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__ Student Hostel Support Scheme

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					Student Hostel Support Scheme - Recurrent Grant
Claim Form for ________
Page 1

Name of hostel:
Student name (Group by school attended) Surname Given names

Address:
Home address (Not post office box address) Please ensure Post Code is included Are parents Qld residents? `yes' or `no' Date boarding commenced in 2009 Date boarding ended (if applicable)

Claim for First/Second/Supplementary Payment
School attended Year level Initials of school principal or delegate

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 NOTE: Hostel Management Authorities and Principals should not certify claims until four weeks after the commencement of each semester.

Hostel Certification
N.B.: (i) (ii) Benefits are paid in two instalments (March and August). See Hostel Assistance Kit 2009 for details. The Student Hostel Support Scheme Recurrent Grant for 2009 is $667 per student per semester for the first 20 students and $445 per student per semester for each additional student. (iii) Hostels with 8 eligible students or less will receive a minimum of $5 336 per semester until enrolments increase or while the hostel retains approved status. (a) the details provided above are true and correct to the best of my knowledge and that the claim is in respect of only those students who are boarding on a full time basis at and who are eligible to attract assistance under the Student Hostel Support Scheme. (b) the Hostel continues to comply with the requirements for approved status as set out in the Hostel Assistance Kit 2009

Principals' Certifications
1. I certify that _____________________ students have attended _____________________________________________(school) during the period of attendance at the hostel. Principal _______________________ Date _____/_____/_____ 3. I certify that _____________________ students have attended _____________________________________________(school) during the period of attendance at the hostel. Principal _______________________ Date _____/_____/_____ 2. I certify that ___________________ students have attended ___________________________________________ (school) during the period of attendance at the hostel. Principal ______________________ Date _____/_____/_____ 4. I certify that ___________________ students have attended ___________________________________________ (school) during the period of attendance at the hostel. Principal ______________________ Date _____/_____/_____

I certify that:

______________________________ _______________________________ Signature Position

____/_____/_____ Date

Claim should be forwarded to the Finance Officer, School Financial Services, Department of Education and Training, PO Box 15033, CITY EAST QLD 4002.

Student Hostel Support Scheme - Recurrent Grant
Claim Form for ________
Page 2

Name of hostel:
Student name (Group by school attended) Surname Given names Home address (Not post office box address) Please ensure Post Code is included Are parents Queensland residents? Write `yes' or `no' Date boarding commenced in 2009 Date boarding ended (if applicable)

Claim for First/Second/Supplementary Payment
School attended Year level Initials of school principal or delegate

21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50

Please ensure that the certifications on Page 1 have been completed.


				
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posted:11/28/2009
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