Application Form

1. PERSONAL DETAILS

Year of Enrolment*

What calendar year do you wish your child to start with us?

Child's Surname*

Legal Surname (if different)

Child's Given Names*

Child's Date of Birth*

Gender*

Male

Female

Not Specified

Surname of parent/responsible person*

Given names of parent/responsible person*

Title*

Residential Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Postal Address (if different from residential address)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone (Home)

Telephone (Work)

Telephone (Mobile)*

Email*

Year Level enrolling in*

Start Date*

If applicable, year level your child is currently enrolled in

If applicable, name of school at which your child is currently or was last enrolled

Are there any Family Court Orders regarding the day to day or long term care, welfare and development of your child?*

YES

Does your child have an Australian Immunisation Register (AIR) Immunisation History Statement?*

YES

If your application is accepted, you will be asked to provide an Australian Immunisation Register (AIR) Immunisation History Statement that is not more than two months old.

Will there be any brothers or sisters attending this school?

Please provide name/s and year levels

Is your child currently under suspension from a school?*

YES

If yes, name of school

Is your child a temporary resident?*

YES

If yes, please provide details below

Date entered Australia if born overseas

Visa Sub Class No.

Visa expiry date

Does your child have health or medical condition, disability or additional needs?*

YES

If your child has a medical condition, please tick the most appropriate box or boxes:

Severe allergy / anaphylaxis

Minor / moderate allergy

Diabetes

Seizures

Asthma

ADHD and/or ASD

Other disability or additional need

Medication required at school

Is this application for the Education Support Program?

Yes

If yes, please provide details:

This information will assist the school principal in planning to provide the best educational program for your child.

1. PERSONAL DETAILS

2. DOCUMENTATION TO BE PROVIDED

3. DECLARATION

Enrolments are now open!

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