Healthcare Card Copied Comments CSEF Comments Birth Certificate Copied Comments Emergency Contacts Comments Medical Details/Disabilities Comments School Asthma Plan Comments Head Lice Consent Comments Consent to be Photographed Comments ICT User Agreement Comments Netbook Agreement Gr.4/5/6 Comments Centrepay Deduction Comments Student Family Occupation Comments Custody/AVO doc. copied Comments VISA/Passports Copied Comments DOB:…………/…………/……………. Parent/s Name:………………………………………………… Enrolment taken by:…………………………………………………Date…………/…………/……………. General Comments:……………………………………………………………..…………………………………. CONSENT FORM I hereby give my consent for my child:………………………………........................to follow and adhere to the following policies and procedures as determined by DEECD and St. Georges Rd. Primary School. Cyber Safety/ICT Agreement YES/NO Head Lice Inspection YES/NO Photographic Consent YES/NO Signed:………………………………………… Date:………./………./………… ……………………………………………………………………………………………………………………………………… St Georges Road Primary School STUDENT ENROLMENT INFORMATION – 20__ Computer Generated Student ID: Surname: Title: (Miss Ms, Mrs Mr) OF
Work Telephone No: Other Work Contact information: After Hours: Is Adult A usually home AFTER business hours? (tick) Yes No Home Telephone No: Other After Hours Contact Information: Mobile No: SMS Notifications: Yes No Adult A’s preferred method of contact: (tick one) (If Phone is selected, Email shall be used for communication that cannot be sent via phone.) Mail Email Phone Facsimile Email address: Email Notifications: Yes No Fax Number: Write “As Above” if the same as Family Home Address No. & Street or PO Box Suburb: State: Postcode: B Business Hours: Can we contact Adult B at work? (tick) Yes No Is Adult B usually home during business hours? (tick) Yes No Work Telephone No: Other Work Contact information: After Hours: Is Adult B usually home AFTER business hours? (tick) Yes No Home Telephone No: Other After Hours Contact Information: Mobile No: SMS Notifications: Yes No Adult B’s preferred method of contact: (tick one) (If Phone is selected, Email shall be used for communication that cannot be sent via phone.) Mail Email Phone Facsimile Email address: Email Notifications: Yes No Fax Number:
Date of first enrolment in an Australian School: _____ / _____ / ______ Name of previous School: Years of previous education: What was the language of the student’s previous education? Does the student have a Victorian Student Number (VSN)? Yes. Please specify: Yes, but the VSN is unknown No. The student has never been issued a VSN. Years of interruption to education: Is the student repeating a year? (tick) Yes No Will the student be attending this school full time? (tick) Yes No If No, what will be the time fraction that the student will be attending this school? (i.e: 0.8 = 4 days/week) Other school Name: Time fraction: 0. Enrolled: Yes No Other school Name: Time fraction: 0. Enrolled: Yes No In some circumstances a child may be enrolled conditionally, particularly if the required enrolment documentation to determine the shared parental responsibility arrangements for a child is not provided. Please refer to the School Policy & Advisory Guide’s Admission page for more information (). Enrolment conditions OFFICE USE ONLY Has the documentation been provided and retained on school records? Yes No Have the conditions been met to complete the enrolment? Yes No Is the student at risk? Yes No Is there an Access Alert for the student? (tick) Yes (If Yes, then complete the following questions and present a current copy of the document to the school.) No (If No, move to the immunisation / medical condition details questions.) Access Type: (tick) Parenting Order Parenting Plan Intervention Order Protection Order Informal Carer Stat Dec DHHS Authorisation Witness Protection Program Order Other