Application for Enrolment – Part B – Como Secondary College

1. Enrolment Information

Parents should read the information in the PDF below before lodging the Enrolment Form with the school.

Enrolment Information

Year of enrolment

2. Student Details

Student's Surname

Student's Legal Surname (If different from Surname)

Given Names

Preferred Name

Student's Date of Birth

Gender

Male Female Not Specified

Pronoun (Optional)

Address (student's usual place of residence)

Suburb

State

Postcode

What is your family’s first language?

Do you always speak Standard Australian English at home?

Yes No

If no – what other language do you speak at home?

Student lives with

If other - Name & Relationship to Student

3. Parent / Carer Details

Parent / Carer 1 Details

This person will be listed as the first contact for the student in an emergency.

Title

First Name

Surname

Relationship to student.

Mobile Number

Fees and charges billing

Yes No

If no, who is responsible?

What is Parent/Carer 1 first language?

Does Parent / Carer 1 always speak Standard Australian English at home?

Yes No

If no – what other language do you speak at home?

What is the highest year of school you have completed

Year 12 or equivalent Year 11 or equivalent Year 10 or equivalent Year 9 or equivalent or below

If you did not attend school, mark 'Year 9 or equivalent or below'

What is the level of the highest qualification you have completed?

Bachelor degree or above Advanced diploma/Diploma Certificate I to IV (including trade certificate) No non-school qualification

Are you currently employed?

Yes No

If yes what is your current job title?

If no, have you worked in the last 12 months?

Yes No

Workplace location

Parent / Carer 2 Details

This person will be listed as the second contact for the student in an emergency.

Title

First Name

Surname

Relationship to student.

Mobile Number

Fees and charges billing

Yes No

If no, who is responsible?

What is Parent/Carer 2 first language?

Does Parent / Carer 2 always speak Standard Australian English at home?

Yes No

If no – what other language do you speak at home?

What is the highest year of school you have completed

Year 12 or equivalent Year 11 or equivalent Year 10 or equivalent Year 9 or equivalent or below

If you did not attend school, mark 'Year 9 or equivalent or below'

What is the level of the highest qualification you have completed?

Bachelor degree or above Advanced diploma/Diploma Certificate I to IV (including trade certificate) No non-school qualification

Are you currently employed?

Yes No

If yes what is your current job title?

If no, have you worked in the last 12 months?

Yes No

Workplace location

Alternative Emergency Contact Details

People other than Parent/Carer 1 and Parent/Carer 2 who may be contacted in an emergency.

Title

First Name

Surname

Relationship to student.

Street Address

Suburb

State

Postcode

Mobile Number

Please advise the school if there are any other contacts you would like recorded.

4. Student Details - Additional Information

Religion

Is there any additional provision required for your child’s religious practice?

Does the student receive any of the following allowances

Secondary Assistance Youth Allowance Assistance for Isolated Children (AIC) Abstudy

Reason for change of school (optional)

If previously enrolled in Home Education, specify the Education Region

USI (Unique Student Identifier) Number

5. Privacy and Declaration

Title

First Name

Surname

Relationship to student.

Date

6. Student Health Care Summary

IF APPLICABLE, ON COMPLETION OF THIS FORM, PLEASE REQUEST AND COMPLETE THE RELEVANT HEALTH CARE PLANS

Note: Where appropriate students should be encouraged to participate in their health care planning.

Section A

Medical Details

Name of medical practice

Name of Doctor

Telephone

Do you have ambulance insurance?

Yes No

If there is a medical emergency, parents/carers are expected to meet the cost of an ambulance.

List any essential information that could affect your child in an emergency e.g. allergy to penicillin.

Medicare No.

Medicare Individual Reference Number

Expiry Date

Government Issued Health Care Card

Card Number

Card Expiry Date

Administration of medication

Written authorisation must be provided for staff to administer any form of medication at the College.
Long term medication – Complete the Medication section of the relevant health care plan.
Short term medication - Request an Administration of Medication form to complete and return to the principal or class teacher.
Note: All medication required must be supplied by parents/carers.

Informed Consent

Your child’s health care information will be shared with staff on a need to know basis unless otherwise stated.

Do you give permission for the College to share your child’s health care information?

Yes No

Note: If your child is enrolled in a TAFE, PEAC or an alternative education program, this includes the transfer of their health care information to the principal or manager of that program.

If no, and the information is to be restricted, who can be informed of your child’s health care information?

Does your child have one or more health condition(s) that will require support from College staff?

Yes No

If No - Skip Section B. If your child’s requirements change, please notify the College. If Yes - complete Section B of this form. You will be given additional forms to complete.

Section B

PLEASE INDICATE YOUR CHILD’S CONDITION(S) WHICH REQUIRE THE SUPPORT OF COLLEGE STAFF (In response to the information below, you will be given further forms for specific health conditions to complete.)

Health Conditions

Other Conditions or Needs (Please specify)

Will College staff require specific training to support your child? (If yes, please specify below)

Has your child’s Medical Practitioner provided a health care plan to assist the College to manage the condition?

Yes No

If yes, please attach the health care plan provided

Section C

If your child has a condition where an emergency may occur, please indicate whether you give consent for staff to place your child’s medical details and photo on view to provide immediate identification.

I give permission for my child’s medical details and photo to be on view for staff

Yes No

Section D

Does your child have a Medic Alert bracelet or pendant?

Yes No

If yes, provide details

7. Consent Form

At Como Secondary College we aim to offer your child the widest range of learning opportunities and celebrate learning whenever possible. This may often require some form of parental consent. This form asks you to consent (or otherwise) to your child’s participation, use or access to several aspects of the school program. At all times we make the very best efforts to exercise exemplary standards in respect of duty of care.

Please read the below PDF for more information regarding Students Online in Public Schools Consent

Online Consent Information

Media Consent

Children’s images and/or their work are often published to recognise excellence or effort and may appear in newspapers, on the internet, in newsletters or on film or video. Their names may also be included but no contact details are provided. Work/images captured by the school will be kept for no longer than is necessary for the purposes outlined above and will be stored and disposed of securely.

Media Consent

Yes, I give consent to my child to have his/her image and/or work published as described above. No, I do not give consent.

Viewing Consent

Children often watch videos / DVDs / television documentaries as part of their learning. Almost always these are ‘G’ rated and don’t require consent. Very occasionally something with a ‘PG’ rating is appropriate for which we would need parental permission.

Viewing Consent

Yes, I consent to my child viewing items with a ‘PG’ rating if deemed suitable by the teacher and school administration. No, I do not give consent.

Students Online in Public Schools Consent

I agree to and understand the responsibilities my child has when using the online services provided at the College for educational purposes, in accordance with the Students Online in Public Schools Consent for College students. I also understand that if my child breaches any of the expectations in the agreement that the principal may take disciplinary action in accordance with the Department’s Student Behaviour in Public Schools Policy and Procedures.

Do you give permission for your child to have an online services account?

Yes No

Note: while every reasonable effort is made by the College and the Department of Education to prevent student exposure to inappropriate online content when using the Department’s Online Services, it is not possible to completely eliminate the risk of such exposure. The Department cannot filter Internet content accessed by your child from home or from other locations away from the College. The Department recommends the use of appropriate Internet filtering software.

Integrity • Care • Ambition • Effort

Enquiries (08) 9365 2000

Application for Enrolment – Part B

1. Enrolment Information

2. Student Details

Student lives with

3. Parent / Carer Details

Parent / Carer 1 Details

Parent / Carer 2 Details

Alternative Emergency Contact Details

4. Student Details - Additional Information

5. Privacy and Declaration

6. Student Health Care Summary

Section A

Medical Details

Administration of medication

Informed Consent

Section B

Section C

Section D

7. Consent Form

Media Consent

Viewing Consent

Students Online in Public Schools Consent

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