2021 Term 4 Week 1 Onsite Attendance Application Form - School Supervision
The Premier of Victoria, Dan Andrews, has outlined the road map out of lockdown and that the remote and flexible learning model will continue for the first two weeks of Term 4.

Next week, all students will continue to learn from home, except for students in the following categories:

Children where both parents and/or carers are considered authorised workers who cannot work from home, work for an essential provider and where no other supervision arrangements can be made:

Where there are two parents/carers, both must be authorised workers, working outside the home in order for
        their children to be eligible for on-site provision.
For single parents/carers, the authorised worker must be working outside the home in order for their
        children to be eligible for on-site provision.

Children experiencing vulnerability, including:

in out-of-home care
deemed vulnerable by a government agency, funded family or family violence service, and assessed as
        requiring education and care outside the family home
identified by a school or early childhood service as vulnerable, (including via referral from a government
        agency, or funded family or family violence service, homeless or youth justice service or mental health or
        other health service)

Where a parent/carer indicates that a student with a disability is vulnerable because they cannot learn from home, and/or informs the school the student is vulnerable due to family stress, the school must provide on-site supervision for that student. This may apply to students enrolled in specialist schools and students with a disability enrolled in mainstream schools.


We are asking all families wishing to access onsite supervision next week to please complete this onsite supervision application form and provide confirmation that you are an essential service worker required to attend work.
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Family Name *
Name of child/ren and class *
I am requesting that my child/ren attend/s onsite schooling because my child/ren cannot be supervised at home and no other arrangements can be made.   *
Required
Parent A Occupation and Employer including Employer contact details (to be verified against information we already hold) *
Parent B Occupation and Employer including Employer contact details (to be verified against information we already hold). If single parent family, please put NONE in the box below. Thank you. *
By submitting this form, I declare that my child/ren is/are well and I will collect my child/ren as soon as is practicable upon the request of the school if my child/ren becomes unwell.                                                                                 Parent / Guardian Name *
Updated Emergency Contact Name and Number (must be different from parents named above). *
I have provided Principal, Rachel Corben, with current copies of authorised worker permits for all parents working as essential service workers out of the home. *
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