/ MENTOR TEACHER
Claim Form / POSTAL: PO Box 1777
Unley SA 5061
T: 8373 8777
F: 8373 1766
E:

Information for Claimant

1.  A daily allowance is offered for the mentoring of a Pre-Service Teacher. See maximum days claimable below. If this responsibility is shared by two or more Mentor Teachers, the daily rate is shared between them. A separate Mentor Teacher Claim Form is needed for each Mentor Teacher.

2.  Completed claim forms should be forwarded to EITHER:

a.  The School Finance Officer who will then raise an invoice to Tabor (please see document, GUIDELINES FOR FINANCE STAFF IN INDEPENDENT SCHOOL located at http://learn.tabor.edu.au/course/view.php?id=487 (Section: FINANCE (CLAIMS & PAYMENTS)) for more information),

OR

b.  Tabor School of Education Professional Experience Office together with a ‘Statement by Supplier’ form (available at https://www.ato.gov.au/uploadedFiles/Content/MEI/downloads/Statement%20by%20a%20supplier.pdf. Please also provide the following details for payment:

BSB ……………………………………………..…………..

Account No ………………………………………..………………..

Account Name …………………………………………………………

MENTOR TEACHER Name:

PRE-SERVICE TEACHER Name:

Pre-Service Teacher Professional Experience (check appropriate box): BEGINNING TEACHING PRACTICE

TEACHING IN DIVERSE SETTINGS INTERNSHIP Other

School Attended:

School Phone: Calendar Year: Semester in School:

MENTORING Supervision details: Indicate the days supervised each week, A total of one day’s allowance is the maximum payable for each day that a Pre-Service Teacher is supervised. The maximum number of days claimable for this Professional Experience is listed below.* (Please note that the ‘Beginning of School Year’ observation is not a claimable Professional Experience).

Dates of Supervision Week (Mon-Fri) / Number of Days Supervised
Total No. Days claimed
(see below * )
Mentor Teacher’s Signature
Maximum days claimable PER PROFESSIONAL eXPERIENCE*
BEGINNING TEACHING PRACTICE = 18 days / TEACHING IN DIVERSE SETTINGS = 15 days / INTERNSHIP = 40 days (block only)
Other = as specified by Tabor
Certificate of Principal or School coordinator of pre-SERVICE Teachers
I certify that the above claimant was bona fide employed as Mentor Teacher of Pre-Service Teachers on the dates and for the proportions of time shown above.
SIGNATURE: DATE: POSITION IN SCHOOL: