Adding an Additional Outside School Hours Care (OSHC) Component Form

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Adding an Additional Outside School Hours Care (OSHC) Component Form

This form is for existing Approved Child Care Benefit OSHC services that operate one or two components of OSHC at one site, and wish to add one or two more components of OSHCat the same site. If you wish to be approved for OSHC components at a different site, you will need to complete a new CCB Approval application form.

Complete the relevant section(s) below only for details that need updating and return to your Department of Education(the department) state office upon completion (see attachment A for details).

Organisation Name:______

Service Name:______

Organisation ID:______CCB Approval ID/s:______

Date changes take effect:______

Address of Existing and New OSHC components

Street:______

Suburb:______

City:______State:______Postcode:______

Components of OSHC the service already provides

 Before School Care (BSC)

 After School Care (ASC)

 Vacation Care (VAC)

Components of OSHC the service would like to provide

 Before School Care (BSC)

 After School Care (ASC)

 Vacation Care (VAC)

Operating times of New OSHC component/s

Before School Care

Proposed start date: ______[dd/mm/yyyy]

Number of places:______Number of weeks per year:______

Operating hours / Start time / Finish time
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

After School Care

Proposed start date: ______[dd/mm/yyyy]

Number of places:______Number of weeks per year:______

Operating hours / Start time / Finish time
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Vacation Care

Proposed start date: ______[dd/mm/yyyy]

Number of places:______Number of weeks per year:______

Operating hours / Start time / Finish time
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Insurance

Do your current Workers Compensation and Public Liability Insurance policies provide coverage for your additional component/s?

 Yes

 No

Please attach a copy of your certificate of currency.

Service Approval

Has your state regulatory authority given you service approval for your new OSHC component/s?

 Yes

 No

Please attach a copy of your service approval issued by your state regulatory authority.

Authorised Persons

As the authorised persons for this service, we confirm the above details are correct. We acknowledge that providing false or misleading information is a serious offence.

Name:______

Position:______

Signed:______Date:______

Name:______

Position:______

Signed:______Date:______

This form needs to be signed by two Authorised Persons from your organisation.

Authorised Persons are those persons from your organisation that have previously been identified to the department as having the authority to make changes to organisation or service details.

Attachment A

Addresses for State and Territory Offices

This form should be sent to your local state or territory office. Addresses for these offices are below. Should you wish to send these from electronically, please contact your state or territory office on 1300 670 305 and ask to speak with the Child Care Benefit Approvals team in your state or territory.

State / Address
New South Wales & Australian Capital Territory / Child Care Benefit Approvals Team
Department of Education
GPO Box 9880, Sydney NSW 2001
Victoria / Child Care Benefit Approvals Team
Department of Education
GPO Box 9880, Melbourne VIC 3001
Queensland / Child Care Benefit Approvals Team
Department of Education
GPO Box 9880, Brisbane QLD 4001
Western Australia / Child Care Benefit Approvals Team
Department of Education
GPO Box 9880, Perth WA 6848
South Australia / Child Care Benefit Approvals Team
Department of Education
GPO Box 9880, Adelaide SA 5001
Tasmania / Child Care Benefit Approvals Team
Department of Education
GPO Box 9880, Hobart TAS 7001
Northern Territory / Child Care Benefit Approvals Team
Department of Education
GPO Box 9880, Darwin NT 0801

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