Student Enrolment Application Form
Student Enrolment Application Form Thank you for your interest in our school. You can save this form at any time to resume later, simply by clicking the 'save' button and entering your email. Please click 'Next' to continue.
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Section 1: Student information
Student Details
Name
First Name
Middle Name
Last Name
Preferred name
Date of birth
-
Day
-
Month
Year
Date
Gender
Female
Male
Other (please specify)
Entry level
Academic entry level
Please Select
Kindergarten
Pre-Primary
Y1
Y2
Y3
Y4
Y5
Y6
Year of entry
Interested in Pre-Kindy?
Yes
No
Demographics
Country of birth
Aboriginal | Torres Strait Islander
Yes
No
Please specify
Aboriginal Origin
Torres Straight Islander Origin
Both Torres Strait and Aboriginal Origin
Is the student an Australian citizen?
Yes
No
Country of citizenship
Visa number
If not Australian citizen
Date of arrival in Australia
-
Day
-
Month
Year
If applicable
Visa expiry date
-
Day
-
Month
Year
Date
Main language spoken at home
Other language(s) spoken at home
If applicable
Religion
Religious denomination
Catholic
Other (please specify)
Parish
If applicable
Baptised
Yes
No
Reconciliation
Yes
No
First Holy Communion
Yes
No
Confirmation
Yes
No
Current school (if applicable)
School
Location
Academic level
Please Select
Pre-Kindy
Kindergarten
Pre-Primary
Y1
Y2
Y3
Y4
Y5
Y6
Additional student Please indicate whether you wish to enrol another student. If the additional student has different caregivers, please submit a separate form.
Do you wish to enrol another student with the same caregivers?
Yes
No
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Section 1: Student information
Student 2 Details
Name
First Name
Middle Name
Last Name
Preferred name
Date of birth
-
Day
-
Month
Year
Date
Gender
Female
Male
Other (please specify)
Entry level
Academic entry level
Please Select
Kindergarten
Pre-Primary
Y1
Y2
Y3
Y4
Y5
Y6
Year of entry
Interested in Pre-Kindy?
Yes
No
Demographics
Country of birth
Aboriginal | Torres Strait Islander
Yes
No
Please specify
Aboriginal Origin
Torres Straight Islander Origin
Both Torres Strait and Aboriginal Origin
Is the student an Australian citizen?
Yes
No
Country of citizenship
Visa number
If not Australian citizen
Date of arrival in Australia
-
Day
-
Month
Year
If applicable
Visa expiry date
-
Day
-
Month
Year
Date
Main language spoken at home
Other language(s) spoken at home
If applicable
Religion
Religious denomination
Catholic
Other (please specify)
Parish
If applicable
Baptised
Yes
No
Reconciliation
Yes
No
First Holy Communion
Yes
No
Confirmation
Yes
No
Current school (if applicable)
School
Location
Academic level
Please Select
Pre-Kindy
Kindergarten
Pre-Primary
Y1
Y2
Y3
Y4
Y5
Y6
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Section 2: CAREGIVER information
This section relates to the student's primary caregivers (e.g. mother and father). You can enter details for up to two primary caregivers using this form. If you need to provide additional caregivers, please contact the office and we will be happy to add their details to the student record.
Caregiver 1
Name
Title
First Name
Middle Name
Last Name
Preferred name
Gender
Female
Male
Other (please specify)
Relationship to child
Mother
Father
Other (please specify)
Does the child live with you?
Please Select
Yes - always
Yes - some of the time
No - never
Contact details Email and mobile phone are our preferred methods of contact. Please provide both if available. We will send a copy of your completed form to this email address, if provided.
Email
example@example.com
Mobile phone
Home phone
Work phone
Current home address
Street Address
Street Address Line 2
Suburb
State / Territory
Postcode
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Other address (e.g. if relocating)
Street Address
Street Address Line 2
City
State / Territory
Postcode
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Demographics
Country of birth
Is the caregiver an Australian citizen?
Yes
No
Country of citizenship
Visa number
If not Australian citizen
Date of arrival in Australia
-
Day
-
Month
Year
If applicable
Visa expiry date
-
Day
-
Month
Year
Date
Main language spoken at home
Other language(s) spoken at home
If applicable
Occupation
If applicable
Employer
If applicable
Religion
Religious denomination
Catholic
Other (please specify)
Data collection All schools are required to collect information on behalf of the Department of Education to enable nationally comparable reporting of students’ outcomes. Results are reported in terms of total numbers of students and no individual, school or system is identifiable in the analysis. The following information, along with the child’s gender, country of birth, indigenous status and main home languages, is submitted to the Department of Education.
Have you been in paid work in the past 12 months (either in full or part of)?
Yes
No
If yes, indicate your occupation group
Group 1: Elected officials, senior executives/manager, management in large business organisation, government administration and defence, and qualified professionals
Group 2: Other business managers/professionals and associate professionals
Group 3: Tradespeople and advanced/intermediate clerical, office, sales, carer and service staff
Group 4: Machine operators, sales/office/service/hospitality staff, assistants, labourers and related workers
Highest year of school completed
Please Select
Year 12 or equivalent
Year 11 or equivalent
Year 10 or equivalent
Year 9 or equivalent or below
Level of highest qualification attained
Please Select
Bachelor’s Degree or above
Advanced Diploma / Diploma
Certificate I to IV (including Trade Certificate)
No non-school qualification
Second caregiver Please indicate whether the student has a second caregiver (e.g. a mother and a father).
Do you wish to add another caregiver?
Yes
No, I am the sole caregiver
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Section 2: CAREGIVER information
Caregiver 2
Name
Title
First Name
Middle Name
Last Name
Preferred name
Gender
Female
Male
Other (please specify)
Relationship to child
Mother
Father
Other (please specify)
Does the child live with you?
Please Select
Yes - always
Yes - some of the time
No - never
Contact details Email and mobile phone are our preferred methods of contact. Please provide both if available.
Email
example@example.com
Mobile phone
Home phone
Work phone
Current address
Street Address
Street Address Line 2
Suburb
State / Territory
Postcode
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Other address (e.g. if relocating)
Street Address
Street Address Line 2
City
State / Territory
Postcode
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Demographics
Country of birth
Is the caregiver an Australian citizen?
Yes
No
Country of citizenship
Visa number
If not Australian citizen
Date of arrival in Australia
-
Day
-
Month
Year
If applicable
Visa expiry date
-
Day
-
Month
Year
Date
Main language spoken at home
Other language(s) spoken at home
If applicable
Occupation
If applicable
Employer
If applicable
Religion
Religious denomination
Catholic
Other (please specify)
Data collection All schools are required to collect information on behalf of the Department of Education to enable nationally comparable reporting of students’ outcomes. Results are reported in terms of total numbers of students and no individual, school or system is identifiable in the analysis. The following information, along with the child’s gender, country of birth, indigenous status and main home languages, is submitted to the Department of Education.
Have you been in paid work in the past 12 months (either in full or part of)?
Yes
No
If yes, indicate your occupation group
Group 1: Elected officials, senior executives/manager, management in large business organisation, government administration and defence, and qualified professionals
Group 2: Other business managers/professionals and associate professionals
Group 3: Tradespeople and advanced/intermediate clerical, office, sales, carer and service staff
Group 4: Machine operators, sales/office/service/hospitality staff, assistants, labourers and related workers
Highest year of school completed
Please Select
Year 12 or equivalent
Year 11 or equivalent
Year 10 or equivalent
Year 9 or equivalent or below
Level of highest qualification attained
Please Select
Bachelor’s Degree or above
Advanced Diploma / Diploma
Certificate I to IV (including Trade Certificate)
No non-school qualification
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Section 3: GUARDIANSHIP
Please identify the legal guardian(s) of the student(s)
Caregiver 1
Caregiver 2
Other (please specify)
Are there any legally binding parenting or restraining orders, or other conditions we should be aware of?
No
Yes (please specify)
Caseworker's name (if applicable)
Title
First Name
Last Name
Department
Branch
Office address
Street Address
Street Address Line 2
Suburb
State / Territory
Postcode
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Phone number
Email
example@example.com
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Section 4: SIBLINGS
How many other siblings does the student(s) have who currently attend this school or another Catholic school?
Sibling 1 name
Year level
Please Select
Pre-Kindy
Kindergarten
Pre-Primary
Y1
Y2
Y3
Y4
Y5
Y6
Y7 to Y12
Currently attending
This school
Another Catholic school
Sibling 2 name
Year level
Please Select
Pre-Kindy
Kindergarten
Pre-Primary
Y1
Y2
Y3
Y4
Y5
Y6
Y7 to Y12
Currently attending
This school
Another Catholic school
Sibling 3 name
Year level
Please Select
Pre-Kindy
Kindergarten
Pre-Primary
Y1
Y2
Y3
Y4
Y5
Y6
Y7 to Y12
Currently attending
This school
Another Catholic school
Sibling 4 name
Year level
Please Select
Pre-Kindy
Kindergarten
Pre-Primary
Y1
Y2
Y3
Y4
Y5
Y6
Y7 to Y12
Currently attending
This school
Another Catholic school
Sibling 5 name
Year level
Please Select
Pre-Kindy
Kindergarten
Pre-Primary
Y1
Y2
Y3
Y4
Y5
Y6
Y7 to Y12
Currently attending
This school
Another Catholic school
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Section 5: MEDICAL INFORMATION
Emergency contacts (other than caregivers)
Contact 1 name
Title
First Name
Last Name
Phone number
Relationship to child
Contact 2 name
Title
First Name
Last Name
Phone number
Relationship to child
Health providers
Family doctor
Medical clinic
Phone number
Medicare card number
Medicare card expiry date
Medicare individual reference number for {name} (number to left of name)
Medicare individual reference number for {name179}
Do you have ambulance cover?
Yes
No
Private health fund name
If applicable
Private health fund policy number
Immunisation Government regulations require schools to obtain immunisation records at the time of enrolment and keep records. School Health Services has to notified of children who are not immunised. Only an Australian Immunisation Register (AIR) Immunisation Status Report can be accepted.
Do you have an AIR Immunisation Status Report for all students on this form?
Yes
No
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Section 6: OTHER INFORMATION
Any other information you would like to provide?
If applicable
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Section 7: BILLING
School fees
Who is responsible for paying the school fees?
Both caregivers
Caregiver 1 only
Caregiver 2 only
Other
Contact details for "Other"
Title
First Name
Last Name
Email
example@example.com
Phone number
Health care card The Health Care Card Discount Scheme provides fee concession to the holders of eligible means-tested family concession cards.
Do you possess a valid concession card?
No
Yes - Family Health Care Card
Yes - Pensioner Concession Card
Card number
Date of expiry
-
Day
-
Month
Year
Date
In order to qualify for a discount on school fees, you must attest to each of the following statements:
I have not claimed, nor do I intend to claim, Aboriginal Secondary Grants Scheme (ABSTUDY).
The student is not in receipt of any Bursary/Scholarship more than $1,000.
I will notify the school if my concession card status changes and will present a new card when this card expires.
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Section 8: Consent and agreement
Consent and agreement are provided for the duration of the student’s enrolment. Any changes need to be notified in writing.
Medical emergency authorisation
I/We authorise the school to seek medical/dental attention, call an ambulance or to hospitalise my son/daughter when considered necessary. I/We further authorise the school that if an emergency occurs requiring surgery, anaesthetic, oxygen, blood transfusion or medication, and I/we am unable to be contacted within a reasonable time, the school has the authority to agree to medically recommended treatment by an accredited medical practitioner on my/our behalf.
Yes
Use of student images
As part of the school’s communication activities, a student’s image may be required for use. The names of children are not published in social media. Only first names are used in the school newsletter. I/We hereby give permission for use of my/our child or children’s image in school and Catholic Education WA’s website, social media, local media and promotional material. If I/we decline permission, then I/we understand that their images will be excluded from assemblies, carnivals, discos, excursions, camps, school publications and all other school events. I/We must inform my/our child or children of my/our decision and direct them to remove themselves from all photos or videos being taken.
Yes
No
Class Representative Mailing List
I/We give permission for my/our email details to be included in my/our child’s class mailing list, managed by the Class Representatives.
Yes
No
Application and enrolment agreement This agreement makes reference to the Enrolment Policy, Privacy Policy and School Fees Policy available on our
website
.
I/We agree to each of the following statements:
1. Submitting an Application for Enrolment does not guarantee an interview nor a place at the school. Conditions for entry are in accordance with the school’s Enrolment Policy.
2. Enrolment in one Catholic school does not guarantee enrolment in any other Catholic school.
3. Students participate in all required parts of the education program, including the Religious Education program.
4. Families abide by the school’s Code of Conduct.
5. Families abide by the policies and directives of the school and CEWA as they are enacted from time to time.
6. Where applicable, documentation relating to Parenting or Restraining Orders and Australian residency status are provided.
7. Acceptance of the Enrolment Policy.
8. Acceptance of the Privacy Policy.
9. Acceptance of the School Fees Policy.
10. Information provided for Application and Enrolment is fully and truthfully completed. Enrolment may be refused or terminated if relevant information has knowingly been withheld.
I, {name72}, hereby provide my consent to this agreement for the duration of my/our child’s enrolment unless I/we withdraw this consent in writing.
Yes
I, {name137}, hereby provide my consent to this agreement for the duration of my/our child’s enrolment unless I/we withdraw this consent in writing.
Yes
Notice When you submit this form an electronic copy will be sent to the school via email. You may also be asked to provide supplementary information or furnish copies of the required documentation listed in the application checklist if you are unable to do so while completing the electronic form.
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Section 9: Documentation
Document Uploads Please provide electronic copies of the following documents. If you do not have access to electronic copies, you can provide printed copies to the school before your application progresses to an interview with the Principal.
Student 1 documents checklist ({name})
Birth Certificate *
Australian Immunisation Register (AIR) Immunisation Status Report *
Passport (if not born in Australia)
Visa (if not an Australian citizen)
Baptism (if applicable)
Reconciliation (if applicable)
First Communion (if applicable)
Confirmation (if applicable)
File Upload
Browse Files
Drag and drop files here
Choose a file
Please ensure each file upload is smaller than the limit of 5MB
Cancel
of
Student 2 documents checklist ({name179})
Birth Certificate *
Australian Immunisation Register (AIR) Immunisation Status Report *
Passport (if not born in Australia)
Visa (if not an Australian citizen)
Baptism (if applicable)
Reconciliation (if applicable)
First Communion (if applicable)
Confirmation (if applicable)
File Upload
Browse Files
Drag and drop files here
Choose a file
Please ensure each file upload is smaller than the limit of 5MB
Cancel
of
Caregiver 1 checklist ({name72})
Caregiver’s Passport (if not born in Australia)
Caregiver’s Visa (if not an Australian citizen)
Health Care Card (if applicable)
File Upload
Browse Files
Drag and drop files here
Choose a file
Please ensure each file upload is smaller than the limit of 5MB
Cancel
of
Caregiver 2 checklist ({name137})
Caregiver’s Passport (if not born in Australia)
Caregiver’s Visa (if not an Australian citizen)
Health Care Card (if applicable)
File Upload
Browse Files
Drag and drop files here
Choose a file
Please ensure each file upload is smaller than the limit of 5MB
Cancel
of
Other documents checklist
Parish Priest Reference (if applicable)
Custodial Court Order (if applicable)
File Upload
Browse Files
Drag and drop files here
Choose a file
Please ensure each file upload is smaller than the limit of 5MB
Cancel
of
Submit
Should be Empty: