Our Philosophy We believe all young people have the right to achieve their full potential irrelevant of circumstance. That the development of the whole person is of utmost importance and we are guided in developing this through the YMCA s own philosophy of valuing a person s Mind, Body and Spirit. We believe that this holistic approach is best delivered through a flexible individualised learning environment to maximise positive outcomes for every individual. Section One - Student and Family Details (completed by parents/caregivers) Please note: No application will be processed unless all details and information is completed in all sections of this form. Please ensure all details are correct and all sections complete before submission. No proof of ID/Age = No interview STUDENT DETAILS Students Surname Given Names E-mail: Mb: Address: Suburb: Postcode: Age: Date of Birth / / Gender: Male/Female (Please attach a copy of Birth Certificate/Proof of ID & Age) Student Details Is the student an Australian Citizen, Permanent Resident? Australian Citizen Permanent Resident Is the student (please Circle) Aboriginal Torres Strait Islander Both Other... Is the student diagnosed with an Educational Special Need or Ascertained? YES / NO (if yes please provide details in Section two: Special circumstances) In which country was the student born? Religion (optional): Australia Other (please specify) : Is the student in the Care of the State? YES /NO Are there any legal issues concerning the student, e.g. Court Orders, DVO or Child protection orders? YES /NO (if Yes please attach a copy of orders)
STUDENT TRAVEL DETAILS The YMCA Vocational School Application Form Intended Mode of Transport to School Walk Car Bus Bicycle Other Medicare Number - / Valid to: Doctor s Address Private Healthcare Fund Name Medical Condition Symptoms/Treatment Doctor s Name Phone Number Membership No. Medical Condition Symptoms/Treatment STUDENT ACCESS Is there any limitation(s) on contact between the student and a parent or another person? If Yes, attach a copy of current Court Order or registered parenting plan that contains the limitation(s). Yes No OTHER SIBLINGS Do you have other school aged children in your care, yes /No Name: Year Level: Name: Year Level: Name: Year Level: Name: Year Level:
Family Details Name of Adults with whom this student lives. Parent / Caregiver 1 Parent / Caregiver 2 Family Name Given Names Title Sex Male Female Male Female Relation To Student Address Post Code Suburb Highest level of Education achieved Occupational Group (See appendix 1) Current Occupation Work Name & Work Address Work Phone Work Mobile Home Phone Home Mobile E-Mail Cultural Background Country of Birth Interpreter needed Yes No Yes No Emergency Contact 3 Name Relationship (e.g. Aunt) Contact number Emergency Contact 4 Name Relationship (e.g. Aunt) Contact number
Section Two: School/Organisation Supporting Referral (Completed by referring agent with Student) Application for entry at year level: Date of Application: / / Student Learner ID: Unique Student Identifier (VET): Application for: (Senior Yr.10-12 Junior Yr. 7-9) Clem Jones Senior Campus & Trade Skills Centre Kingston Clem Jones Junior Secondary Campus Kingston Moreton Bay Campus North Lakes Bremmer Senior Campus (TAFE) Bundamba Ipswich Bremmer Junior Campus Bundamba Ipswich School / Organisation name Student s current year level: is the student s last report available? Person making this Referral / Application Position Contact Details: Phone: E mail Mobile s (Please ensure Past /present school reports, Ascertainment information, SET plan and general education information are enclosed e.g One School report) PRESENT / PAST SCHOOL DETAILS. Name of School 1: Address: Postcode: Date Attended to Reason for leaving: Name of School 2: Address: Postcode: Date Attended to Reason for leaving: Name of School 3: Address: Postcode: Date Attended to Reason for leaving:
SPECIAL CIRCUMSTANCES Are there any special circumstances about the student seeking to be enrolled, that the school should know prior to enrolment (e.g. ascertainment, pregnancy, subject to court order, State arranged out-of-home care, criminal record and or other issues). If yes, please provide a brief description of the circumstances; STUDENT S HISTORY RELEVANT TO RISK ASSESSMENT YMCA VS has a responsibility to assess and manage any risk of harm to its staff and students. This application gives you the opportunity to provide the school with information that will help facilitate the smooth transition of the student into this school setting. This may include preparing appropriate strategies directed at meeting the particular needs of the student. Your responses to the questions below will help the school to support your child, and provide a safe working and educational environment for all students, staff and volunteers. To your knowledge, is there anything in the child s history or circumstances (including medical history), which might pose a risk of any type to him or her, other students, or staff at this school? If yes, please provide a brief description of your child s medical or other history;
Please provide names and contact details of health professionals or other relevant bodies that have knowledge of these issues; Has the child have any history of violent behaviour? If yes, please provide details; Has the child ever been suspended or expelled from any previous school? If yes, what was this for? Did this include? Actual violence to any other person? Possession of a weapon, or any item used to cause harm or injury? Threats of violence or intimidation to staff, students, or others at school? Illegal drugs? Yes/ No Yes/ No Are you aware of any other incidents not listed above in which your child has been involved in, in and outside of school settings? If yes please provide a brief outline of these matters;
What organisations/agencies have or are supporting you in attending school? (E.g. YFS etc.) What additional Issues/personal circumstances have you faced at school which have prevented you attending? Staying at the school Why do you wish to attend the YMCA School? Why do you think you will be more successful here? What are the goals/targets you would like to achieve at the YMCA School? (Min 3) 1. Maintain School Attendance Target or better (compulsory) 2. 3. 4. Additional Agency information Please list below any agencies (e.g. youth and family services, YFS.) That are in contact or working with your child and or family. This information remains confidential and is used in order to support the student in school as effectively as possible. Agency Address Contact phone No. Contact person Any additional information relevant to your child
Section 3: Home School Agreement Reboot & Behaviour Management Strategies: The YMCA Reboot school-based program gives young people a real chance to succeed. Reboot acknowledges the history and holistic needs of young people, and the impact that unmet needs, trauma and neglect have on learning and wellbeing. Each student and staff member is considered a whole-person with physical, mental, emotional, spiritual and energetic needs that if unmet result in unproductive behaviour and impede learning. Reboot empowers both the school staff and students to understand where these behaviours and their motivations emerge from. Through whole-of-school approaches, targeted individual support and a social and emotional wellness program and curriculum Reboot provides practical strategies to turn these behaviours around so that both the students and staff can realise their potential. This Philosophy is supported by our Assertive Discipline Behaviour Management System in which all staff have been trained. This is about developing positive choices in students as they progress through school enabling them to become increasingly positive members of the school and community. All School Staff are also trained in Team -Teach; Positive Handling Techniques and Deescalation Strategies which staff will use in the event of a student s welfare and safety becoming a concern. This program conforms to the World Health Organisation and Human Rights Charters in enabling staff to restrain a student with dignity if they go into a crisis situation and their safety is of concern. All Teachers DO have the right to physically restrain a student if deemed proportionate, necessary and reasonable. Our Mission Statement To positively engage young people in education and lifelong learning thus empowering young people to become productive members of their society, as well as well-rounded, confident and healthy human beings. Our Aim is: 1. To develop healthy, confident, responsible and well-rounded young people able to make positive choices & contributions to their community (Physical-Emotional) 2. To enable students to develop and achieve real and relevant academic success and/or vocation skills (Cognitive) 3. To equip students to a high level of employability, and in doing so open up career pathways, further opportunities for lifelong learning and personal growth. (physical- Social)
DECLARATION I/We the undersigned, apply to have enrolled at YMCA VS. I/We confirm that I/We have read and understood the Enrolment Policy and Guidelines, the notice below and agree to abide by these terms, conditions and policies. By signing below I/We undertake to notify the school immediately of any change of contact or relevant information in this application and acknowledge that the child may be placed on a waiting list for YMCA VS. Important Notice: As an SAS school we work under section 182 of the Education (General Provisions) Act 2006 in providing flexible arrangements for students to engage in and access the curriculum at the best level determined for them. We use past records, parental interviews and relevant assessment tools and ongoing observations to develop a Personal Learning Plan (PEP) for each student. This is an agreement of entry of the parents /Carers on a student s enrolment to the school. Parent / Guardian Signature: Date: / / Referral signature Date / / Student signature Date / / Please forward this completed application to: The Enrolment Officer YMCA Vocational School 41 45 Mary Street Kingston 4114 Phone: (07) 3440 4300 Fax: (07) 3440 4399 --------------------------------------------------------------------------------------------------------------------------- Office Use Only Application Received: / / Status: Green / Amber /Red Campus: Clem Jones Morton Bay Interview Time Date / / Interviewer: Notes: Place offered: YES / NO / Trial / Deferred Group: ZONE: IN /OUT Induction Date: Time: Campus: CJ/MB Approval Signature: Date:
Appendix A - Occupation Groups The YMCA Vocational School Application Form Please select the appropriate group from the following list. If you are not currently in paid work but have had a job in the last 12 months, or have retired in the last 12 months, please use your last occupation to select from the list. If you have not been in paid work for the last 12 months, select N from the occupation code menu on the enrolment form. LIST OF PARENTAL OCCUPATIONS: Occupation Group A Senior management in large business organisation, government administration and defence, and qualified professionals Senior Executive/Manager/Department Head in industry, commerce, media or other large organisation Public Service Manager (Section head or above), regional director, health/education/police/fire services administrator Other administrator (school principal, faculty head/dean, library/museum/gallery director, research facility director) Defence Forces Commissioned Officer Professionals generally have degree or higher qualifications and experience in applying this knowledge to design, develop or operate complex systems; identify, treat and advise on problems; and teach others: o Health, Education, Law, Social Welfare, Engineering, Science, Computing professional o Business (management consultant, business analyst, accountant, auditor, policy analyst, actuary, valuer) o Air/sea transport (aircraft/ship s captain/officer/pilot, flight officer, flying instructor, air traffic controller) Occupation Group B Other business managers, arts/media/sportspersons and associate professionals Owner/Manager of farm, construction, import/export, wholesale, manufacturing, transport, real estate business Specialist Manager (finance/engineering/production/personnel/industrial relations/sales/marketing) Financial Services Manager (bank branch manager, finance/investment/insurance broker, credit/loans officer) Retail sales/services manager (shop, petrol station, restaurant, club, hotel/motel, cinema, theatre, agency) Arts/Media/Sports (musician, actor, dancer, painter, potter, sculptor, journalist, author, media presenter, photographer, designer, illustrator, proof reader, sportsman/woman, coach, trainer, sports official) Associate Professionals generally have diploma/technical qualifications and support managers and professionals:
o o o Health, Education, Law, Social Welfare, Engineering, Science, Computing technician/associate professional Business/administration (recruitment/employment/industrial relations/training officer, marketing/advertising specialist, market research analyst, technical sales representative, retail buyer, office/project manager) Defence Force - senior Non-Commissioned Officer Occupation Group C Tradesmen/women, clerks a and skilled office, sales and service staff Tradesmen/women generally have completed a 4 year Trade Certificate, usually by apprenticeship. All tradesmen/women are included in this group Clerks (bookkeeper, bank/po clerk, statistical/actuarial clerk, accounting/claims/audit clerk, payroll clerk, recording/registry/filing clerk, betting clerk, stores/inventory clerk, purchasing/order clerk, freight/transport/shipping clerk, bond clerk, customs agent, customer services clerk, admissions clerk) Skilled office, sales and service staff: o Office (secretary, personal assistant, desktop publishing operator, switchboard operator) o Sales (company sales representative, auctioneer, insurance agent/assessor/loss adjuster, market researcher) o Service (aged/disabled/refuge/child care worker, nanny, meter reader, parking inspector, postal worker, courier, travel agent, tour guide, flight attendant, fitness instructor, casino dealer/supervisor) Occupation Group D Machine operators, hospitality staff, assistants, labourers and relate related workers Drivers, mobile plant, production/processing machinery and other machinery operators Hospitality staff (hotel service supervisor, receptionist, waiter, bar attendant, kitchen hand, porter, housekeeper) Office assistants, sales assistants and other assistants: o Office (typist, word processing/data entry/business machine operator, receptionist, office assistant) o Sales (sales assistant, motor vehicle/caravan/parts salesperson, checkout operator, cashier, bus/train conductor, ticket seller, service station attendant, car rental desk staff, street vendor, telemarketer, shelf stacker) o Assistant/aide (trades assistant, school/teacher s aide, dental assistant, veterinary nurse, nursing assistant, museum/gallery attendant, usher, home helper, salon assistant, animal attendant) Labourers and related workers: o Defence Forces - ranks below senior NCO not included above o Agriculture, horticulture, forestry, fishing, mining worker (farm overseer, shearer, wool/hide classer, farm hand, horse trainer, nurseryman, greenkeeper, gardener, tree surgeon, forestry/logging worker, miner, seafarer/fishing hand) o Other worker (labourer, factory hand, storeman, guard, cleaner, caretaker, laundry worker, trolley collector, car park attendant, crossing supervisor)