Enrolment Form - Monday afternoon children's classes (Semester 2, 2018)
Children's Division - ACT German Language School Inc.

ACCOUNT DETAILS for fee payments
Westpac
BSB: 032 733
Acc no: 161270
Please include your child’s name in the details field so we can attribute the funds correctly

Email address *
FEES *
SECTION A: DETAILS OF STUDENT
If you are enrolling more than one child, please enter their details separately
Surname *
Your answer
Given name *
Your answer
Date of birth *
DD/MM/YYYY
Your answer
Has the student previously attended the ACT German Language School?
If YES, which class?
If NO, does the student have any prior knowledge of German?
Please detail prior knowledge (if applicable)
Your answer
How did you hear about the school?
SECTION B: EMERGENCY CONTACT DETAILS
Please inform us of any changes to your details - email actgermanschool@yahoo.de
Mobile phone *
Your answer
Surname *
Your answer
Given name *
Your answer
Relationship to student *
Additional mobile phone (optional)
Your answer
Additional email address (optional)
Your answer
Home phone
Your answer
Work phone
Your answer
Residential address *
(street number, street, suburb, postcode)
Your answer
SECTION C: DECLARATION BY PARENT
Accident declaration *
In the event of illness or injury to my child whilst at school, or on an excursion, or travelling to or from school, I authorise the Principal or senior staff member in charge of my child, where it is impracticable to communicate with me, to consent to emergency medical arrangements on my behalf as are deemed necessary by a qualified medical practitioner. Such consent includes anaesthetics, blood transfusions and/or operations. (Please advise by email if consent is not given for any of these procedures).
Required
General Declaration *
I apply for admission to the ACT German Language School Inc. for the student named above. I agree to pay the required school fee and book costs at the beginning of each semester. I also apply for free membership of the School Association and agree to abide by the Association's Constitution (available at http://www.actgermanschool.org.au/about-us/german-language-school-constitution-8-april-2018)
Required
Use of photographs *
From time to time we may like to use group photos of our classes on our internet page, Facebook page and similar. We may also provide these group photos to the Embassies of German-speaking countries for use on their web/Facebook pages. Please indicate your consent or otherwise to using such group photos that include your child.
Required
Date *
DD/MM/YYYY
Your answer
A copy of your responses will be emailed to the address you provided.
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