Holiday Programs Expression of Interest Form

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Child's name* This field is required.
First Name
Last Name
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Parent/Carer Email
example@example.com
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Is your child currently receiving educational intervention at PosAbility?* This field is required.
Yes, they currently have sessions at PosAbility
No, my child has never had educational intervention with PosAbility
No, but they have attended previously
4
Are you seeking assistance in the same learning area as during the term?
Yes
No, we would like to receive assistance in a different learning area, e.g literacy or numeracy
Yes but we would also like assistance in a different learning area (e.g. some literacy and numeracy sessions)
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Has your child undergone an assessment in the requested learning area with PosAbility in the last 6 months?
YESNO
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What is your child's date of birth and grade level?* This field is required.
Date of birth
Grade Level
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Please select the Package you are after (for clients that have completed a placement test in preferred learning area within the last 6 months only)* This field is required.The session bundles are designed for students that are significantly below age expectations in one or more areas of learning and would benefit from short-term intervention to boost their skills. We use an intensive approach to achieve specific targets within a holiday period. These targets consolidate and further build basic learning skills in the academic areas of literacy (including reading, spelling, writing and/or comprehension) or Maths. If selecting "other", please note your preferences below.
8 x 1 hour session pack for $1295
10 x 1 hour session pack for $1595
12 x 1 hour session pack for $1890
16 x 1 hour session pack for $2390
20 x 1 hour session pack for $2900
Study Skills / Executive Functioning (number of sessions to be confirmed) $155 per hour
Other (please outline preferences below)
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Parent Names and Contact Details* This field is required.
Parent 1 (Key Contact)
Parent 2
Please enter the Key Contact's phone number
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For individual sessions, please select your holiday program bundle (New clients to PosAbility OR existing clients in NEW learning area)* This field is required.All new students or students who have not attended PosAbility for over 6 months, require an initial assessment to see where their skills are in an academic area (maths and/or literacy). This informs us of what specific areas require focus, and a new program is created to suit their individual learning needs. The session bundles are designed for students that are significantly below age expectations in one or more areas of learning and would benefit from short-term intervention to boost their skills. We use an intensive approach to achieve specific targets within a holiday period. These targets consolidate and further build basic learning skills in the academic areas of literacy (including reading, spelling, writing and/or comprehension) or Maths.
Literacy OR Numeracy Initial assessment + 8 X 1 hour session pack for $1720
Literacy OR Numeracy initial assessment + 10 X 1 hour session pack for $2020
Literacy OR Numeracy initial assessment + 12 X 1 hour session pack for $2315
Literacy OR Numeracy initial assessment + 16 X 1 hour session pack for $2815
Literacy OR Numeracy initial assessment + 20 session pack for $3325
Combined initial assessment + 16 X 1 hour session pack (8 X literacy, 8 X Numeracy) for $4065
Other
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Please select the number of Booster sessions requested in current learning area (Existing clients only)
4 X 1 hour for $580
8 X 1 hour for $1160
12 X 1 hour for $1690
Other
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Please specify the subject areas that have been identified as areas of concern by teachers/parents* This field is required.
Reading
Spelling
Writing
Comprehension
Unsure
Maths
Study Skills / Executive Functioning
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Please tick the weeks you child is available to attend* This field is required.
Week commencing 6th January
Week commencing 13th January
Week commencing 20th January
Week commencing 27th January
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Are there any days in your selected week when your child is UNAVAILABLE to attend?
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How many hours each day would you like your child to attend?* This field is required.
1 hour per day
2 hours per day
3 hours per day (for suitable students)
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Please detail any particular requests you have regarding the interventionPlease detail any request for times, consultant etc. here
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Has your child received or are they currently receiving intervention or additional help for learning? Please detail any intervention or additional assistance your child has received or is currently receiving at school or through other tutors or professionals.
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Has your child undergone any previous assessments? Please list any assessments that have previously been completed that are relevant to the area of concern or your child's academic development (including the date and with whom they were completed)
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Please attach previous reports Please attach any reports or information (from the last 2 year) that are relevant to your child's academic program. For example, NAPLAN, previous standardised assessments, most recent school report, OT reports, Speech and Language reports or psychometric reports.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Does your child have any medical, behavioural, emotional or other concerns that may impact on their intervention sessions? Please detail any medical, behavioural, emotional or other concerns that may require additional support or preventative plans to ensure they receive maximum benefit from their intervention sessions.
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Holiday Program Bookings, Payments and Cancellation Policy

Upon receipt of the expression of interest form, our team will email you the available sessions and suggested schedule. Any times offered are reserved for 48 hours only.

To confirm the schedule and program, a Holiday Program Confirmation Form will need to be completed, including a $250 non-refundable deposit to secure the bookings. If we not receive the completed booking form within 48 hours, then the times are made available for other clients.

An invoice will then be sent for the remainder of the program fee, which is payable a week prior to commencement of the school holidays.

No refunds are given for any holiday programs once the holidays have begun. Rescheduling of booked sessions may occur prior to the commencement of the school holidays. Any changes requested after this date cannot be guaranteed.

A minimum of 24 hours notice is required for all cancellations in order for credits to be applied. Credits may be used for additional sessions in the same school holidays or for sessions in the following school holiday period.

Cancellations must be made via phone call to our office number during normal business hours (94204101) or email to admin@posability.com.au outside of these hours.
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Brief Summary of Privacy Policy

(Please refer to full policy for more information)

The management of PosAbility Australia are committed to protecting the privacy of our clients without our practice. Information is kept strictly confidential and used only for the health, well-being and care of our clients.

At PosAbility Australia, we will;

Take steps as are reasonable in all circumstances to implement practices, procedures and systems to ensure compliance with the Australian privacy laws and deal with enquiries or complaints respectfully and professionally.

Collect personal information for the primary purpose of managing a client’s care and for financial claims and payments

Only interpret and apply a client’s consent for the primary purpose for which it was provided. The Practice staff must seek additional consent from the patient if the personal information collected may be used for any other purpose.

Inform clients of what and why information has been collected, how the information will be used or disclosed, why and when consent is necessary and what the procedures are for access and correction of information.

Collection, Use and Storage of personal information

We have adopted the privacy compliance standards relevant to PosAbility Australia to ensure personal information is protected.

For administrative and billing purposes and to ensure quality and continuity of a client’s care, a client’s educational information and psychometric test results are shared between staff of PosAbility Australia. Staff will only access this information if they are directly involved in a client’s care.

Collected personal information will include a client’s;

Names, addresses and contact details

Relevant background history and medical information

Previous reports from other professionals

Other information stored about your child or a client may include;

PosAbility test results and reports

End of term reviews

Goal sheets and evaluation of goals

Session records

A client’s personal information may be held at the practice in various forms;

Paper records

Electronic records

Audio recordings

All personal information is stored securely and is confidential, subject to Australian privacy laws. A parent's consent is required prior to any disclosure of information about a child except in the case of a supboena or in accordance to Mandatory reporting laws.
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Please tick to indicate that you have read and agree to abide by the PosAbility Psychology and Learning Clinic policies and procedures* This field is required.
I have read and agree to abide by the Holiday Program Payments and Cancellation Policy
I have read and agree to the Privacy Policy
If my child is unwell with any respiratory, Flu or COVID symptoms, they will not attend the clinic
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