PART 5: REFEREES Referee 1: A person other than your Principal / Line Manager or Authorised Representative Title First Name Surname Name: Position: School / Campus / College Telephone: Work: Email: : Referee 2: A person other than your Principal / Line Manager or Authorised Representative Title First Name Surname Name: Position: School / Campus / College Telephone: Work: Email: : PART 6: ENDORSEMENT The following endorsement must be signed by your School principal, line manager or authorised representative. I have read the Terms and Conditions which apply to this application and the award of a scholarship. I hereby confirm that the applicant named on this application form is a teacher at the School or TAFE NSW Campus / College specified. I endorse and support the application and suitability for the award of a NSW Teacher applicant’s Premier’s Scholarship. I endorse and support the applicant as a suitable ambassador for the Premier of NSW. Signature: Print Name: Position: School / Campus / College: Contact Telephone: Date:
PART 5: REFEREES Referee 1: A person other than your Principal / Line Manager or Authorised Representative Name: Title First Name Surname Position: School / Campus / College Telephone: Work: : Email: Referee 2: A person other than your Principal / Line Manager or Authorised Representative Name: Title First Name Surname Position: School / Campus / College Telephone: Work: : Email: PART 6: ENDORSEMENT The following endorsement must be signed by your School principal, line manager or authorised representative. I have read the Terms and Conditions which apply to this application and the award of a scholarship. I hereby confirm that the applicant named on this application form is a teacher at the School or TAFE NSW Campus / College specified. I endorse and support the applicant’s application and suitability for the award of a NSW Premier’s Teacher Scholarship. I endorse and support the applicant as a suitable ambassador for the Premier of NSW. Signature: Print Name: Position: School / Campus / College: Contact Telephone: Date:
Hicksons_health_education.docx