Attachment 2
APPLICATION FOR APPROVAL OF OVERSEAS EXCURSIONS – SECTION 1
COPIES OF ALL CORRESPONDENCE TO PARENTS AND STUDENTS MUST BE ATTACHED
Checklist
This application must:
- be completed with reference to the Overseas Excursions – Policy & Mandatory Procedures
- be endorsed by the school board and signed by the principal
- have copies of all correspondence to parents and students attached
- have the form Application for approval of Outdoor Adventure Activities attached if appropriate
- be lodged with the relevant Director (Schools) at least FOUR MONTHS prior to the proposed excursion
School: ...... Year Level(s): ......
Destination: ...... Date(s): ......
Number of Students Participating:Male: …...... Female: …...... Total:
All adults accompanying this excursion must be listed:Gender
Teacher in Charge: ...... ………………………………....
Accompanying Teachers:
Name: ...... …...... …..
Name: ...... …...... …..
Other Accompanying Adults:
Name: ...... …...... …..
Name: ...... …...... …..
Name of Qualified First Aid Person(s): ...... ….…….. ……………………………
Approximate Cost of Excursion Per Student: $…......
Educational activities/major learning outcomes & relevance to the curriculum (this information may be included in your documentation to parents)
......
......
......
......
Principal’s Checklist
School Board Approval (minutes) attached / / Immunisation requirements / Excursion details to parents and students attached / / Emergency Plan attached /
Medical information form to parents attached / / Risk assessment completed and attached /
Parent consent form attached / / Foreign Affairs & Trade contacted and details attached /
Application for Approval of Outdoor Adventure Activities completed, if required, and attached
I verify that all mandatory procedures have been carried out in accordance with this policy
Principal’s signature: ……………………………………………………………….……..… Date: ……..…
Recommended for approval by Director School Operations: ………………………… Date: ……......
Approved by the Executive Director School Education: …………………………….…… Date: …….....
DO NOT SEPARATE THESE TWO PAGES
APPLICATION FOR APPROVAL OF OVERSEAS EXCURSIONS – SECTION 2
This application (section 1 and section 2) must be re-submitted to the relevant Director School Operations with final details ie. any changes to the initial application plus emergency plans for illness, accident and hospitalisation, at least FOUR WEEKS prior to departure.
The documents listed below are also required to be attached to the re-submitted application.
Emergency plan (revised if necessary)
Department of Foreign Affairs and Trade current travel advice
Risk Assessment (revised if necessary)
ACT Insurance Authority Overseas Excursion – Request for Insurance
(completed showing date faxed to ACTIA)
Statement from teacher in charge that medical information and parent consent
forms have been received from all students attending
Principal’s signature: …………………….…………………………… Date: ……...…
FINAL DETAILS INCLUDING ANY CHANGES TO INITIAL APPLICATION TO BE RESUBMITTED AT LEAST FOUR WEEKS PRIOR TO DEPARTUREFinal details approved by Director (School Operations): ……………….. Date: …..….
Updated August 2006