CONSENT TO TRANSFER INFORMATION Student Details Surname:* - required First name:* - required First name: Date of birth:* - required School Transfer Details Current School E No: Suburb:* - required School:* - required New School/Catholic Education Commission of Victoria Ltd (CECV) E No: Suburb:* - required School:* - required The teacher/principal has discussed with me/us how and why certain information about my child is provided to the new school. I understand that in addition to formal reports etc. details regarding the educational program will be supplied.I/We provide informed and express consent for all relevant health and/or educational information held by school A, detailed below, to be provided to school B. I understand that this information will be collected and used by St Augustine's College to inform health and safety management strategies and educational programming for my child. Type of Information (e.g. personalised learning plans/student program, medical reports, specialist notes, information regarding adjustments, medical management plans, attendant care plans, behaviour support plans, safety plans) Do you have more information to share* - required Yes No More Information to Share Date Date Author Author e.g. psychologist, medical practitioner's name Title Title (e.g. speech pathologist, psychologist, paediatriatrician) Description Description (e.g. cognitive assessment, language assessment) File Upload (if applicable, share reports) Consent Parent/Guardian name* - required Parent/Guardian name Parent/Guardian name* - required Parent/Guardian name Date* - required Date* - required Signature* - required Type It Draw It Clear Print your name Please type your signature Please sign here Signature* - required Type It Draw It Clear Print your name Please type your signature Please sign here Please refer to each school's information about their use and disclosure of information, and information regarding their privacy policy. Further clarification is available on request for the principals. Mandatory field(s) marked with *