Statement of Authority for School Transport Assistance Instructions
This form contains 41 fields organized into 11 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Closer Transport Pick-up Point Availability | ||
| No | Checkbox |
Check this box if a closer transport pick-up point could not be made available to the family, even if requested.
|
| Yes | Checkbox |
Check this box if a closer transport pick-up point could be made available to the family if requested.
|
| Decimal Distance | Number |
Please enter the fractional part of the distance to the nearest tenth of a kilometre.
|
| Whole Kilometre Distance | Number |
Please enter the whole number part of the distance to the possible alternate pick-up point in kilometres. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| Distance Verification Confirmation | ||
| No | Checkbox |
Check this box if you are NOT the person who measured and/or verified the distance or time requested in questions 6, 7, and 8.
|
| Yes | Checkbox |
Check this box if you ARE the person who measured and/or verified the distance or time requested in questions 6, 7, and 8.
|
| General | ||
| Instructions button | Button | |
| Print button | Button | |
| Clear button | Button | |
| Principal Family Home Address | ||
| Address Line 1 | Text |
Enter the first line of the principal family home address.
|
| Address Line 2 | Text |
Enter the second line of the principal family home address.
|
| Address Line 3 | Text |
Enter the third line of the principal family home address.
|
| Postcode | Text |
Enter the postcode of the principal family home address.
|
| Proximity to Alternate State School | ||
| No | Checkbox |
Check this box if the principal family home is not less than 4.5km (one way) from available transport to another appropriate state school.
|
| Yes | Checkbox |
Check this box if the principal family home is less than 4.5km (one way) from available transport to another appropriate state school.
|
| Name of School | Text |
Please provide the name of the alternate state school.
|
| Additional School Information | Text |
Please provide any additional information or details regarding the alternate state school. Fill only if 'Yes' is 'Yes'.
Depends on:
Yes
|
| School and Travel Details | ||
| Nearest School Name | Text |
Enter the full name of the state school nearest to the student's principal family home that offers tuition at the student's level.
|
| Distance Home to School (No Transport) | Number |
Enter the exact one-way distance in kilometers from the principal family home to the named state school by the shortest practical route, specifically where no transport service is available.
|
| Distance Home to Transport Pick-up | Number |
Enter the exact one-way distance in kilometers from the principal family home to the nearest transport pick-up point (e.g., bus stop) using the shortest practical route towards the named state school.
|
| Distance Transport Pick-up to School | Number |
Enter the exact one-way distance in kilometers from the transport pick-up point to the named state school using the transport service route.
|
| Return Journey Time (Hours) | Number |
Enter the duration in hours that a return journey takes from the principal family home to the named state school.
|
| Return Journey Time (Minutes) | Number |
Enter the duration in minutes that a return journey takes from the principal family home to the named state school.
|
| Statement Of Authority | ||
| Type of Authority or Organisation | Text |
Enter the type of authority or organisation making this statement, for example, Shire Clerk or Bus Proprietor.
|
| Name of Authority or Organisation | Text |
Enter the full name of the authority or organisation making this statement.
|
| Signature of Authority Representative | Text |
Provide the signature of the authority or the person representing the organisation.
|
| Date | Date |
Enter the date when this statement is made.
|
| Student's Date of Birth | ||
| Student's Date of Birth | Date |
Provide the student's date of birth.
|
| Student's Name | ||
| Family Name | Text |
Please provide the student's family name.
|
| First Given Name | Text |
Please provide the student's first given name.
|
| Second Given Name | Text |
Please provide the student's second given name.
|
| Your Date of Birth | ||
| Date of Birth | Date |
Please provide your date of birth.
|
| Your Name | ||
| Mr | Checkbox |
Check this box if your title is 'Mr'.
|
| Mrs | Checkbox |
Check this box if your title is 'Mrs'.
|
| Miss | Checkbox |
Check this box if your title is 'Miss'.
|
| Ms | Checkbox |
Check this box if your title is 'Ms'.
|
| Mx | Checkbox |
Check this box if your title is 'Mx'.
|
| Other Title | Text |
Please enter your preferred title if it is not listed in the options provided. Fill only if 'Mr', 'Mrs', 'Miss', 'Ms', 'Mx' is not selected.
Depends on:
Mr, Mrs, Miss, Ms, Mx
|
| Family Name | Text |
Please provide your family name or surname.
|
| First Given Name | Text |
Please provide your first given name.
|
| Second Given Name | Text |
Please provide your second given name, if applicable.
|