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Online Application Form
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1. Name of Child (Full name) *
2. Family Address *
3. Telephone (Home) *
4. Date Of Birth *
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DD
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5. Gender of child *
6. Entry Grade Requested
7. Requested entry grade for the Year *
8. Place of Birth *
9. Date of child's arrival in Australia (if applicable)
MM
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DD
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YYYY
10. Last child care (Kindergarten)/ School (school age students) Attended
11. Language(s) spoken at home
12. Father's Name (full name) *
13. Mother's Name (full name) *
14. Father's Work Telephone
15. Father's Mobile Number
16. Mother's Work Telephone
17. Mother's Mobile Number
18. Fax
19. Email
20. Father deceased
21. Mother deceased
22. Emergency Contact In Case Of Emergency (Name, Phone and Relationship To Child)
23. Other Children In Family
24. Student Method Of Travel To School
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25. Date Of Child's Baptism
MM
/
DD
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YYYY
26. Church Of Baptism
27. Current Family Church
28. Family Doctor (Full Name) *
29. Family Doctor (Phone) *
30. Please tick if your child has been immunised against the following *
Required
31. Medication to be administered
32. Allergies or chronic complains (eg. Athma)
33. Known Learning Difficulties
34. Medicare Number
35. Private Health Fund Number
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