Negotiated Make Up Day Form
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1FACUlTY OF EDUCATION AND SOCIAl wORK
OffiCE Of PrOfESSiOnal ExPEriEnCE
NEGOTIATED MAKE UP DAY FORM
Preservice Teachers who are absent from any allocated professional experience days are required to make up the absences.
Preservice Teachers should negotiate mutually acceptable make up day(s) with their Cooperating Teacher and must submit
this form to the Professional Experience Office prior to the commencement of the negotiated days (if necessary by fax from
the early childhood service on the morning of the make up day).
Preservice Teachers are reminded that on the morning (8 am or before shift commencement) of any absences, they should
notify the Early Childhood Service, the Tertiary Mentor and the Professional Experience Office.
PRESERVICE TEACHER:
STUDENT ID:
_______________________________________________________
__________________________________________________________________
•
•
TwO | YEAR
SEMESTER:
ONE
(eg 2012)
_______________________________
PROFESSIONAl ExPERIENCE:
(eg (Early Childhood).)
_____________________________________________________________________________________________________________
NAME OF EARlY CHIlDHOOD SERVICE:
____________________________________________________________________________________________________________________
MEDICAl CERTIFICATE OR OTHER
DATE OF
DOCUMENTARY EVIDENCE
DATE OF AbSENCE
REASON FOR AbSENCE
CORRESPONDING
ATTACHED (REqUIRED FOR MORE
MAKE UP DAY
THAN ONE CONSECUTIVE DAY)
/
/
/
/
/
/
/
/
/
/
/
/
TOTAl NO. OF MAKE UP DAYS:
_______________________
I certify that the make-up days as described will be
completed and undertake to notify the Professional
Experience Office in writing if they are not carried out.
PRESERVICE TEACHER’S SIGNATURE:
DATE:
_________________________________________________________
_____________________________________________
FAx THIS FORM TO THE PROFESSIONAl ExPERIENCE OFFICE: 9351 4235
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