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Changes to contact details

 
​The Department of Education and Training, through Pacific Paradise State  School, is collecting personal information in accordance with Education (General Provisions) Act 2006 in order to update family and student emergency contact details. The information will only be accessed by Department of Education and Training. The information will not be given to any other person or agency unless consent is provided.
  • Student surname
    Mandatory field
  • Student given name
    Mandatory field - (Only complete fields below where changes are required to stored information).
  • Parent/Guardian contact 1 - Name
  • Parent/Guardian contact 1 - Address
  • Parent/Guardian contact 1 - Home telephone
  • Parent/Guardian contact 1 - Occupation and place of work
  • Parent/Guardian contact 1 - Work telephone
  • Parent/Guardian contact 1 - Mobile
  • Parent/Guardian contact 1 - Email address
  • Parent/Guardian contact 2 - Name
  • Parent/Guardian contact 2 - Address
  • Parent/Guardian contact 2 - Home telephone
  • Parent/Guardian contact 2 - Occupation and place of work
  • Parent/Guardian contact 2 - Work telephone
  • Parent/Guardian contact 2 - Mobile
  • Parent/Guardian contact 2 - Email address
  • Additional emergency contact priority 1 - Name
  • Additional emergency contact priority 1 - Relationship to student
  • Additional emergency contact priority 1 - Home telephone
  • Additional emergency contact priority 1 - Work telephone
  • Additional emergency contact priority 1 - Mobile
  • Additional emergency contact priority 2 - Name
  • Additional emergency contact priority 2 - Relationship to student
  • Additional emergency contact priority 2 - Home telephone
  • Additional emergency contact priority 2 - Work telephone
  • Additional emergency contact priority 2 - Mobile
  • Additional emergency contact priority 3 - Name
  • Additional emergency contact priority 3 - Relationship to student
  • Additional emergency contact priority 3 - Home telephone
  • Additional emergency contact priority 3 - Work telephone
  • Additional emergency contact priority 3 - Mobile
  • Name and contact number of person completing form
    Please note that no alterations will be made to your stored contact information until we have made a phone call to verify any changes as indicated. I confirm that the above information is correct and understand that these details will be verified by the school before information is changed in school records.