2016

Year 10 and Year 11 Entry to John Monash Science School

Illness/Misadventure Form

For students who were unable to sit the examination in May or June 2015

Instructions to Parents

Note: In this document ‘parent’ includes ‘guardian’ and ‘carer’.

If some problem, such as sickness or accident, prevents your child from taking the John Monash Science School examination on 30 May 2015 for Year 11 applicants, and 20 June 2015 for Year 10, you should complete the illness/misadventure form as soon as possible. You should include evidence to support a misadventure claim. You must include a medical certificate that covers the examination date if your child was sick and contact details of the medical officer. You should also include a supporting statement from your child’s current principal.

The completed illness/misadventure form should be returned to the John Monash Science School no later than 2nd June 2015 for Year 11, and 23rd June 2015 for Year 10.

If your submission is successful you will contacted by the John Monash Science School and be informed of alternative examination arrangements.

Contact Details

John Monash Science School

Monash University

Email:

Postal address: John Monash Science School, P.O. Box 8016, Monash University, 3800.

Telephone: 03 99051002 or 99020740

Fax: 99029952

Website: http://www.jmss.vic.edu.au

Illness/Misadventure Form

Student Details

1. Student’s family name:

2. Student’s given names:

3. Student’s number:

To be completed by Parents/Carer

Please indicate the grounds for your illness/misadventure claim.

I give permission for a representative of John Monash Science School to discuss medical issues which relate to the exam with my son/daughter’s doctor.

Parent’s full name:

Parent’s signature:

Date:

Illness/Misadventure Procedure

Note: Supporting information from the student’s principal and health professionals must be attached to this form.

This information must include a medical certificate covering 30th May 2015 for Year 11 applicants, and 20th June 2015 for Year 10, and the medical officer’s contact details.

The completed form and supporting information should be mailed to the:

John Monash Science School

PO Box 8016

Monash University

Victoria 3800

This material must be received by 2nd June 2015 for Year 11, and 23rd June 2015 for Year 10.

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