Application for internal review

Section 1: Applicant details

Full name of person or entity applying for review: *

If entity – full name of representative:

Email address: *

Phone number: *

Postal address

Street address *

City *

State *

Postcode *

QCT application, registration, or reference number (if applicable):

Section 2: Decision for review

Other – please specify: *

Date of the decision you are seeking to have reviewed*: *

Internal review applications must be submitted within 28 days of receiving the decision notice or becoming aware of the decision. If more than 28 days have passed since the date of your decision ending, contact internalreview@qct.edu.au to request an extension, providing reasons to support why more time should be granted.

Please upload a copy of the decision notice (if available):

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Section 3: Grounds for review

On what grounds do you believe the original decision was incorrect? *Please outline the specific reasons or grounds for your request for a review. If you have multiple reasons or grounds, it may be helpful to list them in numbered paragraphs for clarity.

Do you have any supporting evidence or documentation to support your application? If yes, please upload documents here:

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There is no need to resubmit information already provided to the QCT – please only upload new evidence or documentation. Ensure your documents are in an accepted format (e.g. PDF, Word, JPG, PNG, MP3), do not exceed 5MB per file, are clear and legible, and have clear file names. To prioritise child safety and wellbeing, ensure no identifying student information is included in your evidence.

For decisions relating to certification, please also complete and attach the documents listed below: *

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Review of a certification decision – Highly Accomplished

Review of a certification decision – Lead

The QCT reviews all information provided during the internal review process. In some cases, if new information is submitted, the QCT may amend the original decision without referring the matter to the internal review committee. If the matter proceeds to the internal review committee, you will have the opportunity to provide additional verbal or written submissions. While this can be confirmed closer to the hearing date, please indicate your initial preference for the type of additional submission you intend to provide: *

Section 4: Representation (if applicable)

Is someone representing you? *

YesNo

Note: This refers to another person acting on your behalf, such as a legal representative. By providing their details, you consent to them receiving copies of all correspondence related to the internal review process.

Please provide the following details of your representative: *

Section 5: Declaration

Please confirm the extent to which artificial intelligence (AI) has been used in this application: *Use of technologies including artificial intelligence should be in adherence with employer policies and guidelines (if applicable) and adhere to the Code of Ethics for Teachers in Queensland.

Other – please specify *

Declaration: I declare that the information provided in this application is true and correct to the best of my knowledge. *

I agree

Signature: *

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