and Student work is required in accordance with the Copyright Act 1968 (Cth), the Education (General Provisions) Act 2006 and the Information Privacy Act 2009 (as applicable). The Department will only disclose the Student’s personal information in accordance with the consent, except where authorised or required by law. If you wish to access or correct any of the personal information on this form or discuss how it has been dealt with, or if you have a concern or complaint about the way the Student’s personal information has been collected, used, stored or disclosed, please contact the Department.
20 9. PART F - PARENT’S AGREEMENT
I give permission for the student to enter in The Premier’s Anzac Prize 2018 I have read and understand the privacy notice on page 1 of Part A. In particular I note that my contact details may be provided to media representatives for the purpose of them contacting me about the student and the prize and that it is my decision whether I allow the media to directly communicate with the student. I have read and understand the conditions of entry [Part B], the tour rules [Part C] and the Student Code of Conduct [Part D]. I have signed the consent form [Part E] I agree to assist and/or encourage the student to comply with the conditions of entry, above and I have no reason to think that the conditions of entry have been breached by the student.
If the student is chosen for The Premier’s Anzac Prize 2018 tour I agree: it will be my responsibility to: o pay for all incidentals that may arise in connection with The Premier’s Anzac Prize 2018 (including excess baggage fees, spending money, mobile/phone charges, personal purchases, any excess payable under the travel insurance policy) o arrange and pay for their passport that is valid up to 31 December 2018 and ensure there are no restrictions on the student travelling to the tour destinations (United Kingdom (London), Belgium and France) and any stopover countries (Singapore) — Visas will be arranged and paid for by the Department of Education and Training (the Department) o seek medical advice about and pay for any vaccinations o ensure the student is medically fit to travel o disclose all pre-existing medical/health conditions (including those that do not require medication) to ensure that adequate travel insurance coverage is purchased. Note that any costs associated with medical treatment or the repatriation of the applicant, as a result of non-disclosure, will be borne in full by the parent/guardian. o arrange transfers to and from Brisbane (this is only applicable to those students located within reasonable driving distance to Brisbane — Student’s domestic flights will be paid for, where required) to comply with all reasonable requests by the organisers for any additional information or documentation for the purposes of organising the tour (including but not limited to arranging and booking transport, insurance, tours and accommodation) to supply the completed Student Medical Information and Authorisation Form when requested (a sample form, which is indicative of what will be sent to the winners, is available for viewing at www.education.qld.gov.au/students/grants/scholarships/anzac/resources.html) to promptly advise organisers of any changes to information supplied on the application form and any issues which may affect my child’s participation in the tour (for example, a change to my child’s health, family situation, financial situation, school, or a need for any special requirements or assistance on the tour) to ensure the Department, chaperones and supervising staff have up to date contact details for me at all times the student’s selection for the tour may be revoked in accordance with the tour rules [Part C] and the Department is not responsible for any loss or damage if the student’s selection for the tour is revoked that the student is under the care and control of the chaperones and supervising staff on the study tour that the consequences for breach of the conditions of entry, or breach of the Student Code of Conduct may involve the student’s school being notified, the student being sent home under supervision and any other disciplinary action under relevant school rules and I will be responsible for all costs associated with the student being sent home in such circumstances that the student may be sent home at my expense if the student or I revoke the consent given in The Premier’s Anzac Prize 2018 (because the tour will involve many media and promotional activities) the Department is not responsible for any loss or damage to persons or property if the student is sent home in accordance with the tour rules to assist and/or encourage the student to comply with the tour rules.
Signature of parent 1 ______Date ______
21 Signature of parent 2 ______Date ______
22