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