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Self-Referral Form

Last updated on: February 7, 2025
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Our Philosophy

We believe that access to education is critical for young people to achieve their aspirations for a healthy and productive future.

Educational achievement supports young people to contribute their talents and passions to society.

Young people need to experience success in their endeavours and build the skills and attributes that they can carry into further training, employment, and life pathways as valued members of their communities.

Criteria

The criteria for Special Assistance Schools (SASs) in Queensland requires a student to have disengaged or be at serious risk of disengagement from mainstream schooling. Factors may include behaviour, social emotional factors, or the impact of a disability.

Student Details

If known
If known

Parent/Carer Details

Parent/Carer Name:

Referral Details

Clear Signature

A staff member from Impact ACADEMY will be in contact to discuss your referral form and next steps.

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