Application for Extended Leave - Vacation/Travel Pform
ID:0 | 23/11/2017 |
Recipient: Guest
Originator: Guest
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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
* Mandatory fields | 
1
Guest Info

Full Name *

Email Address *
2
PART A

STUDENT INFORMATION


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

Family Name: *


Family Code:

Given name/s and date of birth of students going on leave: *

Student address: *

Dates of extended leave applied for from: *

to: *

Number of school days: *

Reason for travel: *

Relevant travel documentation such as an e-ticket 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 eticket or itinery, 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

Family name and given name: *


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
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