In the suspension or expulsion process, it is sometimes necessary for the student or their parent or guardian to nominate an alternate adult to participate in the process as a relevant person.
THIS FORM SHOULD BE USED IN THE FOLLOWING CIRCUMSTANCES
•	 Where a student is under 18 years of age and is not considered a mature minor, and the parent would like to nominate another adult to participate in the suspension or expulsion process 
•	 Where a student is under 18 years of age and is considered a mature minor, and the student wishes to nominate an adult who is not a parent to participate in the suspension or expulsion process; or 
•	 In the expulsion process, where a relevant person is unable or unwilling to attend the  pre-expulsion meeting and the student or relevant person would like to nominate another person to attend the Behaviour Review Conference.

NOMINATION: PART A
TO BE COMPLETED BY THE STUDENT/PARENT
SECTION 1 - STUDENT’S DETAILS
Name		
Date of birth		Year level		
Age		VSN		
Telephone		Email		

School name		
School principal name		

Process to be undertaken (tick)	Suspension		Expulsion		

SECTION 2 - PARENT’S DETAILS
In the suspension or expulsion process, ‘parent’ is defined as any person who has parental responsibility for ‘major long term issues’ as defined in the Family Law Act 1975 (Cth) or has been granted guardianship for the child under the Children Youth and Families Act 2005 (Vic) or other state welfare legislation.
Name		
Telephone		Email		
Address		
Relationship to student		

Are there any relevant Court Orders? (tick)	YES 	NO 	

Relevant Court Orders may include the following:
–	Parenting Orders made pursuant to the Family Law Act 1975 (Cth)
–	Personal Safety Intervention Orders made pursuant to the 
–	Personal Safety Intervention Orders Act 2010 (Vic) 
–	Family Violence Protection Orders made pursuant to the Family Violence Protection Act 2008 (Vic)
	
Please list any relevant Court Orders below, and attach copies of those Court Orders to this form.

	

SECTION 3 - NOMINATION OF A RELEVANT PERSON
Name of person nominating a relevant person		
Telephone		Email		
Address		
Status of person nominating the Relevant person (please tick one box)
⁃	Student who is a mature minor 
⁃	Parent with parental responsibility for major long term issues 
⁃	Guardian with guardianship responsibilities granted pursuant to the Children Youth and Families Act	
Name of person nominated as Relevant person		
Telephone		Email		
Address		
Have there been any previous nominations?  If so, please provide details.

I,____________________   (name of person making nomination)

nominate ____________________  (name of person being nominated)

to be the relevant person for the purposes of the suspension or expulsion process.
I understand and agree that the school principal or his or her nominee may disclose personal information and health information about the student to the person being nominated in order to enable the person nominated to participate in the suspension or expulsion process. I consent to the disclosure of the student’s personal information and health information in these circumstances and for these purposes.
I understand and agree that the person being nominated may receive personal information and health information about the student that is relevant to the suspension or expulsion process. I consent to the nominated person receiving this personal information and health information in these circumstances and for these purposes.
I understand that I can revoke this nomination at any time by putting my revocation in writing and sending it to the principal of the school in which the student is currently enrolled.
I understand that this nomination does not transfer my ongoing parental responsibility to ensure the student is enrolled at and attending school. I also understand that this parental responsibility remains with me both during and after a suspension or expulsion process. 
Signature of person making nomination  ____________________

Date ____________________

NOMINATION: PART B
TO BE COMPLETED BY THE PERSON NOMINATED AS THE Relevant person
NOMINEE’S DETAILS & ACCEPTANCE
Relevant person’s name		
Relationship to student (if applicable)		
Telephone		Email		
Address		

I, ____________________   (nominee’s name)

Accept ____________________(nominator’s name)
nomination as the relevant person in the suspension / expulsion (please circle) process.
I agree and understand that my role is: 
⁃	To attend all meetings; 
⁃	To communicate with the School principal or his or her nominee as necessary;
⁃	To provide relevant information and documentation that may assist in making decisions about the student’s suspension or expulsion; 
⁃	To receive information and documentation about the suspension and expulsion process; 
⁃	To ensure that the student understands the suspension or expulsion process and that the student has the opportunity to be heard; 
⁃	To advocate for the student.

I understand that the person who nominated me to participate in this process may revoke this nomination at any time.

I understand that in participating in the suspension and expulsion process, I may receive personal information and health information about the student. I agree not to use or disclose this personal information and health information in any way other than to participate in the suspension and expulsion process.

I have read and understood the attached fact sheet.
Signature  ____________________  

Date  ____________________  

FACT SHEET FOR NOMINATED RELEVANT PERSONS 
This fact sheet applies to nominated relevant persons of a student who is enrolled in a Victorian government school and who is participating in a suspension or expulsion process.

The information provided below explains the role and responsibilities of a nominated support person in a suspension or expulsion process. For more information you can visit: www.education.vic.gov.au/school/principals/participation/Pages/discipline.aspx 
Nomination and acceptance of relevant person 
If you are being nominated by the parent of the student, or the student who is subject to the suspension or expulsion process, you and the parent / student will need to complete the attached nomination and acceptance form and return this form to the student’s school before you can participate in the suspension or expulsion process.
This nomination and acceptance form is for the purpose of participating in the suspension and expulsion process only.
Please note that the parent of the student,  or the student who is subject to the suspension or expulsion process, can revoke your nomination at any time.
Roles and responsibilities of support person participating in the suspension or expulsion process 
Before the suspension or expulsion process, you should:
⁃	Familiarise yourself with the suspension or expulsion procedures used in Victorian government schools (see above link) 
⁃	Help the student and the parent / carer (if appropriate) to understand the suspension or expulsion process
⁃	Discuss the proposed suspension or expulsion with the student and the parent / carer (if appropriate) and determine any relevant facts, information or documentation 
⁃	Locate and obtain the relevant information or documentation.

During the suspension or expulsion process, you should: 
⁃	Act as the primary contact
⁃	As the relevant person you will be the primary contact for the school principal for any issues arising during the suspension or expulsion process. You will also receive any formal correspondence or written notification related to the suspension or expulsion. 
⁃	You are responsible for passing on any information and documentation about the suspension or expulsion to the person who nominated you as the support person (e.g. the student’s parent or the student).
⁃	Attend all meetings 
⁃	As part of the expulsion process there is a ‘Behaviour Review Conference’ which you and the student are encouraged to attend. You should work with the school to find an agreeable time for the meeting to be held. 
⁃	In the case of a suspension process, the school does not have to hold a meeting with the student and an appropriate support person. However, you are able to request a meeting with the school at any point during the suspension process if you feel this is necessary to address the issues leading to the suspension and support the student to make a successful return to school. 
⁃	Ensure that the student has an opportunity to  be heard 
⁃	Represent the views of the student and/or their parent/carer as necessary
⁃	Provide the relevant facts, information and documentation to the principal to assist them in their decision-making
⁃	Ensure that other disciplinary measures have been considered 
⁃	Ensure that support services for the student have been considered / offered / provided if relevant in the circumstances 
⁃	Ensure that appropriate work has been provided to the student including the development of a Student Absence Learning Plan and/or Return to School Plan if appropriate in the circumstances 
⁃	In the event that a Behaviour Review Conference is held, and an expulsion is being considered, contribute to discussions about:
⁃	Future educational training or employment options that may be available for the student 
⁃	The development of appropriate transition arrangements 
⁃	The development of an action plan.
After a decision has been made: 
⁃	Ensure that you have obtained any relevant documentation in relation to the decision that has been made i.e. Notice of Suspension or Notice of Expulsion 
⁃	Ensure that you have provided the relevant documentation to the person who has nominated you as the support person i.e. the parent of the student or the student 
⁃	Help the student understand the decision that has been made and the consequences of the decision that has been made 
⁃	Discuss the options and supports that are available to the student.
ADDITIONAL CONSIDERATIONS
Maintaining privacy 
During the suspension and expulsion process, you will be privy to personal information and health information of the student. This personal information and health information belongs to the student and may be sensitive in nature. As a support person you agree not to use or disclose this information in any way other than to participate in the suspension and expulsion process. 

Respectful behaviour
All persons participating in a suspension or expulsion process are expected to be respectful to all other participants in the process.
If all persons are calm and respectful, it is more likely that communications and meetings will be productive; that the process will enable all persons an opportunity to be heard; and that the process will lead to an outcome that is in the best interests of the student. 
If you do not abide by these roles and responsibilities, you may be excluded from participating in the suspension and expulsion process.
If you have any concerns about the suspension or expulsion process, you should raise your concerns with the principal of the school in the first instance. If you feel that the principal of the school has not adequately addressed your concerns, you can contact the relevant Department regional office.
WHO CAN I CONTACT FOR MORE INFORMATION OR SUPPORT?
The procedures for suspension and expulsion are detailed in the Student Engagement and Inclusion Guidance which can be found by visiting: www.education/vic.gov.au/school/principals/participation/Pages/discipline.aspx 
If you require additional information and support, particularly when dealing with the school or principal, you should contact the Community Liaison Officer at your closest regional office. 
Department of Education and Training Regional Offices
North Eastern Victoria Region
Email:	nevr@edumail.vic.gov.au 
Benalla
Phone:	(03) 5761 2100
Glen Waverley
Phone:	(03) 8392 9300

North Western Victoria Region
Email:	nwvr@edumail.vic.gov.au 
Bendigo
Phone:	(03) 5440 3111 
Coburg
Phone:	(03) 9488 9488

South Eastern Victoria Region
Email:	sevr@edumail.vic.gov.au 
Dandenong
Phone:	(03) 8765 5600
Moe
Phone:	(03) 5127 0400

South Western Victoria Region
Email:	swvr@edumail.vic.gov.au 
Ballarat
Phone:	(03) 5337 8444
West Footscray
Phone:	(03) 9291 6500
Geelong
Phone:	(03) 5225 1000