I understand that if the application is accepted

I am responsible for his/her supervision during the period of extended leave
The provided period of extended leave is limited to the period indicated
The provided period of extended leave is subject to the conditions listed on the Certificate of Extended Leave - Travel
The period of extended leave will count towards my child's absences from school

I declare the information provided in this application is to the best of my knowledge and belief; accurate and complete. I recognise that should statements in this application later prove to be false or misleading any decision made as a result of this application may be reversed. I further recognise that a failure to comply with any condition set out in the Application for Extended Leave - Travel may result in the provided period of extended leave being cancelled.

LPS-Extended Leave Form

Lansvale Public School