Student Details

Surname

First Given Name

Second Given Name

Preferred First Name

Gender

MaleFemaleSelf-described

If self-described, please specify

Date of Birth

Student Mobile Number

Which year are you seeking to enrol this student?

12345689101112

Intended start date

Day 1, Term 1Other

If Other, intended start date

Are you seeking to enrol the student at this school full-time?

YesNo

If No, how many days a week would the student be attending this school?

If No, provide reason you are seeking part-time enrolment

If No, provide details for other schools

Student Permanent Residence

No. & Street Address

Suburb

State

Postcode

How often does this student live at this address?

AlwaysMostlyBalanced (50%)

If the student lives at another address during the school week, provide further details including the address, who they reside with and how many days a week the student lives there

Student Living Arrangements

What are the student’s living arrangements?

Student lives with parents/carers together at the same residenceStudent lives with each parent/carer at different timesStudent lives with one parent/carer onlyState Arranged Out of Home CareInformal care arrangementStudent is independentHomeless

If the student has a Case Manager, please provide their contact details below

Siblings

Does the student have any siblings at this school?

YesNo

Sibling details

Student Demographics

Does the student speak English?

YesNo

Does the student speak a language other than English at home?

No, English onlyYes

If Yes, please specify the main language spoken at home

Is the student of Aboriginal or Torres Strait Islander origin?

NoYes, AboriginalYes, Torres Strait IslanderYes, Both Aboriginal & Torres Strait Islander

Is the student a young carer?

YesNo

Student Residency Status

In which country was the student born?

If born overseas, on what date did the student arrive in Australia?

What is the student’s residency status?

Australian citizen – holds Australian PassportAustralian citizen – eligible for Australian PassportPermanent ResidentTemporary ResidentNew Zealand citizen

Visa Sub Class

Visa Expiry Date

Visa Statistical Code

Does the student hold a Bridging Visa?

YesNo

If Yes, what was the student’s previous visa?

If Yes, what visa has the student applied for?

International Student ID

Students with Additional Learning and Support Needs

Does the student have additional needs and require support for learning?

YesNo

Please indicate any adjustments that may assist the student to participate at school

Has the student had a disability assessment before?

NoYes

If Yes, specify outcome

Has the student received individualised disability funding before?

NoYes

If Yes, please specify

Has any previous education provider prepared a documented plan to support the student’s additional learning needs?

NoYes

If Yes, provide details

Additional needs in the following areas

HearingVisionSpeech/LanguagePhysicalCognitive/LearningSocial/Emotional

Please provide details for the additional needs selected above

Previous Education – Other

Has the student previously been enrolled at another school?

Yes, in Victoria – Government SchoolYes, in Victoria – Catholic or Independent SchoolYes, interstateYes, overseasNo

If Yes, name of last school attended

If Yes, location of last school attended

If Yes, date of attendance from

If Yes, date of attendance to

If Yes, year levels of previous education

If the student studied overseas, what age did the student first start school?

What was the language of the student’s previous education?

Period of interruption to education

Is the student repeating a year level?

YesNo

Parent/Carer Details – Enrolling Adult 1

Surname

Title

First Given Name

Gender

MaleFemaleSelf-described

If self-described, please specify

No. & Street Address

Suburb

State

Postcode

Preferred language of notices

Mobile

Work Phone

Home Phone

Email

Can we contact Adult 1 during school hours?

YesNo

Is Adult 1 usually home during school hours?

YesNo

SMS Notifications

YesNo

Email Notifications

YesNo

Adult 1’s preferred method of contact

MobileEmailMailHome PhoneWork Phone

Specify any other special conditions or times related to contact

Relationship to student

ParentStep ParentFoster ParentHost FamilyRelativeFriendSelfOther

If Other, specify

In which country was Adult 1 born?

Does Adult 1 speak a language other than English at home?

No, English onlyYes

If Yes, please specify

Please indicate any additional languages spoken by Adult 1

Is an interpreter required?

YesNo

Student lives with Adult 1

AlwaysMostlyBalanced (50%)Occasionally

Adult 1 Job Title

Adult 1 Employer

Is Adult 1 interested in being involved in school group participation activities?

YesNo

What is the highest year of primary or secondary school that Adult 1 has completed?

Year 12 or equivalentYear 11 or equivalentYear 10 or equivalentYear 9 or equivalent or below / no schooling

What is the level of the highest qualification that Adult 1 has completed?

Bachelor degree or aboveAdvanced diploma / DiplomaCertificate I to IV (including trade certificate)No non-school qualification

What is the occupation group of Adult 1?

Occupation groups:

Click here to view the occupation group codes

Group AGroup BGroup CGroup DN

Parent/Carer Details – Enrolling Adult 2

Surname

Title

First Given Name

Gender

MaleFemaleSelf-described

If self-described, please specify

No. & Street Address

Suburb

State

Postcode

Preferred language of notices

Mobile

Work Phone

Home Phone

Email

Can we contact Adult 2 during school hours?

YesNo

Is Adult 2 usually home during school hours?

YesNo

SMS Notifications

YesNo

Email Notifications

YesNo

Adult 2’s preferred method of contact

MobileEmailMailHome PhoneWork Phone

Specify any other special conditions or times related to contact

Relationship to student

ParentStep ParentFoster ParentHost FamilyRelativeFriendSelfOther

If Other, specify

In which country was Adult 2 born?

Does Adult 2 speak a language other than English at home?

No, English onlyYes

If Yes, please specify

Please indicate any additional languages spoken by Adult 2

Is an interpreter required?

YesNo

Student lives with Adult 2

AlwaysMostlyBalanced (50%)OccasionallyNever

Adult 2 Job Title

Adult 2 Employer

Is Adult 2 interested in being involved in school group participation activities?

YesNo

What is the highest year of primary or secondary school Adult 2 has completed?

Year 12 or equivalentYear 11 or equivalentYear 10 or equivalentYear 9 or equivalent or below / no schooling

What is the level of the highest qualification that Adult 2 has completed?

Bachelor degree or aboveAdvanced diploma / DiplomaCertificate I to IV (including trade certificate)No non-school qualification

What is the occupation group of Adult 2?

Occupation groups:

Click here to view the occupation group codes

Group AGroup BGroup CGroup DN

Additional Parents/Carers

Are there additional parents/carers in the student’s life?

YesNo

Name of Adult 3

Name of Adult 4

Emergency Contacts

Emergency contact details

Correspondence Details

Send correspondence addressed to

Adult 1Adult 2Both AdultsNeither

Billing Details

Send bills to

Adult 1Adult 2Another person / address

Name to be used for all billing correspondence

No. & Street or PO Box

Suburb

State

Postcode

Billing Email

Student Medical Details

Doctor’s Name

Medical Centre

Street Address

Suburb

State

Postcode

Telephone Number

Asthma

Does the student have asthma?

YesNo

Has a current Asthma Management Plan been provided to School?

YesNo

Does the student take medication?

YesNo

Name of medication taken

Is the medication taken regularly by the student (preventive) or only in response to symptoms?

PreventativeResponse

Indicate the usual dosage of medication taken

Indicate how frequently the medication is taken

Medication is usually administered by

StudentAdultOther

If Other, specify

Medication is to be stored

with Studentwith StaffOther

If Other, specify storage details

Dosage time

Reminder required?

YesNo

Medical Conditions

Does the student have an allergy?

YesNo

Is the student at risk of anaphylaxis?

YesNo

Does the student have any other medical condition or other relevant medical assessment that the school needs to know about?

YesNo

If Yes to any of the above, please specify

Symptoms

If the student displays any of the symptoms above, inform emergency contact

YesNo

If the student displays any of the symptoms above, administer medication

YesNo

Other medical action

YesNo

If Yes, please specify other medical action

Medication

Does the student take medication?

YesNo

Is the medication required during school hours?

YesNo

Name of medications taken

Allied Health Support

Has the student previously accessed support from an allied health professional?

Occupational therapySpeech pathologyPhysiotherapyExercise physiologyBehaviour supportOther

If Other, specify

Student Safety, Access, and Special Circumstances

To your knowledge, is there anything in the student’s history or circumstances which might pose a risk of any type to this student, other students, or staff at this school?

YesNo

If Yes, please provide further detail

Is there an intervention order, parenting order or any other court order impacting the student?

YesNo

Court Order or other access document type

Family Law Order / Parenting OrderParenting Plan / AgreementIntervention OrderChild Protection OrderDFFH AuthorisationOther

If Other, specify

Please provide further details of the Court Order or other access documents, and any other safety concerns

End Date

Are there any activities that the student cannot participate in?

YesNo

If Yes, please provide further detail

Student Travel Details

How will the student primarily travel to and from school?

WalkingSchool BusTrainDriven by parent/carerTaxi / Ride ShareBicyclePublic BusTramSelf-DrivenOther

If Other, specify

If the student catches public transport to school, what station/stop does their journey commence?

If the student drives themself to school, what is their Car Registration Number?

Is the student applying for the Conveyance Allowance Program?

YesNo

Is the student applying for the School Bus Program?

YesNo

Is the student applying to travel on a school bus or other travel assistance?

YesNo

First date of travel

Next school yearAlternate date

Alternate first date of travel

Type of travel assistance requested

Access to School BusConveyance Allowance

If applicable, specify the student’s mode of assisted mobility

WheelchairWalker

Comments relevant to travel

Photographing, Filming and Recording Students

Do you give permission for your child’s photograph, filming or recording to be used in the College’s website, Facebook, newsletter, magazine, handbook and/or promotional material?

YesNo

Supporting Documents

Upload supporting documents if applicable

Declaration

Name of Enrolling Adult signing this form

Name of second Enrolling Adult signing this form

Please select the category that best describes who has signed and completed this form

Both parents/carers have completed and signed this form.Parents/carers are completing separate forms.One parent has completed and signed this form on behalf of both parents.One parent has completed and signed this form and the contact details for the other parent are unknown.There is only one parent/carer with legal responsibility for the child.Other

If Other, please specify

Additional comments

Declaration Acceptance

I/We confirm that the information in this form is true and correct and agree to authorise this form electronically.