Application for Exemption from Attendance at School v1.2

1

Students* This field is required.Please include all children covered by this application.

2

Student Address* This field is required.

Street Address

Street Address Line 2

City

State

Post Code

Country

3

Exemption from* This field is required.Start date for exemption

Please enter a date

4

Exemption to* This field is required.End date for exemption

Please enter a date

5

Assessments during student absence

Please note the following when planning holiday/travel absences.

Primary

Missed assessments are listed as not completed on reports.

Years 7–9

No penalty for missed assessments/exams where at least one weeks’ notice is provided.

Years 10–12

Zero grade for missed assessments/exams as per assessment policy.

Student handbooks are available on the SEQTA portal in the Documents area.

6

Acknowledgement* This field is required.I understand it is the responsibility of the guardian (for primary students) or student (for high school) to liaise with their teacher/s to ensure they have collected and understand any work required during an absence.

Yes, I understand.

7

Exemption category* This field is required.Please select the appropriate category that applies to this absence.

Family holiday/travel for 5 - 20 days

Long term holiday/travel of more than 20 school days

Direction under Section 43D of the Public Health Act 1991 (eg. diagnosis of contracting vaccine preventable illness)

Employment in the entertainment industry (eg. role in stage production)

Participation in elite sporting event (NB. For state or national level only)

8

Reason for exemption* This field is required.Please provide further details regarding this absence request.

9

Supporting documentsPlease attach any relevant supporting documents to accompany this request. For long term holiday/travel of more than 20 school days, copies of travel documentation should be included.

Drag and drop files here

Select files to upload

Min. file size1.0KB, Max. file size: 19.5MB

10

Parent/Guardian Name* This field is required.

First Name

Last Name

11

Email* This field is required.

example@example.com

Confirm Email

12

Relationship to student* This field is required.

Mother

Father

Guardian

Other

13

Acknowledgement

As the parent/guardian of the student/s mentioned above, I hereby apply for a Certificate of Exemption from Attendance at School, under the Education Act 1990. I understand that if the exemption is granted:

I understand it is the responsibility of the guardian (for primary students) or student (for high school) to liaise with their teacher/s to ensure they have collected and understand any work required during an absence.
I am responsible for consulting with teachers regarding possible missed assessments and consequences.
I understand it is the responsibility of the guardian (for primary students) or student (for high school) to liaise with their teacher/s to ensure they have collected and understand the work required during their absence.
I am responsible for his/her supervision during the period of exemption.
The exemption is limited to the period indicated on the application.
The exemption is subject to the conditions listed on the Certificate of Exemption from Attendance at School.
The exemption may be cancelled at any time.

I declare the information provided in this application for a Certificate of Exemption from Attendance at School 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 acknowledge that a failure to comply with any condition set out in the exemption may result in the exemption being revoked.

14

Parent/Guardian Signature* This field is required.By signing this you acknowledge that you have read and understood "Assessments during student absence" and the "Acknowledgement" above.

Clear

15

Date

16

Please verify that you are human* This field is required.