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Enrolment Form

Step 1 of 6 - Student Details

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Student Details

Student Name(Required)
Gender(Required)

Date of Birth(Required)
Intended start date (other)(Required)
If No, provide details for other schools(Required)
Other school name
Days / week
Has enrolment been accepted? (Yes/No)
 

Student’s Permanent Residence

Your child’s permanent residence is the address where they spend the majority of their days during the school week. If they spend an equal amount of time at two addresses, both are considered their permanent address and your child will be entitled to enrol in the designated neighbourhood school for either address. The school may make enquiries to verify the information provided, such as checking the electoral roll at an Australian Electoral Commission office or the Victorian Electoral Commission head office; checking with a real estate agent; or checking whether there are any regulations/codes limiting the number of people living at one residence, for example if a rental property is a studio or one bedroom unit.

Student’s Permanent Residence(Required)
* Students who live in court ordered alternative care arrangements away from their parents. These court ordered care arrangements include living with relatives or friends (kinship care), living with non-relative families (foster care or adolescent community placements) and living in residential care units.
* If the student is living in an informal care arrangement, please contact the school for an Informal Carer’s Statutory Declaration, which must be completed.

Siblings

A sibling is defined broadly and can include step-siblings and students residing together as part of a multiple family cohabitation or out-of-home-care arrangements, including foster care, kinship care and permanent care.
Siblings(Required)
Full Name
Current Year Level
Reside at same residential address as the student (Yes/No/Sometimes)
 

Student Demographics

Does the student speak a language other than English at home?

If OTHER, please specify the main language spoken at home
* A young carer is a young person under 25 years of age who provides, or intends to provide care, assistance, or support to a family member with a mental illness, physical illness, disability, chronic illness, or who is aged or has an addiction.

Student Residency Status

In which country was the student born?(Required)

If born overseas, on what date did the student arrive in Australia?(Required)
* Note: An Australian birth certificate does not guarantee Australian residency or citizenship. Further information is available click here
Visa Expiry Date
* Note: If you are unsure of your International Student ID, please contact the International Education Division via phone (03 9084 8497) or email (international@education.vic.gov.au).

Students with Additional Learning and Support Needs

The Department of Education recognises that adjustments may be required for students with additional needs, including students with disability, so that they can participate at school. School personnel and parents or carers work together to identify the adjustments that may be needed to meet the student’s learning and support needs.

Has the student had a disability assessment before?(Required)

If OTHER, specify outcome
Has the student received individualised disability funding before?(Required)

If OTHER, please specify
Has any previous education provider prepared a documented plan to support the student’s additional learning needs?(Required)

If OTHER, provide details

Does the student have additional needs in any of the following areas?

Hearing(Required)

If OTHER, please specify
Vision(Required)

If OTHER, please specify
Speech/Language(Required)

If OTHER, please specify
Physical(Required)

If OTHER, please specify
Cognitive/Learning(Required)

If OTHER, please specify
Social/Emotional(Required)

If OTHER, please specify

Previous Education – Students Enrolling in Foundation for the First Time

* Note: A kindergarten program that is funded and approved by the Victorian Government, has a play-based learning program, and is delivered by a qualified teacher. Funded kindergarten programs click here

Previous Education – Other

Location of last school attended(Required)
If Yes, date of attendance (From)(Required)
If Yes, date of attendance (To)(Required)

Parent/Carer Details – Adult A

Name (Adult A)(Required)
Gender (Adult A)(Required)

Address (Adult A)(Required)
Adult A’s preferred method of contact(Required)
Relationship to student (Adult A)(Required)

In which country was Adult A born?(Required)

Does Adult A speak a language other than English at home?(Required)

If OTHER, please specify
e.g., School Council , excursions

For more more information on occupation groups see this link

If the person has not been in paid work for the last 12 months, enter ‘N’.

Parent/Carer Details – Adult B

Name (Adult B)
Gender (Adult B)

Address (Adult B)
Adult B’s preferred method of contact
Relationship to student (Adult B)

In which country was Adult B born?

Does Adult B speak a language other than English at home?

If OTHER, please specify
e.g., School Council , excursions

For more more information on occupation groups see this link

 If the person has not been in paid work for the last 12 months, enter ‘N’.

Additional Parents/Carers

Adult Names(Required)
If yes, please complete the Adult 3 and/or Adult 4 sections as attachments to this form on pages 16-17. If required, you may request a separate form for additional parents/carers from the school. The separate form allows for the capture of four further parents/carers.
Emergency Contacts(Required)
Name
Relationship (Neighbour, Relative, Friend or Other)
Telephone Contact
Language Spoken (Write E for English)
 
Please provide emergency contacts in the event that the enrolling parents/carers are unavailable. Please ensure those listed as emergency contacts are aware that their information has been provided for this purpose.

Billing Details

You are not required to make payments or voluntary financial contributions to your school. Schools may request payments for extracurricular items and activities. For more information, please click here
Billing Address(Required)
* Note: If you would like to send bills to another person / address, please ensure Additional Parent/Carer details are completed on pages 16-17.

Student Medical Details

The Department of Education and Victorian Government Schools require the health information requested in this section to plan for and support the health and wellbeing needs of students.

If there is a situation or incident which requires first aid to be administered to your child, school staff will administer first aid that is reasonably necessary and appropriate to their level of training. School staff will also seek emergency medical attention for your child if it is considered reasonably necessary. Any costs associated with student injury rest with parents/carers unless the Department of Education is liable in negligence (liability is not automatic). In the event that your child needs medical attention, school staff will contact you as soon as practically possible.

Doctor’s Name(Required)
Medical Centre Address(Required)

Asthma

Asthma Details

Drop files here or
Max. file size: 16 MB.
    Medication(Required)
    Name of medication taken
    Is the medication taken regularly by the student (preventive) or only in response to symptoms?
    Indicate how frequently the medication is taken
    Dosage time
     
    Medication is usually administered by

    Medication is to be stored

    Medical Conditions

    If yes, please provide the school with an ASCIA Action Plan for Allergies
    If yes, please provide the school with an ASCIA Action Plan for Anaphylaxis

    If the student displays any of the symptoms above, please

    Medication

    Allied Health Support

    Has the student previously accessed support from an allied health professional?
    Other(Required)

    If OTHER, please specify

    Student Risk

    The Department of Education has a responsibility to assess and manage any risk of harm to its staff and students. This form gives you the opportunity to provide information that will help facilitate the student’s transition to school. This may include preparing a behaviour management plan or other appropriate strategies to meet the particular needs of the student. The actions taken in response to the information you provide will help ensure the safety of this student, other students and staff.

    Court Orders and Other Care Arrangements

    Details

    Drop files here or
    Max. file size: 16 MB.
      Court Order or other access document type(Required)

      End Date (if applicable)

      Activity Restrictions and Considerations

      Student Travel Details

      Students residing in rural and regional Victoria or attending special schools may be entitled to receive travel assistance. Travel assistance may be in the form of access to a school bus service or financial support through a conveyance allowance to assist with the cost of travel. Information on eligibility and the application process can be obtained from the school.
      How will the student primarily travel to and from school?(Required)

      Any required documents can be presented to the school office if they are unable to be uploaded and attached to this form

      Drop files here or
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                Declaration

                Thank you for completing this Student Enrolment form. The information provided is required to enable staff to properly enrol your child at our school as such it is important that it is accurate and up to date.
                I/We confirm that(Required)
                - I am/We are the person/people named as completing this form
                - The information in this form is true and correct.
                - I/We agree to authorise this form by electronic means with an electronic signature.
                Date(Required)
                Date
                Please select the category that best describes who has signed and completed this form. This will assist the school with the enrolment process.
                For instance, where the contact details for the other parent are known but it is not appropriate or safe to contact them

                Enrolment

                • 2023 Transition Program for 2024 school year
                • Enrolment Form
                • Parental Occupation Group Codes
                • School Tours
                • Virtual School Tour
                • International Student Program

                Documents

                • Student Enrolment Form School Entry 2024

                Book a Tour Enrol Now

                Clarinda Primary School
                (03) 9544 3231 Email Us
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                Clarinda Primary School
                1166 Centre Road
                Clarinda, Victoria 3169
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                Phone: (03) 9544 3231
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                Clarinda Primary School

                • Home
                • About Us
                  • About Us
                  • Principal’s Message
                  • Leadership & Staff
                  • School History
                  • School Council
                  • School Hours
                  • Important Documents
                • Curriculum
                  • Beyond the Classroom
                  • Character & Capability
                  • English
                  • Health & Physical Education
                  • Humanities
                  • Languages
                  • Learning
                  • Mathematics
                  • Science
                  • Science Technology Engineering Mathematics (STEM)
                  • Sustainability
                  • Technologies
                  • The Arts
                • Student Wellbeing
                  • Child Safe Standards
                  • Harmony Day
                  • Play is the Way
                  • School Chaplaincy Program
                  • Speech Pathologist
                  • Student Leadership
                  • Therapy Dogs
                • Parent Information
                  • Camp Australia – Before & After School Care
                  • Lunch Orders
                  • Financial Assistance (CSEF)
                  • Parent Payment – Essential Education
                  • Parenting Resources
                  • Parent Teacher Interviews
                  • School Breakfast Club
                  • Uniform
                • News & Events
                  • Calendar
                  • Newsletters
                • Enrolment
                  • 2023 Transition Program for 2024 school year
                  • Enrolment Form
                  • International Student Program
                  • School Tours
                  • Virtual School Tour
                • Pre Prep Program
                • Contact Us