Tel: 01296 382765
Fax: 01296 424661
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National Professional Qualification for Middle Leadership 2014-15

Application Form

I would like to be considered for the NPQML programme.

*First Name: / *Surname
*FullSchool Address including Postcode:
*School type/phase
*email (not school address as the firewalls block our messages)
*Role: / School e-mail:
*Phone: / *Teacher Ref No:
Delivery groups are allocated using your school postcode. If you would rather that your home postcode be used please provide it here:
Have you attended any of the Partnership’s “standalone” elective modules? If so, please state which module(s).
Please answer the following and add comments where relevant:
I have the support of my headteacher in applying for this programme. / Yes/No
The Headteacher accepts that the school is committed to ensuring attendance for the whole of each “Face-To-Face” training event of the programme. / Yes/No
Name of Head: / E-mail:
Personal Statement:
How has the experience and impact of your role or career made you eligible for the NPQML?
Please complete in no more than 500 words.
Headteacher’s Supporting Statement:
Please explain how the applicant has demonstrated his/her readiness for this programme.
Please complete in no more than 500 words.
I confirm that I will have the opportunity to take responsibility for an aspect of whole school development / Yes / No
I confirm that I am working as part of the middle leadership team, (or I will be enabled to work alongside the middle leadership team for the duration of my leadership development task) / Yes / No
I confirm that my school will provide coaching support for my work and that they are open to quality assurance visits / Yes/No
Name of coach: / E-mail:
Are you currently involved any other national courses/Masters programmes or have you completed work at this level in the last two years. / Yes/No
Please give details
My school accepts the costs of the programme / Yes/No
Please supply any relevant information you wish to draw to our notice e.g. a disability or a special dietary requirement
How would you describe yourself?
These categories of ethnic origin are recommended by the UK Equal Opportunities Commission as the most appropriate for the UK. We recognise however that the specified categories may not be appropriate for everyone. If this is the case, please use the last box, “Other Ethnic Group”.
Please highlight appropriate categories:
Male / Female
White British / Irish / Other* / Mixed
White/Black Caribbean / White/Black African / White/Asian / Mixed Other*
Asian / Asian British / Indian / Pakistani
Bangladeshi / Asian Other* / Black / Black British
Caribbean / African / Black Other*
Chinese / Chinese Other* / Other Ethnic Group*
* Please define.

Email to or fax to 01296 424661.

Licensed by the National College to deliver national leadership programmes