KSR Application
Please fill out the form and then press "submit" at the end.
Applicant's Details
For when are you applying? (eg. Sem 2 2016, Sem 1 2017 etc.)
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First Name
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Last Name
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Address
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Town/Suburb
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State
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Postcode
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Home Phone
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Mobile
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Email
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Date of Birth
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Place of Birth
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Parent/Guardian Details
Mother
Full Name
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Address (if different from above)
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Town/Suburb
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State
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Postcode
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Home Phone (if different to above)
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Mobile
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Email
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Father
Full Name
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Address (if different to above)
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Town/Suburb
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State
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Postcode
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Home Phone (if different to above)
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Mobile
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Email
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Education
VCE (or equivalent)
Year Completed
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Subjects Attempted
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Secondary Education (Institution and Years)
List all schools attended and the years attended (eg. Eaglehawk High School 2008 - 2011; Bendigo Senior Secondary 2012 - 2013)
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Current Tertiary Studies (if applicable)
Course
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Institution
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Subjects
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Course(s) and Institution(s) Applying for Next Year
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Referees
Two people who are not relatives
Name
Personal
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Address
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Home phone
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Mobile
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Relationship
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Name
School or Academic
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Address
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Home phone
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Mobile
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Relationship
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Other Information
Other accommodation applied for:
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Church Involvement:
(if any)
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Hobbies/Interests:
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Positions of Responsibility Held:
(if any)
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Awards/Prizes:
(if any)
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Special Dietary Needs:
(if any)
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Reasons for Applying to KSR:
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How Did You Hear About KSR?:
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Declaration
I declare that, to my best knowledge, all information provided here is true and accurate.
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