MAITLAND HIGH SCHOOL - Millennium
MAITLAND HIGH SCHOOL - Millennium
MAITLAND HIGH SCHOOL - Millennium
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<strong>MAITLAND</strong> <strong>HIGH</strong> <strong>SCHOOL</strong><br />
PRELIMINARY / HSC CERTIFICATE<br />
ILLNESS / MISADVENTURE APPEAL APPLICATION<br />
This form must be completed and returned within one school day.<br />
Student: __________________________________________________________<br />
Year: _______________<br />
Subject: ______________________________ Course: ______________________ Units: _______<br />
Assessment Task: _____________________________________________________________________________<br />
Due Date: _______________ Date of Application: _______________ Date Returned: ______________<br />
Reasons for failure to meet requirements by / on due date: _____________________________________________<br />
____________________________________________________________________________________________<br />
____________________________________________________________________________________________<br />
____________________________________________________________________________________________<br />
Medical Certificate: Is attached / Is not attached / N/A (cross out as necessary)<br />
Further supporting evidence: ____________________________________________________________________<br />
Signed: ______________________________ (Caregiver)<br />
________________________________ (Student)<br />
Teacher’s Recommendation: ____________________________________________________________<br />
____________________________________________________________________________________<br />
____________________________________________________________________________________<br />
____________________________________________________________________________________<br />
Signed: _____________________________________________<br />
Date: ______________________<br />
Head Teacher’s Recommendation: _______________________________________________________<br />
____________________________________________________________________________________<br />
Signed: _____________________________________________<br />
Date: ______________________<br />
This form must be forwarded to the Appeal Committee.<br />
Appeals Committee Recommendation: ____________________________________________________<br />
____________________________________________________________________________________<br />
____________________________________________________________________________________<br />
BOS Contact: __________________________________________ Date: ______________________<br />
Copies to: a) Faculty Head Teacher c) Principal / Deputy Principal<br />
b) BOS Contact d) Year Adviser<br />
Note: If this alters assessment ranks all affected students must be notified.<br />
_____________________________________________________________________________________________________________________<br />
Maitland High School 2011 Preliminary Assessment Booklet