• Application for Extended Leave

    Submit a separate application for each student and include the relevant dates, location, and supporting documents.

  • Parent/Carer Details

  • Relationship to Student*
  • Format: (000) 000-0000.
  • As the parent/carer and applicant, I apply for a Certificate of Extended Leave and understand that my child will only be granted a period of extended leave if the Principal accepts the reason provided.

  • Student Details

  • Date of birth*
     - -
  • Student is in*
  • Will you need to submit an application for another child in your family?*

  • Extended Leave Details

  • First day absent*
     - -
  • Last day absent*
     - -
  • Expected return date to the College*
     - -
  • Does the leave include Overseas Travel?*
  • Departure date from Australia*
     - -
  • Return date to Australia*
     - -
  • Has this student previously taken extended leave during the current calendar year?*

  • Family Circumstances Details

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  • Representative Sport Details

  • Event start date*
     - -
  • Event end date*
     - -
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  • Other Leave Details

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  • Travel Details

  • Has travel already been booked?*
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  • Entertainment Details

  • Is payment involved?*
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  • Medical Details

  • Is this for surgery, treatment, a medical appointment or recovery?*
  • Date of procedure, treatment or appointment*
     - -
  • Expected date of return to the College*
     - -
  • Will the student require any restrictions, adjustments or support on return?*
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  • PRIVACY STATEMENT

  • The information that you provide will be used to process your child’s application for Extended Leave. It will only be used or disclosed for the following purposes:
    • general student administration relating to the education and welfare of the student
    • communication with students and parents
    • to ensure the health, safety and welfare of students, staff and visitors to the college
    • state and National reporting purposes
    • for any other purpose required by law
    The information will be stored securely. You may access or correct any personal information by contacting the school. If you have a concern or complaint about the way your personal information has been collected, used, or disclosed, you should contact the College.

  • PARENT/CARER DECLARATION

  • As the parent and applicant, I hereby apply for Extended Leave 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

    By submitting this form 

  • Date of declaration*
     - -

  • College Use Only

  • Should be Empty: