On-Site Attendance / COVID-19 Declaration Form
All Victorian schools will be in lockdown for the period of Friday 3rd until (and including) Friday 17th September 2021 for all students.  On-site supervision may be approved for vulnerable children and children of essential service workers.

As with other remote learning periods, our school will provide on-site supervision for students in the following categories:

Children where both parents and/or carers are 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:
*children in out-of-home care
*children deemed vulnerable by a government agency, funded family or family violence service, and is assessed as requiring education and care outside the family home
*children 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.

If you are eligible and would like to apply for on-site supervision for your child(ren), please register to do so by completing and submitting this application form.  You can include more than one child on the form.


All information provided will be dealt with in the strictest of confidence in accordance with the Australian Privacy Principles contained in the  Commonwealth Privacy Act 1988 as detailed in the school’s Privacy Policy.  A copy of the Privacy Policy is available on the school’s website.

St. Patrick's School reserves the right to refuse your child/ren and yourself entry to the school if you have answered Yes to any of these questions. We trust that you appreciate your declaration is in the best interests of the health and well-being of all members of our school community.
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Student(s) Name *
Please select ONE of the following options *
Has anyone who lives at your address returned from domestic or international travel within the last 14 days? *
In the last 14 days, has anyone who lives at your address been in physical contact with a person/s who has been diagnosed with the COVID-19 virus? *
Is anyone who lives at your address currently under a form of self-isolation as a result of an order of a government authority or as the result of a recommendation by a health professional? *
In the last 14 days, has anyone who lives at your address experienced symptoms such as: >Flu-like symptoms >Fever >Coughing >Shortness of breath >Fatigue *
Dates required
AM
PM
All Day
Friday, 3 September
Monday, 6 September
Tuesday, 7 September
Wednesday, 8 September
Thursday, 9 September
Friday, 10 September
Monday, 13 September
Tuesday, 14 September
Wednesday, 15 September
Thursday, 16 September
Friday, 17 September
Disclaimer *
Required
Parent/Guardian Name *
Parent/Guardian mobile phone number *
Date *
MM
/
DD
/
YYYY
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