IRP Application Form

Application Form

To be eligible you need to meet 5 eligibility criteria. If you answer no to questions 1-5 your application will be ineligible.

Are you the classroom teacher who is responsible for providing reading instruction to the student? *

Yes No

Does your IT support area confirm that your school internet allows for connectivity to the Lenovo TAB M8 Tablet with the WiFi standard 802.11 b/g/n? *

Yes No

Please click here for further technical specifications for the tablet device.

Is the student an Aboriginal and/or Torres Strait Islander person? *

Yes No

This year is the student enrolled and attending school for a minimum of 90% of actual school days? *

Yes No

Is the student aged 8-15 years? *

Yes No

Your contact details.

Teacher First Name *

Teacher Last Name *

What is your work telephone number? *

Enter the full number and area code without any spaces e.g 0264348417

What is your mobile telephone number? *

Only enter a mobile telephone number.

What is your work email address? *

example@yourschool.edu.au

We require student, parent and school information so we can contact you.

Student First Name *

Student Last Name *

Student date of birth *

Date

What is the student's sex? *

What is the student's current age? *

Parent/carers First Name *

Parent/carers Last Name *

What is the parent/carers mobile telephone number? *

What is the parent/carers email address? *

Does your student have a reliable internet connection at home? *

Full school name *

School Postal Address *

City/Town *

Postcode *

State/Territory *

School Email *

What is the first name of a back-up contact teacher at your school? *

Backup teacher Last Name *

What is the work email address of the back-up contact teacher? *

example@yourschool.edu.au

What is the mobile telephone number of the back-up contact teacher? *

Only enter a mobile telephone number that the back-up teacher can be reached on.

We need information about the student and their reading ability. *Note for the following rating questions, drag the slider to the preferred position.

Student Profile

Tell us about your student. Who are they and what do they bring to the classroom? Describe their attitude to learning and how they interact with peers and staff at the school. *

0/500

On average, how much time does the student spend reading quietly, by themselves each week? Record your answer in minutes. For example, 1 hour and 40 minutes = 100 minutes. *

How do you rate the student's reading ability in their year level? (0= Minimal Achievement, 100=Outstanding)

How motivated to read is the student now? (0= Not motivated, 100=Very highly motivated) *

Do you think that the student will be a consistent reader throughout the 12 weeks of the program? (0= No, 100=Definitely)

Does your student believe they will improve their reading ability? (0= No, 100=Definitely)

How would you rate the quality of your teacher/student relationship? (0= Very poor, 100=Excellent)

Is the parent/carer engaged and supportive of the students schooling? (0= No, 100=Yes, fully engaged & supportive)

We need to confirm that parents and teachers understand and agree to participate in the Indigenous
Reading Project E-reading program. Please respond to the following statements.

Thank you for taking an interest in our E-reading program. The information that you have provided in this application form indicates that you do not meet our eligibility requirements. Unfortunately, this means that you will not be able to apply.

PARENT CONFIRMATION
I/we have read and understood all of the information in this application.
I /we will actively encourage, monitor and support the student to complete the E-reading Program.
I /we will pay replacement costs to IRP if the tablet is lost/stolen/damaged while on loan.
All of the information that I have provided in this application is true.

Parent Confirmation *

Yes

TEACHER CONFIRMATION
I have read and understood all of the information in this application.
I will actively encourage, monitor and support the student to complete the E-reading Program.
I will provide reports to IRP about the students reading progress.
All of the information that I have provided in this application is true.

Teacher Confirmation *

Yes

Eligibility

Teacher contact information

Contact Information

School contact information

Reading

Parent and teacher checklists