Enrolment - MYCollege

Enrollment

Step 1 of 9

11%

STUDENT INFORMATION

Family Name(Required)

Given Name(Required)

Middle Name

Date of Birth(Required)

DD slash MM slash YYYY

Gender(Required)

Male

Female

Country of Birth(Required)

Australia

Other

Citizenship(Required)

Australian Citizen

Aboriginal origin

Torrest Strait Islander

Other Nationality(Required)

Visa

Permanent Visa

Temporary Visa

Visa Number

Address(Required)

Suburb(Required)

Post Code(Required)

Who does the student reside with?(Required)

Both parents

Mother only

Father only

Other

Are there any custody restrictions i.e. Intervention Orders?(Required)

Yes

Is the student an EAL (English as an Additional Language) student?(Required)

Yes

If Yes, specify arrival date to Australia

DD slash MM slash YYYY

Current School(Required)

Current year level(Required)

Proposed Entry Level to My College(Required)

Proposed Year of Entry(Required)

Main language spoken at home(Required)

FAMILY INFORMATION

Do you have any other children who is currently enrolled in My College?(Required)

Yes

This field is hidden when viewing the form

If yes, please tell us their name and year level

CONTACT 1

Primary contact for SMS alerts

Parent/Guardian

Parent

Guardian

Relation to Student

Title

Family Name(Required)

Given Name(Required)

Country of Birth(Required)

Language/s spoken at home(Required)

Nationality(Required)

Religion(Required)

Islam

Other

Residential Address(Required)

Postcode(Required)

Postal Address (as above)

Telephone (H)

Telephone (W)

Telephone (M)(Required)

Email(Required)

Occupation

Highest level of school education completed including overseas(Required)

Year 12

Year 11

Year 10

Year 9

No School

Highest level of qualification post school completed including overseas(Required)

Bachelors Degree/Above

Diploma/ Advanced Diploma

Certificate I to IV inc. Trade Cert

No Post- School Qualification

CONTACT 2

Primary contact for SMS alerts

Parent/Guardian

Parent

Guardian

Relation to Student

Title

Family Name(Required)

Given Name(Required)

Country of Birth(Required)

Language/s spoken at home(Required)

Nationality(Required)

Religion(Required)

Islam

Other

Residential Address(Required)

Postal Address (as above)

Telephone (H)

Telephone (W)

Telephone (M)(Required)

Email(Required)

Occupation

Highest level of school education completed including overseas(Required)

Year 12

Year 11

Year 10

Year 9

No School

Highest level of qualification post school completed including overseas(Required)

Bachelors Degree/Above

Diploma/ Advanced Diploma

Certificate I to IV inc. Trade Cert

No Post- School Qualification

BILLING DETAILS

School fees will be paid by

Contact 1 & 2

Contact 1

Contact 2

Other (please list below)

Title

Given Name

Family Name

Relation

Address

Postcode

Contact Number

EMERGENCY CONTACT DETAILS

Full Name (1)(Required)

Contact Number (1)(Required)

Relation (1)(Required)

Full Name (2)

Contact Number (2)

Relation (2)

Full Name (3)

Contact Number (3)

Relation (3)

MEDICAL INFORMATION

Medicare Number(Required)

Name on Card (Medicare)(Required)

Expiry (Medicare)(Required)

DD slash MM slash YYYY

Health Care/Pension Card Number

Name on Card (Health Care/Pension)

Expiry (Health Care/Pension)

DD slash MM slash YYYY

Family Doctor’s Name

Name of Clinic

Address (Clinic)

Postcode (Clinic)

Contact Number (Clinic)

Do you have Ambulance Cover for any Emergency?(Required)

Yes

Ambulance Cover Number(Required)

Expiry (Ambulance Cover)(Required)

DD slash MM slash YYYY

Does the child suffer from any of the following(Required)

Asthma

Allergies

Diabetes

Anaphylaxis

Epilepsy

None of the above

Details (for above conditions)

Does the child have any disabilities/impairments?(Required)

Yes

Details (for disabilities)

Is the child on any long-term medications?

Yes

Details (for medications)

Has the child previously attended Counselling?

Yes

Do you feel your child may need to be referred to a School Counsellor?

Yes

Does your child attend any Specialist Services i.e. Speech Therapy, Behaviour Management?

Yes

Other

Type of service

Name of Service

Contact Person

Address (Service)

Postcode (Service)

Contact Number (Service)

DATABASE PHOTOGRAPHS

School database photographs are used internally within the school’s student management system, therefore it is compulsory for enrolment and security purposes.

PHOTOGRAPH AND VIDEO CONSENT

Do you consent to your child’s photos/videos being used for internal school publications (ie. internal school displays and school yearbook)?(Required)

Yes

Do you consent to your child’s photos/videos being used for external school publications(ie. newspapers), school social media, school newsletter and promotional material (ie. advertising, promotional documents/magazines, etc.)?(Required)

Yes

DECLARATION

By signing this Application for Enrolment Form, you agree to the Enrolment Terms and Conditions.

Full Name (1)

Relation to child (1)(Required)

Date (1)(Required)

DD slash MM slash YYYY

Full Name (2)(Required)

Relation to child (2)(Required)

Date (2)(Required)

DD slash MM slash YYYY

Kindergarten/School Contact Parent Consent

Student Name(Required)

Kindergarten/School Name

Kindergarten/School Address

Postcode

Kindergarten/School Number

Kindergarten/School Teacher

Kindergarten Only Days attending

Monday

Tuesday

Wednesday

Thursday

Friday

Session times

Morning

Afternoon

Other

Other (Session times)

Parent/Guardian Full Name(Required)

Date(Required)

DD slash MM slash YYYY

Comments and Notes

Payment

Amount to pay

Price:

Credit Card

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