KSR Application
Please fill out the form and then press "submit" at the end.
Applicant's Details
For when are you applying? (Note: 2019 Applications are now closed) *
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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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DD
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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
Your answer
Secondary Education (Institution and Years) *
List all schools attended and the years attended (eg. Eaglehawk High School 2008 - 2011; Bendigo Senior Secondary 2012 - 2013)
Your answer
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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Referee
Personal or Academic (not a relative)
Name *
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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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