ABEC Preservice Teacher Emergency Contact Details
PROJECT PARTNERSHIPS COLLEGE OF EDUCATION PO BOX 14428 MELBOURNE VICTORIA 8001 AUSTRALIA PHONE +61 3 9919 7591 FAX +61 39919 7574 Sharon.Ciantar@vu.edu.au BACHELOR OF EDUCATION (EARLY CHILDHOOD-PRIMARY) PRESERVICE TEACHER EMERGENCY CONTACT DETAILS Preservice teachers are to complete and submit this form to their Mentor Teacher Name of Preservice Teacher ________________________________________________ Student ID ________________________________________________ Emergency Contact Name ________________________________________________ Relationship ________________________________________________ Emergency Contact Home Phone ________________________________________________ Emergency Contact Home Mobile ________________________________________________ Emergency Contact Phone at Work ________________________________________________ MEDICAL CONDITION/S (including allergies, medications, treatment required if incident occurs) _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Preservice teachers are to ensure that the contact nominated above has agreed to being contacted in the case of an emergency and that the details provided are current. The preservice teacher is to notify the setting Coordinator if any details above change. Privacy: School/Setting Partnerships Coordinators/mentor Teachers are to ensure these forms are kept in a secure and confidential location and that personal health details are only communicated to relevant personnel in the event of an emergency.
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