John Flynn Placement Program - student travel request form

PLEASE NOTE: Travel requests need to be submitted at least six weeks prior to your departure for placement, and each placement must be at least 14 nights. If your placement date is in less than 6 weeks, or your placement is less than 14 nights, please contact your Project Officer on 1800 231 231 to discuss. All requests are subject to approval.

In addition, you must have also confirmed your placement with your mentor or the NTGPE. Do not proceed if this is not the case.

The JFPP pays for travel to and from your placement community via the most economical means of transport which can include plane, bus, train or ferry. If you choose to drive your car to and from your placement community, you are entitled to a travel allowance in lieu of other forms of transport. The allowance is calculated using the Travel Allowance Table on page 5 of the Guidelines. Any additional costs incurred (eg. accommodation) whilst driving are your responsibility and will not be covered by the program.

In addition the JFPP will organise accommodation on your behalf, in either nurses' quarters, budget accommodation or with a host family. If you would like to organise your own accommodation you must first seek approval from the JFPP team or incur additional expenses yourself. Please note commercial accommodation will not be approved.

Please note that the travel request form is confirmation of your travel requirements and will be regarded as approval to book and purchase your ticket for travel. This means that you’ll need to be certain of your travel requirements prior to submission. Once booked, any changes that incur additional charges will be at your own expense.

The College works with CTM travel agency to organise the travel to and from the placement. It is your responsibility to respond to all emails from the agency within 72 hours. Failure to do so may affect the placement.

Please note that you will be responsible for any costs associated with changing your confirmed itinerary. Please ensure that the information you enter below is correct.

Before submission of this form, you must email the JFPP team at jfpp@acrrm.org.au a valid copy of the following documents:

  • Your indemnity insurance cover dated for the period to cover your JFPP placement.
  • Current immunisation checks, and
  • Police clearance (except students with placements in Northern Territory, whose
    police clearance will be received by NTGPE directly)

If you are planning on combining this placement with your university rotation, or completing this placement within your university semester, you must also provide the JFPP team with

  • letters of approval from your university.

Confirmation

Indemnity insurance, immunisation check and police clearance

Please indicate you have provided the JFPP team a copy of the following mandatory documents, as detailed above. Do not proceed if this is not the case.

Students with placements in Northern Territory, whose police clearance will be received by NTGPE directly please also check this box

Personal information and contact details

(As per photo ID that will be used to obtain tickets and/or boarding pass for travel)

As per photo identification
As per photo identification
Please include area code.
Please include area code if applicable.

Emergency out-of-semester contact details

While on placement, if I am injured/ill please contact the following person (all fields are mandatory).

Please include area code

Placement information

Students with placements in the Northern Territory, enter NTGPE as your Mentor and Practice details.

Extra time may be required to travel to and from your community. This will be indicated in the 'Travel Booking' section later in this form.

Have you confirmed your placement with your Mentor or the NTGPE?

Please note: This is the date of your first night in your community.
Please note: This is the date of your last day in your community.
Are there further details we need in regards to this placement, including any culturally sensitive issues that need to be taken into consideration?
Are you combining this placement with your university rotation?

University approval Letter:
Are you completing this placement within your University Semester

University approval letter
Have you discussed the 'Placement Planning Guide' with your Mentor?

Community Contact information

Please fill in all applicable details.

Have you been provided a Community Contact (NTGPE Students please answer N/A)?


Have you contacted your Community Contact?

(Please Note: If you have not yet contacted your Community Contact, you must do so as soon as possible before commencing your placement.)
If you have been notified of your Community Contact, please provide their name here.
Please include area code
If you have not been provided a Community Contact, is there someone in the community that has been helpful on your previous placements? Please provide their name & contact details:

Travel booking request

Students usually allow an extra day to undertake travel to & from their placement community. Please keep this in mind when organising your travel and placement dates.
Mode of transport

If you choose to drive your car to & from your placement community, you are entitled to request travel allowance in lieu of other forms of transport. The allowance is calculated using the Travel Allowance Table on page 5 of the Guidelines. Any additional costs incurred whilst driving are your responsibility and will not be covered by the program.

Important

The details you provide below are confirmation of your travel requirements and will be regarded as approval to book and purchase your ticket for travel. This means that you'll need to be certain of your travel requirements prior to booking. Once booked, any changes will incur additional charges at your own expense.

Please note:

You must be in your community on placement for a minimum of 14 nights. Extra time may be required to travel to and from your community. Please indicate time either side of the placement dates for this travel ie earliest date to travel to placement, latest date you can travel from placement. Contact the JFPP if this is not possible, do not proceed with booking.

Please give your frequent flyer number, along with your frequent flyer carrier.
Are you able to travel outside the hours 6am - 6pm?

Your safety is to be taken into consideration when booking travel. Arrival and departure times must be between the hours of 6am - 6pm. If you are departing/arriving outside these times CTM must seek your approval prior to booking.

Departure

Please allow extra time for travel. Please note - if you plan on staying in the community outside of your placement dates you may be liable to cover any extra accommodation.

Return

Please allow extra time for travel. Please note - if you plan on staying in the community outside of your placement dates you may be liable to cover any extra accommodation.
Please give details of any preferred route. This can not be guaranteed.
Declaration

Accommodation booking request

If alternative accommodation is organised by CTM or John Flynn and you have not notified either parties financial penalties may be incurred.

Accommodation booking options

Please indicate your accommodation preference

Arranged accommodation details

Commercial accommodation will not be approved.

Please provide details of your host / mentor, including name, address, email address, phone number
If you can see this do not enter anything here.