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.
Personal information and contact details
(As per photo ID that will be used to obtain tickets and/or boarding pass for travel)
Emergency out-of-semester contact details
While on placement, if I am injured/ill please contact the following person (all fields are mandatory).
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.
Are there further details we need in regards to this placement, including any culturally sensitive issues that need to be taken into consideration?
Community Contact information
Please fill in all applicable details.
(Please Note: If you have not yet contacted your Community Contact, you must do so as soon as possible before commencing your placement.)
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.
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.
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.
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.
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.
Please give details of any preferred route. This can not be guaranteed.
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.
Commercial accommodation will not be approved.
Please provide details of your host / mentor, including name, address, email address, phone number