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Travel Application

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adeena Faisal
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16 views4 pages

Travel Application

Uploaded by

adeena Faisal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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NSW Department of Education

Application for extended leave - travel


Note: Part A is to be completed by the student’s parent and returned to their
child’s school principal. Separate applications are to be completed for each school
if siblings do not attend the same school.

Part A: Student details


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

Family name Given name DOB Age Grade SRN

Siddiqui Junaid 22/08/2006 17 11

Student address: 7/30 Wangee Rd Lakemba


Postcode: 2195

School name Homebush Boys High School

Dates of extended leave applied for: From 22/07/2024 to 02/07/2024

Number of school days: 12 days

Reason for travel Perform the holy pilgrimage, first holiday in 12 years!

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.

Details of prior exemptions/extended leave – travel (if applicable)


Date of prior exemption/extended leave: From 22/07/2024 to 02/07/2024

Number of school days: 12

Copy of Certificate of Exemption/Extended Leave - Travel attached: Yes No

education.nsw.gov.au
NSW Department of Education

Parent details (applicant)


Family name: Faisal Given name: Urooj

Student address: 7/30 Wangee Rd Lakemba


Postcode: 2195

Phone number: 0415593049 Relationship to student: Mother

As the parent and applicant, I hereby apply for a Certificate of Extended Leave-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:

‫ظ‬ I am responsible for his/her supervision during the period of extended leave
‫ظ‬ The provided period of extended leave is limited to the period indicated
‫ظ‬ The provided period of extended leave is subject to the conditions listed on the
Certificate of Extended Leave - Travel
‫ظ‬ The period of extended leave will count towards my child’s absences from school

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 - Travel may result in the provided period of extended
leave being cancelled.

Signature of parent/s:
Date: 25/06/2024

Privacy statement
The Department of Education is subject to the Privacy and Personal Information Protection
Act 1998. The information that you provide will be used to process your child’s Application for
Extended Leave - Travel during the period indicated.

It will only be used or disclosed for the following purposes.

‫ظ‬ General student administration relating to the education and welfare of the student
‫ظ‬ Communication with students and parents
‫ظ‬ To ensure the health, safety and welfare of students, staff and visitors to the school
‫ظ‬ State and National reporting purposes
‫ظ‬ 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 school.

education.nsw.gov.au
NSW Department of Education

Part B: To be completed by the principal


I accept this Application for Extended Leave - Travel: Yes No

Please provide more detail here (if required):

Principal’s name: Phone number:

Signature of principal:
Date:

Note: Please complete the Certificate of Extended Leave - Travel if requested leave is to be provided.

education.nsw.gov.au
NSW Department of Education

Certificate of extended leave – travel


The student/s whose details appear below has been provided a period as indicated,
of extended leave from school for the purpose of travel.
Where an application is made by a parent with more than one child a separate copy
of this Certificate should be placed in each student’s file.

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

Family name Given name DOB Age Grade SRN

Student address:
Postcode:

School name

Dates of extended leave applied for: From to

Reason for providing the period of extended leave:

Conditions applicable to providing the period of extended leave:

It has been explained to the parent of the above mentioned student/s that they are responsible for his/her
supervision during the provided period of extended leave.

The parent understands that the period of extended leave is limited to the period indicated and
acknowledges that the provided period of extended leave is subject to the conditions listed.

Principal’s name:

Signature of principal:
Date:

This certificate has been issued without alteration and must be produced when
requested by police or other authorised attendance officers.

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