HEADSHIP (NPQH) APPLICATION FORM 2015 / 16 (Cohort 6) PERSONAL INFORMATION Name: Position in School: Teacher Unique Reference Number: 7 digits provided when you are awarded QTS Gender: Ethnicity: White British White Irish White Other Mixed White & Black Caribbean White & Black African Mixed White & Asian Mixed Other Mixed Asian or Asian British Indian – or Asian British Pakistani – Asian or Asian British Bangladeshi – Asian or Asian British Other Asian – Black or Black British Caribbean – Black or Black British African – Black or Black British Other Black – Chinese Other Any Other – I Prefer Not to Say Any Disability: Yes / No / Prefer not to say School Name & Address: Local Authority: Home Address: Home Phone: Mobile Phone: Date of Birth: Preferred Email Address: (we will use this to contact you regarding the course) Second Email Address: National College Unique Reference Number: PROGRAMME COSTS AND HEADTEACHER’S CONSENT The total cost of the NPQH programme is £2,495.00 (less the amount of any scholarship awarded) Amount of Scholarship Awarded: Please confirm who will fund the balance of your fees Self / School / Leadership Levy (difference between course cost and scholarship received) **YOUR HEADTEACHER MUST GIVE THEIR CONSENT TO YOUR APPLICATION AND ATTENDANCE ON THIS PROGRAMME** I hereby confirm that the above named has my support in applying for this programme -------------------------------------------- -------------------------------------------- Signed by Headteacher Date ELECTIVE MODULES To achieve the NPQH qualification you will need to successfully complete three essential modules (Succeeding in Headship, Leading and Improving Teaching, Leading an Effective School) and two further elective modules. 1 Closing the Gap Leading Change for Improvement Leading Staff and Effective Teams Using Data and Evidence to Improve Performance Curriculum Development
HEADSHIP (NPQH) APPLICATION FORM 2015 / 16 (Cohort 6) PERSONAL INFORMATION Name: Position in School: Teacher Unique Reference Number: 7 digits provided when you are awarded QTS Gender: Ethnicity: White British White Irish White Other Mixed White & Black Caribbean White & Black African Mixed White & Asian Mixed Other Mixed Asian or Asian British – Indian or Asian British – Pakistani Asian or Asian British – Bangladeshi Asian or Asian British – Other Asian Black or Black British – Caribbean Black or Black British – African Black or Black British – Other Black Chinese Other – Any Other I Prefer Not to Say Any Disability: Yes / No / Prefer not to say School Name & Address: Local Authority: Home Address: Home Phone: Mobile Phone: Date of Birth: Preferred Email Address: (we will use this to contact you regarding the course) Second Email Address: National College Unique Reference Number: PROGRAMME COSTS AND HEADTEACHER’S CONSENT The total cost of the NPQH programme is £2,495.00 (less the amount of any scholarship awarded) Amount of Scholarship Awarded: Please confirm who will fund the balance of your fees (difference between course cost and scholarship received) Self / School / Leadership Levy **YOUR HEADTEACHER MUST GIVE THEIR CONSENT TO YOUR APPLICATION AND ATTENDANCE ON THIS PROGRAMME** I hereby confirm that the above named has my support in applying for this programme -------------------------------------------- -------------------------------------------- Signed by Headteacher Date ELECTIVE MODULES To achieve the NPQH qualification you will need to successfully complete three essential modules (Succeeding in Headship, Leading and Improving Teaching, Leading an Effective School) and two further elective modules. 1 Closing the Gap Leading Change for Improvement Leading Staff and Effective Teams Using Data and Evidence to Improve Performance Curriculum Development
NPQH-Application-Form-Cohort-6.docx