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NSW Education Standards Authority

2024 Disability Provisions - Student Declaration


The student who is applying for provisions must complete this form.

Student’s name: ____________________ Student number:

I request that the NSW Education Standards Authority (NESA) consider my application for disability
provisions. I currently use the following provisions to complete timed tasks/exams.

How does this provision assist you to read and respond to the
Provision
question? (E.g. Why did you need a writer? What did you do in your rest breaks?)

DO NOT COMPLETE THIS OR ANY OTHER SECTION ON BEHALF OF THE STUDENT.

If the student cannot write, they may dictate this section.

I give NESA permission to contact the author of any reports I have submitted if there is a need to clarify
any details provided.

I acknowledge that if I change schools during the year, my application and all documents contained
within will be transferred to my new school.

I understand that providing false or fraudulent evidence in a disability provisions application is a breach
of HSC rules and may result in an HSC penalty.

Note: Once NESA has processed your application, we will notify you in Students Online that a decision letter is
available. Your school will provide you with your letter. Provisions for the HSC exams are not confirmed until you
receive the decision letter. If you do not receive a decision letter before your HSC exams begin, contact your
school’s disability provisions coordinator.

Appeals:
I have the right to appeal if NESA declines any part of my application for disability provisions
 It is expected the school will lodge my appeal within 14 days of receiving the decision letter
 The appeal must include new current evidence and comments supporting my need for the
declined provision(s)
 NESA will review my appeal and will endeavour to make a decision regarding this appeal within
21 days
 NESA will then reply to my Principal via Schools Online who will provide me with a copy of the
reviewed decision letter.

Are you of Aboriginal or Torres Strait Islander origin?  Yes  No  Not disclosed  Not known
Student’s Signature: _______________________________________ Date: ____/____/____

UAC has an educational disadvantage scheme that can help you get into university.
To check if you’re eligible, go to uac.edu.au/eas‐disadvantage.
If you have any questions, please call Student Support on (02) 9367 8117

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