Craigslea State High School

Access Arrangements and Reasonable Adjustments

(AARA) Application form

The QCAA recognises that some students may have disability impairment and/or medical conditions, or experience other circumstances that may be a barrier to their performance in assessment. Access arrangements and reasonable adjustments (AARA) are designed to assist these students. AARA are provided to minimise, as much as possible, barriers for a student whose disability, impairment, medical condition or other circumstances may affect their ability to read, respond to or participate in assessment.

* Please refer to Craigslea State High School’s Assessment Policy prior to the submission of an AARA application.

* Application is to be received a minimum of 2 weeks before the assessment due date, where possible.

Student Details
Name:	Click or tap here to enter text.	Roll Class:	Click or tap here to enter text.
Date:	Click or tap here to enter text.	LUI:

Period of AARA Please indicate	☐Unit 3	☐Unit 4

AARA eligibility details Please indicate and briefly describe the disability, condition or circumstance

Time-frame	Category	Examples	Details
☐ Permanent ☐ Temporary ☐ Intermittent	☐ Cognitive	specific learning disability, ADD/ADHD, executive functioning disorders, intellectual disability	Click or tap here to enter text.
☐ Physical	diabetes, cerebral palsy, epilepsy
☐ Sensory	hearing/visual impairment
☐ Social /emotional	anxiety, depression, ODD, OCD
☐ Illness /misadventure	unforeseen circumstances/ unexpected event, injury or diagnosed illness, bereavement, trauma

Medical report

Not required for students with a current EAP verification or where the condition or circumstance is not medical (other relevant official documentation is required instead).

Must be completed by a relevant practitioner who is a general practitioner (GP), medical specialist, or psychologist (registered under Queensland’s Medical Practitioners Registration Act 2001 and/or Queensland’s Psychologists Registration Act 2001), and who is not related to the student or employed by the school) that provides:

diagnosis of disability and/or medical condition

date of diagnosis

date of occurrence or onset of the disability and/or medical condition

symptoms, treatment or course of action related to the disability and/or medical condition

information about how the diagnosed disability, impairment and/or medical condition affects the student participating in assessment, particularly timed assessment when considering external assessment

professional recommendations regarding AARA.

School appointed AARA Assessor check: ☐ Principal approved ☐ QCAA approved Office Use Only

☐ Medical report received with required information

or ☐ EAP Verified with Click or tap here to enter text.

or ☐ Other relevant official documentation received

Unit 3: Subject	Teacher + HoD	Assessment due date	Requested extension date	Description of task
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Unit 4: Subject	Teacher + HoD	Assessment due date	Requested extension date	Description of task
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Student statement

Describe how the disability, impairment, medical conditions or other circumstance is a barrier to your access to the assessment and/or ability to communicate a response to assessment
Click or tap here to enter text.
Comment on how the disability, impairment, medical conditions or other circumstance affects your daily functioning in the classroom
Click or tap here to enter text.
Detail what kind of arrangements or adjustments enable you to complete assessment
Click or tap here to enter text.

Student signature: ___________________________	Date: ________________________

Parent/guardian signature: ______________________ Parent name: ____________________

In signing this I give my consent for relevant information to be shared with the Queensland Curriculum and Assessment Authority (QCAA) in order to process this application.

School-appointed AARA Assessor signature: _______________________	Date: ____________

Office Use Only

AARA approved?	☐ Yes ☐ No
Description of AARA approved (including amended dates for submission) Enter text
Reason for refusal: Enter text	☐ Parent informed ☐ Contact recorded
Signature of Principal’s delegate:	Date: Enter text

Checklist
☐	Confirmation email completed (sent to student, parent/carer, teacher, HOD), CC to Principal’s delegate
☐	Original copy in student file
☐	Student recorded in AARA spreadsheet
☐	OneSchool AARA support provision recorded
☐	Submission/notification to QCAA via portal