Relocation Application Form

RELOCATION APPLICATION FORM Principal, Deputy Principal, Head of School, Head of Campus Head of Department, Head of Special Education Services, Head of Curriculum and Guidance Officer PRIVACY: The Department of Education Training and Employment is collecting, using and storing your personal information in accordance with the Information Privacy Act 2009 as part of the ongoing management of your application for relocation. The information will only be accessed by authorised employees within the department. Your information will not be given to any other person or agency unless you have given us permission or we are required to do so by law.

Please type or print clearly the relevant details in the spaces provided. If there is insufficient space, please attach another document or letter. Applicants are able to apply for relocations at level to positions other than their current substantive position. Applicants seeking this type of relocation must refer to the policy to ensure that correct documentation is submitted with application. Email is the preferred method of delivery. You should email this form to your Regional Director and provide a copy to the Principal Human Resource Consultant in your Regional Office. Your application will be forwarded by the Regional Director to: – [email protected]. Notification of receipt of your application will be forwarded within 14 working days. Contact Phone (07) 3237 1300 Fax (07) 3210 0714. Personal Identification Details ID Number Title Surname Given Names

Substantive Position Band Base School or Location Region

Residential Address Details Number and Street Suburb/Town Post Code

Contact Nos Telephone Email Address Fax Mobile School/Location Home/Preferred Supervisor’s Name Supervisor’s Position Contact Number

Application for the Position/s of: Band Sector ie Primary, Secondary, Special

Reason of Application – Insert Y for Yes or N for No in the appropriate non-shaded box below. Requested - Based on Service Required – Loss of Entitlement Other Preferences - (NB) As an applicant for relocation you may be relocated to any school (sector match) within a nominated geographic area. You should therefore nominate only those geographic areas to which you wish to be relocated. Individual schools can only be nominated if they do not belong to a geographic area. Refer to geographic area listing reference in relocation policy document. List Region/s List of preferred geographic areas within nominated region

Partner Information Is your partner an employee with the Department? YES/NO If yes, Partner ID No Is your partner an applicant for transfer/relocation? YES/NO Current Location

To confirm that you understand statements above please place yes in space provided: Comments – Insert extra information regarding particular circumstances or attach additional information. Officer Declaration: In submitting this application I confirm my understanding of the preferences information above. I also understand that the information contained herein remains current only for the year in which the application is submitted. I undertake to advise of any change of circumstances that may impact on my application. Signature and Date (if faxed):

Principal/Regional Director Declaration: In submitting this application I confirm my support and advise that there are: no unsatisfactory work performance processes in progress; no formal investigation in progress; and no performance issues. Both signatures required. Signature and Date (if faxed): Signature and Date (if faxed):

Information below for Workforce Recruitment and Employment use only: Date Received Acknowledged Details Checked Appointment Date Location Pts Yrs @ Pts Total Points Acting Service Status Eligibility Verification Required – Y or N

Uncontrolled copy. Refer to the Department of Education, Training and Employment Policy and Procedure Register at http://ppr.det.qld.gov.au to ensure you have the most current version of this document. Page 1 of 1