Applicant’s Name:
Telephone:
Email:
Sydney Grammar School and State Library of New
South Wales Fellowship
This fellowship is generously supported by Sydney Grammar School and is aimed at
teachers developing suitable educational resources for primary and secondary
students. It involves the development of classroom ready resources such as, learning
activities, lesson sequences, interactive learning objects or applications, games or any
other learning resource which is based on the extraordinary collections of the State
Library of NSW.
Application requirements
Please enter your contact details in the header above. All applications are to be
typed into the application form provided by Monday 12 November 2015.
Applications can be submitted via email to jessica.harris@sl.nsw.gov.au or posted to
the following address:
Learning Services Manager
Mitchell Librarian Division
C/o Jessica Harris
State Library of New South Wales,
Macquarie Street, Sydney, 2000.
For further information or enquiries please contact Jessica Harris on 02 9273 1909.
The personal information on this form will be treated as confidential and managed in
accordance with NSW privacy legislation.
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Applicant’s Name:
Telephone:
Email:
2015 Sydney Grammar School and State Library of
New South Wales Fellowship Application Form
Project Title:
Project summary brief: (no more than 250 words)
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Applicant’s Name:
Telephone:
Email:
Stage and syllabus
Please describe your target audience and the NSW Syllabus for the Australian Curriculum
subject areas that your proposal intends to address. (100 words)
Resources required, timeline, benefits
Please outline the resources that will be required to achieve and develop our proposed
learning tool, a brief time line for project delivery, and explain how the resource will benefit
teachers and students. (100 words)
Collection relevance
Please indicate the collections of the Mitchell, Dixson and State Libraries upon which your
resource will be based. (100 words)
Research outcomes and results
Please indicate how you see teachers using your resource and what you anticipate would be
its major outcome. (100 words)
Examples of your experiences, ideas and completed projects in the
development of teaching and curriculum resources
Please list your experience in developing learning resources for school students. (100 words)
Has this project commenced?
Yes
No
(please circle)
If yes, please outline when the project was started and the current state of progress
on the project.
Have you applied to any other funding body for this project?
Yes
No
(please circle)
If yes, please give details of the funding body, the amount requested and the result
of the application, if known.
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Applicant’s Name:
Telephone:
Email:
Will this project be undertaken as part of the requirements for a formal
qualification?
Yes
No
(please circle)
If yes, please give details.
Current position or occupation
Education and career record
Please give details of your educational background and teaching career.
Names and contact details of two referees who are familiar with your work an
your skills as they apply to library and archival research
Please note: Referee personal information provided to the State Library below is done with
their consent.
1.
Name:
Telephone:
Email:
2.
Name:
Telephone:
Email:
How did you learn about this Fellowship?
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Applicant’s Name:
Telephone:
Email:
Declaration
I have read the conditions relating to the Sydney Grammar School and State
Library of New South Wales Fellowship. I certify that, to the best of my
knowledge, all the information in this application is correct.
If my application is successful, I agree to abide by the conditions for
appointment as the Sydney Grammar School Fellow at the State Library of
NSW.
Signature: ______________________________
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Date: ______________