Teacher Chaperone Application Form

History Teachers’ Association of Australia affiliates can apply to be considered for selection as a Simpson Prize Teacher Chaperone. The Simpson Prize Advisory Committee will select 3 applicants to accompany the students on Simpson Prize study tours, initially to Canberra in early 2027, then to key historical and commemorative site/s overseas at a time to be confirmed*

Please ensure you have read the Teacher Chaperone Entry Requirements prior to filling out and submitting the form below.

Your Details

Your given name(s) *

Your surname *

Your personal email address *

Your state/territory

Your postcode

Your mobile phone number *

School Details

School name *

School postal address *

School state/territory *

School postcode *

School phone *

Your work email address *

Your Application

Please provide no more than 300 words indicating why you want to accompany the students.

References:

Please include 2 references commenting on your suitability for a Teacher Chaperone role.

ATTACH YOUR REFERENCES

References can be uploaded as .doc, .docx, .rtf or PDF files.

Declaration:

I confirm that my School Principal is fully aware of and supports this application.

Confirm

Please leave this field empty.

*Final itinerary is subject to confirmation.

The Simpson Prize follows the Australian Privacy Principles Guidelines issued by the Office of the Australian Information Commissioner.

The Simpson Prize adheres to the Australian Privacy Principles in the Privacy Act 1988 (the Privacy Act), which regulate how agencies collect, use, disclose and store personal information, including sensitive information, and how individuals may access and correct records containing their personal information.

In addition, the Simpson Prize adheres to the Information Privacy Act 2014 (ACT) and the Territory Privacy Principles.

The Simpson Prize may collect personal information such as student name, student email address, student phone number, parent/guardian name, parent/guardian email address, parent/guardian phone number, school name, school address, teacher name, teacher contact email address and teacher contact mobile phone number.