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No Claim Absence Form
1
2
Parent/Guardian
(Required)
First Name
Last Name
Email
(Required)
Educator
(Required)
First Name
Last Name
Email
(Required)
Who is filling out this form?
(Required)
Educator
Parent/Guardian
FAMILY ASSISTANCE LAW
All chidlcare services are permitted to claim up to 42 absences per child, per annum, with no discounts applied or exemptions granted. Although childcare services are under no obligation to offer discounts or exemptions, our Service has chosen to both discount absences and wave the need for prior notification, to make payments to Educators. Our Absence Policy reflects a Service culture that both values Families and Educators for whom they provide service.
TO BENEFIT FAMILIES
Claimed Absences will have a discount applied to the Families usual fee schedule, then the CCS applied, so that a heavily reduced Absence GAP fee, can be detailed on the Family’s invoice.
TO BENEFIT EDUCATORS
Claimed Absences will result in the Educator receiving a set Absence payment in arrears fortnightly instead of their usual wage.
Provide a reason for Absence Claim or Exemption Request
Reason for Absence
(Required)
Holiday
Illness
Injury
Other
Who is taking the holiday?
(Required)
Family
Educator
Both
Is this one date or a range of dates?
(Required)
One date
Range of dates
Please select one
(Required)
MM slash DD slash YYYY
Start Date
(Required)
MM slash DD slash YYYY
End Date
(Required)
MM slash DD slash YYYY
Your Educator receives a nominal payment for each successfully claimed absence. Would you like us to claim this absence so that your Educator receives this payment?
(Required)
Yes, I want them to receive the payment
No, I do not want them to receive the payment
I confirm that I have discussed this absence with the above named Educator and they have agreed to submit this absence as a 'No Claim Absence' and understand they will NOT receive an absence payment
(Required)
Yes, a discussion has been had with the Educator and they have agreed that the 'No Claim Absence' criteria has been met
No, I have not yet discussed and reached an agreement
ABSENCE WILL BE CLAIMED - PLEASE SUBMIT THIS FORM FOR OUR RECORDS.
We thank you for upholding our service values, which will result in the Educator receiving a payment. Showing gratitude to Educators in this way aligns strongly with our business culture and beliefs.
You are confirming - that BOTH the Family and the Educator AGREE and REQUEST that the service grant EXEMPTION from Absence Claim Policy
Where the Educator and Family’s opinions DIFFER, this form should not be submitted. INSTEAD please get in contact with our office team for support so that we can assist with reaching an amicable solution.
Do NOT submit this form - unless BOTH the Family and Educator have already discussed and AGREED to REQUEST exemption from Absence Claim Policy.
Where the Educator and Family’s opinions DIFFER, our team will assist with reaching an amicable solution. Please get in contact with our office team for support.
Exemption criteria not met (ABSENCE WILL BE CLAIMED)
Please submit this form for our records. If you have any questions, please be in contact.
Who is unwell?
(Required)
Family
Educator
Both
Is this one date or a range of dates?
(Required)
One date
Range of dates
Please select one date
(Required)
MM slash DD slash YYYY
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Is your Educator experiencing an illness that is the result of an attended session of care?
(Required)
Yes (e.g. Exclusionary Illness or infection prevention protocols were not sufficient to protect the Educator from contracting the illness from the Family)
No (e.g. Educator went to see a concert with friends and contracted an illness)
Your Educator receives a nominal payment for each successfully claimed absence. Would you like us to claim this absence so that your Educator receives this payment?
(Required)
Yes, I want them to receive the payment
No, I do not want them to receive the payment
I confirm that I have discussed this absence with the above named Educator and they have agreed to submit this absence as a 'No Claim Absence' and understand they will NOT receive an absence payment
(Required)
Yes, a discussion has been had with the Educator and they have agreed that the 'No Claim Absence' criteria has been met
No, I have not yet discussed and reached an agreement
ABSENCE WILL BE CLAIMED - PLEASE SUBMIT THIS FORM FOR OUR RECORDS.
We thank you for upholding our service values, which will result in the Educator receiving a payment. Showing gratitude to Educators in this way aligns strongly with our business culture and beliefs.
You are confirming - that BOTH the Family and the Educator AGREE and REQUEST that the service grant EXEMPTION from Absence Claim Policy
Where the Educator and Family’s opinions DIFFER, this form should not be submitted. INSTEAD please get in contact with our office team for support so that we can assist with reaching an amicable solution.
Do NOT submit this form - unless BOTH the Family and Educator have already discussed and AGREED to REQUEST exemption from Absence Claim Policy.
Where the Educator and Family’s opinions DIFFER, our team will assist with reaching an amicable solution. Please get in contact with our office team for support.
Exemption criteria not met (ABSENCE WILL BE CLAIMED)
Please submit this form for our records. If you have any questions, please be in contact.
Was the Educator injured during a session of care, not due to Educator negligence?
(Required)
Yes (e.g. Educator was struck by a ball whilst playing a sports game causing concussion; maximum 10 absences)
No, this injury was due to Educator negligence (e.g. Educator wore inappropriate footwear to work and sprained their ankle whilst playing a sports game)
No, this injury occured outside of a session of care
Please describe the incident which led to the injury
(Required)
Please enter the date the injury occurred
(Required)
MM slash DD slash YYYY
Please enter the FIRST date of Educator consequential unavailability due to injury recovery (if applicable)
MM slash DD slash YYYY
Please enter the LAST date of Educator consequential unavailability due to injury recovery (if applicable)
MM slash DD slash YYYY
Your Educator receives a nominal payment for each successfully claimed absence. Would you like us to claim this absence so that your Educator receives this payment?
(Required)
Yes, I want them to receive the payment
No, I do not want them to receive the payment
I confirm that I have discussed this absence with the above named Educator and they have agreed to submit this absence as a 'No Claim Absence' and understand they will NOT receive an absence payment
(Required)
Yes, a discussion has been had with the Educator and they have agreed that the 'No Claim Absence' criteria has been met
No, I have not yet discussed and reached an agreement
Exemption criteria not met (ABSENCE WILL BE CLAIMED)
Please submit this form for our records. If you have any questions, please be in contact.
ABSENCE WILL BE CLAIMED - PLEASE SUBMIT THIS FORM FOR OUR RECORDS.
We thank you for upholding our service values, which will result in the Educator receiving a payment. Showing gratitude to Educators in this way aligns strongly with our business culture and beliefs.
You are confirming - that BOTH the Family and the Educator AGREE and REQUEST that the service grant EXEMPTION from Absence Claim Policy
Where the Educator and Family’s opinions DIFFER, this form should not be submitted. INSTEAD please get in contact with our office team for support so that we can assist with reaching an amicable solution.
Do NOT submit this form - unless BOTH the Family and Educator have already discussed and AGREED to REQUEST exemption from Absence Claim Policy.
Where the Educator and Family’s opinions DIFFER, our team will assist with reaching an amicable solution. Please get in contact with our office team for support.
Is this a Family or Educator absence?
(Required)
Family
Educator
What is the reason for the absence?
(Required)
Is this one date or a range of dates?
(Required)
One date
Range of dates
Please select one date
(Required)
MM slash DD slash YYYY
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Your Educator receives a nominal payment for each successfully claimed absence. Would you like us to claim this absence so that your Educator receives this payment?
(Required)
Yes, I want them to receive the payment
No, I do not want them to receive the payment
I confirm that I have discussed this absence with the above named Educator and they have agreed to submit this absence as a 'No Claim Absence' and understand they will NOT receive an absence payment
(Required)
Yes, a discussion has been had with the Educator and they have agreed that the 'No Claim Absence' criteria has been met
No, I have not yet discussed and reached an agreement
ABSENCE WILL BE CLAIMED - PLEASE SUBMIT THIS FORM FOR OUR RECORDS.
We thank you for upholding our service values, which will result in the Educator receiving a payment. Showing gratitude to Educators in this way aligns strongly with our business culture and beliefs.
You are confirming - that BOTH the Family and the Educator AGREE and REQUEST that the service grant EXEMPTION from Absence Claim Policy
Where the Educator and Family’s opinions DIFFER, this form should not be submitted. INSTEAD please get in contact with our office team for support so that we can assist with reaching an amicable solution.
Do NOT submit this form - unless BOTH the Family and Educator have already discussed and AGREED to REQUEST exemption from Absence Claim Policy.
Where the Educator and Family’s opinions DIFFER, our team will assist with reaching an amicable solution. Please get in contact with our office team for support.
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