Department of Education and Training

2017

Living Away from Home Allowances Scheme (LAFHAS)
Application Form — 2017

this application form is to be completed in conjunction with reading the
Living Away from Home Allowances Scheme (LAFHAS) — Information Guide

(included with every paper application package)

Choose ONE method of applying for LAFHAS assistance

(a)	Online Application Form (Internet): complete and submit electronically. 

(b)	Static Application Form (.pdf) (Internet): print, manually complete and return via post to School Financial Resourcing or via facsimile 3034 5890 or email to LAFHAS@det.qld.gov.au .

Accessing the Online and Static Application Forms

(a)	Access internet application forms via the Department of Education and Training website
http://education.qld.gov.au/schools/grants/parents-students/

Instructions — General

(a)	You must reside in Queensland to be eligible to apply for LAFHAS assistance.	
(b)	You must answer all questions on this application form or your application may be returned.	

(c)	This application form caters for up to three (3) students. If applying for more than 3 students, a second application form will be required. Contact School Financial Resourcing on freecall 1800 248 997.	
(d)	Use BLOCK LETTERS and TICK boxes where required.	
(e)	Complete a separate page for each student.	
(f)	Distances are measured by the shortest trafficable route by land or sea.	
(g)	Distances provided must be correct. Contact the local Department of Transport and Main Roads Regional Office to confirm if any distances have changed as a result of roadwork or bus route changes.	
(h)	Distances close to eligibility thresholds are checked prior to payment. Final assessment may be delayed.	
(i)	Overpayments that may result from incorrect distances are recoverable.	

Instructions — Student page
QUESTION

14.	Enter the shortest practicable and trafficable route by road or by sea for the distance to the boarding location.	
15.	Approved bypass schools: Where the distance eligibility criteria to the nearest Queensland Government school with the appropriate school year level for the student is not met and the school is an approved bypass school, enter the next nearest appropriate Queensland Government school.	
15.	Agricultural campus: for students accessing agricultural courses, equivalent to and in lieu of Years 11 and 12, at one of the Queensland campuses of the Queensland Agricultural Training College (QATC) or at a campus of a state high school offering QATC agricultural courses, the name of the nearest Queensland Government school with Years 11 and 12 must  be entered.	
17.	Enter the shortest distance from the home garage (provided it is within proximity of the family home) to the entrance of the nearest appropriate Queensland Government school.	
25.	You will be contacted by School Financial Resourcing if your application is based on one of the Special circumstances
categories.	
For assistance in completing this application form contact
School Financial Resourcing, Department of Education and Training, 1800 248 9971.

Applicant details

QUESTION

FAMILY NO: 0  	
OFFICE USE ONLY

Applicant’s name
Parent, guardian or carer of the student/s

1.	Title	Mr	Mrs	Miss	Ms	Other  	

2.	Surname

3.	Given names

4.	Date of birth	/	/
5.	Have you submitted a LAFHAS application in any
other year?	YES	NO

6.	If YES, provide the most recent year

7.	and LAFHAS Family Number (if known)	0  	

8.	Have you received LAFHAS assistance in any other
year under a different surname?	YES	NO

9.	If YES, what was your previous surname?

Applicant’s postal address
This address will be used for all correspondence

10.	Property name

11.	Street address, PO Box or Mail Service

12.	Town or suburb

13.	Postcode

Student’s permanent home address
Do not use a post office box or write ‘as above’. If you will not be living at this address for the full year, please attach details

14.	Property name

15.	Number and street name
(include rural address number if available)

16.	Town or suburb

17.	Postcode

Property location

18.	Council

19.	Property description where your home is located
(Lot No. and Plan No. from Council rate notice e.g. L68/RP112)

20.	Global Positioning System

Latitude	(South)

(GPS) of home location

Contact details

21.	Home telephone

22.	Mobile

23.	Work telephone

24.	Facsimile

25.	Email

Changed address

Longitude

QT region:

Date received:

(East)

26.	Have you changed your address since January 2016?	YES	NO
1.	

27.

/	/

If YES, please enter the date you took up residence at the new address.

Applicant details

Personal Account details
Please provide YOUR financial institution account details for payment of the Remote Area Travel Allowance, Remote Area Allowance or Remote Area Disability Supplement. Remote Area Tuition Allowance (if payable) is paid directly to  the relevant non-state school. It is your responsibility to ensure that the account details are correct. It is also your responsibility to notify School Financial Resourcing (freecall 1800 248 997) of any change in account details after you have submitted your application form.

Account Holder 1

Account Holder 2

Type of account (card, savings, cheque etc.)

Full name of bank, building society or credit union etc.

Branch where account is held (Town)

Branch number (BSB) Account number

This is a six digit number — check with your branch

Notes:

1.	Mother	Father	Stepmother	Carer/guardian	Foster carer

You may be contacted by School Financial Resourcing. If you are the Carer/Guardian for this student please attach a statutory declaration stating your relationship to the student and why the parents are unable to apply also include a copy of your Centrelink card which shows student full name. If you are the Foster Carer please provide a letter from the Foster Care Organisation who has placed the student in your care as well as a statutory declaration giving relevant details and copy of the Centrelink card showing student full name.

2.	Student’s Surname

3.	Given names

4.	Date of birth	/	/

5.	Is the student ...	Male	Female

6.	School year level enrolled in current and previous
2 years	2017	2016	2015

7.	Agricultural College equivalent
(Please supply a copy of course acceptance)	11+ 12	Other (Please supply a copy of course acceptance)

8.	Is the student to receive a Commonwealth Indigenous allowance (ABSTUDY) in 2017?
If YES, you are not eligible for assistance for this student.

YES	NO

9.	Is the student of Aboriginal or Torres Strait Islander
origin? (Optional question)	YES	NO

10.	Nearest Queensland Government school
with student’s school year level
Where the distance criteria are not met and the nearest school is an approved bypass school, enter the next nearest Queensland Government school.

11.	Address of this school

12.	Shortest distance to this school (from the home garage)

13.	Is there a school transport service to this school?
If YES, answer questions 14 to 25...and 26 if applicable. If NO, go to question 20 to 25...and 26 if applicable.

YES	NO

						

KM (up to 3 decimals)

14.	

Shortest distance from your home garage to the
nearest transport service to this school	KM  (up to 3 decimals)

15.	Transport service number

16.	

Distance to this school via the transport service
From your home garage to the bus pickup point [Question 19] plus
the distance via the official school transport service.	KM (up to 3 decimals)

17.	Is your home less than 4.5 km from transport to
another Queensland Government school?	YES	NO

18.	If YES provide school name (Alternate school)

19.	and distance from your home via the transport service

20.	Name of the school to be attended

21.	Address of the school

22.	Where will the student board?

If second home or private board, you are not eligible for assistance for this student.

23.	What is the boarding address?

						

KM (up to 3 decimals)

Boarding school		Private board    	An agriculture campus Second home	 	Hostel

24.	What date will the student commence boarding? 

(this must be the first day of term)	/	/ 2  0  1  7
What is the distance from your home to the boarding
address?	KM (Nearest kilometre)

1.	Mother	Father	Stepmother	Carer/guardian	Foster carer

You may be contacted by School Financial Resourcing. If you are the Carer/Guardian for this student please attach a statutory declaration stating your relationship to the student and why the parents are unable to apply also include a copy of your Centrelink card which shows student full name. If you are the Foster Carer please provide a letter from the Foster Care Organisation who has placed the student in your care as well as a statutory declaration giving relevant details and copy of the Centrelink card showing student full name.

2.	Student’s Surname

3.	Given names

4.	Date of birth	/	/

5.	Is the student ...	Male	Female

6.	School year level enrolled in current and previous
2 years	2017	2016	2015

7.	Agricultural College equivalent
(Please supply a copy of course acceptance)	11+ 12	Other

8.	Is the student to receive a Commonwealth Indigenous allowance (ABSTUDY) in 2017?
If YES, you are not eligible for assistance for this student.

YES	NO

9.	Is the student of Aboriginal or Torres Strait Islander
origin? (Optional question)	YES	NO

10.	Nearest Queensland Government school
with student’s school year level
Where the distance criteria are not met and the nearest school is an approved bypass school, enter the next nearest Queensland Government school.

11.	Address of this school

12.	Shortest distance to this school (from the home garage)

13.	Is there a school transport service to this school?
If YES, answer questions 14 to 25...and 26 if applicable. If NO, go to question 20 to 25...and 26 if applicable.

YES	NO

						

KM (up to 3 decimals)

14.	

Shortest distance from your home garage to the
nearest transport service to this school	KM  (up to 3 decimals)

15.	Transport service number

16.	

Distance to this school via the transport service
From your home garage to the bus pickup point [Question 19] plus
the distance via the official school transport service.	KM (up to 3 decimals)

17.	Is your home less than 4.5 km from transport to
another Queensland Government school?	YES	NO

18.	If YES provide school name (Alternate school)

19.	and distance from your home via the transport service

20.	Name of the school to be attended

21.	Address of the school

22.	Where will the student board?

If second home, you are not eligible for assistance for this student.

23.	What is the boarding address?
If private board, provide name of family, address and relationship to student.

						

KM (up to 3 decimals)

Boarding school		Private board    	An agriculture campus Second home	 	Hostel

24.	What date will the student commence boarding?	/	/ 2  0  1  7
25.	

What is the distance from your home to the boarding
address?	KM (Nearest kilometre)

1.	Mother	Father	Stepmother	Carer/guardian	Foster carer

You may be contacted by School Financial Resourcing. If you are the Carer/Guardian for this student please attach a statutory declaration stating your relationship to the student and why the parents are unable to apply also include a copy of your Centrelink card which shows student full name. If you are the Foster Carer please provide a letter from the Foster Care Organisation who has placed the student in your care as well as a statutory declaration giving relevant details and copy of the Centrelink card showing student full name.

2.	Student’s Surname

3.	Given names

4.	Date of birth	/	/

5.	Is the student ...	Male	Female

6.	School year level enrolled in current and previous
2 years	2017	2016	2015

7.	Agricultural College equivalent
(Please supply a copy of course acceptance)	11+ 12	Other (Please supply a copy of course acceptance)

8.	Is the student to receive a Commonwealth Indigenous allowance (ABSTUDY) in 2017?
If YES, you are not eligible for assistance for this student.

YES	NO

9.	Is the student of Aboriginal or Torres Strait Islander
origin? (Optional question)	YES	NO

10.	Nearest Queensland Government school
with student’s school year level
Where the distance criteria are not met and the nearest school is an approved bypass school, enter the next nearest Queensland Government school.

11.	Address of this school

12.	Shortest distance to this school (from the home garage)

13.	Is there a school transport service to this school?
If YES, answer questions 14 to 25...and 26 if applicable. If NO, go to question 20 to 25...and 26 if applicable.

YES	NO

						

KM (up to 3 decimals)

14.	

Shortest distance from your home garage to the
nearest transport service to this school	KM  (up to 3 decimals)

15.	Transport service number

16.	

Distance to this school via the transport service
From your home garage to the bus pickup point [Question 19] plus
the distance via the official school transport service.	KM (up to 3 decimals)

17.	Is your home less than 4.5 km from transport to
another Queensland Government school?	YES	NO

18.	If YES provide school name (Alternate school)

19.	and distance from your home via the transport service

20.	Name of the school to be attended

21.	Address of the school

22.	Where will the student board?

If second home, you are not eligible for assistance for this student.

23.	What is the boarding address?
If private board, provide name of family, address and relationship to student.

						

KM (up to 3 decimals)

Boarding school		Private board    	An agriculture campus Second home	 	Hostel

24.	What date will the student commence boarding?	/	/ 2  0  1  7
25.	

What is the distance from your home to the boarding
address?	KM (Nearest kilometre)

CHECKLIST

•	Use this checklist to ensure pertinent questions have not been omitted to be answered.
•	Your application may be RETURNED if ALL relevant questions are not completed and this will delay the application being processed.

Post completed applications by 30 November 2017 to: School Financial Resourcing
Department of Education and Training PO Box 15033, City East Qld 4002
Facsimile: 3034 5890

Have you:

Applicant details

26- 27: Indicate if you have changed address?

Student details

6: Entered enrolment year levels?

8: Answered the ABSTUDY question?

24: Entered the date the student will commence boarding? 25: Entered the distance to the boarding location?
10-19: Completed all relevent questions? Provided YOUR account details Page 3? SIGNED THE APPLICATION BELOW?
Have you attached all required documents?

150324

Declaration of the applicant: I declare that the statements made in this application including the details of my personal particulars are true to the best of my knowledge and belief.

Signature of applicant...................................................................................... Date ........................................................

Reconfirm relationship to student/s ........................................................................................................................................

Note:  A person who makes a false or misleading statement may, by virtue of the Education (General Provisions) Act 2006, be liable to a maximum penalty fine.

Privacy notice:  This form collects personal information pursuant to Chapter 13, Part 2, section 368 of the Education (General Provisions) Act 2006.
The purpose of the collection is to process applications for Living Away from Home Allowances available to eligible Queensland students. The information collected may be disclosed to the Department of Transport and Main Roads to enable distance checks to be conducted. Relevant information collected is provided to schools attended.
The information may also be provided to Centrelink as required to clarify LAFHAS/AIC entitlements.

OFFICE USE ONLY		
Amendments	Student No.	Date	Ref. / Initial