Application for Extended Leave - Vacation/Travel Pform
ID:0 | 12/04/2021 |
Recipient: Guest
Originator: Guest
School Logo
1 1. Guest Info
1. Guest Info
2 2. PART A: STUDENT DETAILS
2. PART A: STUDENT DETAILS
3 3. PART B: APPLICANT DETAILS AND CONFIDENTIAL
3. PART B: APPLICANT DETAILS AND CONFIDENTIAL
4 4. HCS APPROVAL
4. HCS APPROVAL
* Mandatory fields | 
Print
1
Guest Info

Full Name of Caregiver completing application: *

Email Address *
2
PART A

STUDENT INFORMATION

Please complete information below with details of all students associated with the period of travel:

Student/s Full Name: *


Family Code:

Student/s Year Level and Date of Birth: *

Student address: *

Will the student require access to their school email address during this period of leave? *

Dates of extended leave applied for from: *

to: *

Number of school days: *

Reason for travel: *

Relevant travel documentation such as an e-itinerary or itinerary (in the case of non-flight bound travel within Australia only) MUST be attached to this application.

IF YOU ARE TRAVELLING INTERNATIONALLY OR DOMESTICALLY BY FLIGHT, YOU MUST ATTACH AN E-TICKET. IF YOU ARE TRAVELLING DOMESTICALLY (E.G. ROADTRIP), YOU MAY ATTACH AN ITINERARY or complete the following question.

If you have not uploaded an e-tinerary or itinerary, please give details of your travel including but not limited to the mode of transport and specific destination. eg. Brisbane

PART A: DETAILS OF PRIOR EXEMPTIONS/EXTENDED LEAVE – VACATION/TRAVEL (if applicable)

Date of prior exemption/extended leave from:

to:

Number of school days:

Attach a copy of Certification of Exemption/Extended Leave
3
PART B

TO BE COMPLETED BY THE APPLICATN

TO BE COMPLETED BY THE APPLICANT

Parent or Caregiver Full Name/s: *


Address: *

Telephone number: *

Relationship to the student: *

As the parent/caregiver and applicant, I hereby apply for a Certificate of Extended Leave-Vacation/Travel and understand my child will be granted a period of extended leave upon acceptance by the Principal of the reason provided.
I understand that if the application is accepted:

  • I am responsible for his/her supervision during the period of extended leave
  • The provided period of extended leave is limited to the period indicated
  • The provided period of extended leave is subject to the conditions listed on the Certificate of Extended Leave-Vacation/Travel
  • The period of extended leave will count towards my child’s absences from school
  • I agree to contact my child's teacher (preferably two weeks prior to leave) to arrange for work to be completed whilst on leave

I declare the information provided in this application is to the best of my knowledge and belief; accurate and complete. I recognise that should statements in this application later prove to be false or misleading any decision made as a result of this application may be reversed. I further recognise that a failure to comply with any condition set out in the Application for Extended Leave- Vacation/Travel may result in the provided period of extended leave being cancelled. *

4
HCS APPROVAL

OFFICE USE ONLY





Principal Comment:




Enter the verification text below * :
 
Next Temporary Save
Save & Submit Close

eForms Workflow statistics  
   Refresh
Please select the student associated with this eForm from the list
  Next  
Do you want to continue the partially filled eForm from the last session?


Yes, continue from where I leftNo, I want to fill a new eForm

Warning: Saving New eForm will destroy any partially filled old eForm!