Ripley Valley State Secondary College eNewsletter

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Ripley Valley State Secondary College

18 Parkway Ave
Ripley QLD 4306

Phone: 3819 5333

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18 Parkway Ave
Ripley QLD 4306
Subscribe: https://ripleyvalleyssc.schoolzineplus.com/subscribe

Email: principal@ripleyvalleyssc.eq.edu.au
Phone: 3819 5333

RVSSC - Extension Request Form - Year 7

This form is to be completed by the student and parent/carer and submitted to the HoD for approval.

Student Name *

Access Class *

Student Email address *

Name of best Parent/Carer to contact if more information is required *

Subject/s requiring an extension *

Teacher/s Name/s *

What type of assessment does your extension request relate to? *

Draft

Exam

Final Submission

Reason for Extension Request (Extension Requests can only be approved for a limited number of reasons. If your reason does not fit into a category below, it is unlikely your request will be approved.) *

Detailed Description of Reason for Extension Request *

Number of Additional Days Requested for Extension? *

Have you attended Tutoring or Homework Club? *

Yes

Occasionally

Have you submitted a draft? *

Applying for Draft Extension

Incomplete Draft

Yes

Have you previously applied for any extensions this year? *

Yes

Please attach any supporting documentation that may support your request (eg. medical certificate, note from parent/carer)

Student Signature *

Undo

Clear

Write your signature above the line

Parent / Carer Signature *

Undo

Clear

Write your signature above the line

Thank you for your submission. It has been received successfully.