Studet s Family ame / First ame: Applicatio to erol i a NSW Govermet school NSW Public Schools Leadig the way This iformatio sheet explais how to complete the applicatio to erol. The applicatio form is to be completed i Eglish. If you eed ay further explaatio for ay of the questios or help i completig the applicatio, please ask for assistace from the school staff. If your applicatio is accepted, the iformatio you have provided will be used by the school to erol your child. The school will otify you of the results of your applicatio. Please do ot purchase items such as uiforms util you receive cofirmatio of erolmet. Whe you come to the school to erol please brig these documets with you: Birth certificate or idetity documets (ot eeded if curretly erolled i a NSW govermet school) Trasfer certificate (if trasferrig from aother NSW govermet school, except for those studets movig from Year 6 to Year 7) Immuisatio history statemet (oly required for studets erollig i primary schools for the first time) Court order (if applicable) Proof of address (e.g. Coucil rates otice) If your child is ot a Australia Citize, you will eed to provide: Passport or travel documets Curret visa ad previous visas (if applicable) If your child is a temporary visa holder you will also eed to provide: Authority to Erol issued by the Temporary Visa Holders Program Uit is required for visitor ad temporary residet visa holders (other tha sub class 571P referred to below). Authority to Erol or evidece of permissio to trasfer issued by the Iteratioal Studet Cetre (if holdig a Iteratioal full fee studet visa, sub class 571P) Evidece of the visa the studet has applied for (if the studet holds a bridgig visa) 1
Welcome Your Privacy Protected The school ad the NSW Departmet of Educatio ad Traiig are subject to the Privacy ad Persoal Iformatio Protectio Act 1998 (NSW). The iformatio you provide will be used to process your child s applicatio for erolmet. It will oly be used or disclosed for the followig purposes: Geeral studet admiistratio Commuicatio with studets ad parets or carers State ad Natioal reportig purposes Promotio of the school School-related activities (e.g. reuios, school publicatios, school histories, school aiversary celebratios) To esure the health ad safety of studets, staff ad visitors to the school For other matters relatig to the educatio ad welfare of the studet; ad For ay other purpose required by law. The iformatio will be stored securely. You may access or correct ay persoal iformatio by cotactig the school. If you have a cocer or complait about the way your persoal iformatio has bee collected, used, or disclosed, you may cotact the school. The health-related iformatio collected is subject to the Health Records ad Iformatio Privacy Act 2002. It is beig collected for the primary purpose of esurig the health ad safety of all studets, staff ad visitors to the school. It may be used ad disclosed to medical practitioers, health workers, other govermet departmets ad/or schools for this primary purpose, or for other, related purposes. Do parets have to aswer the questios? We are required by law to esure the health ad safety of studets, staff ad visitors o our premises. It is therefore compulsory for you to aswer all questios o this form except those about your occupatio ad educatio. The iformatio you provide will assist the school to commuicate with you ad to care for your child while at school. Should statemets made i this applicatio later prove to be false or misleadig, ay decisio made as a result of this applicatio may be reversed. Why have we asked for iformatio about your occupatio ad educatio? All Australia Educatio Miisters have agreed o Natioal Goals for Schoolig i the Twety-First Cetury. The Natioal Goals specifically state that the achievemet of studets i schools should ot be affected by discrimiatio based o sex, laguage, culture ad ethicity, religio or disability; or by differeces arisig from social ad ecoomic backgroud or geographic locatio. The goals also state that the learig outcomes of educatioally disadvataged studets [should] improve ad, over time, match those of other studets. To help us to make sure we are achievig this goal all parets across Australia, o matter which school their child atteds, are beig asked to provide iformatio about family backgroud. The mai purpose of collectig this iformatio is to promote a educatio system which is fair for all Australia studets regardless of their backgroud. We use the iformatio to evaluate whether our policies are effective ad to esure that o group is experiecig udue disadvatage because of their ecoomic or social backgroud. Providig iformatio about your occupatio ad educatio is volutary but your iformatio will help us to esure that all studets are beig well served by Australia schools. The four groups listed o page 3 are used by the Australia Bureau of Statistics to classify occupatios. Please choose the group that you thik best describes you. If you have retired or stopped work i the past year please choose the group i which you used to work. You will eed to use this table to aswer the questios o pages 6-7. Secure Iteret Access ad Email Studets are provided with a Iteret ad email accout to eable learig opportuities i a protected ad secure eviromet. Studets must abide by the school s policy whe usig the DET Iteret ad email services. Parets will eed to iform the school i writig if they do ot wat their child to have access to the NSW DET Iteret ad email facility.
Paret Occupatio Groups Group 4: Machie operators, hospitality staff, assistats, labourers ad related workers Drivers, mobile plat, productio/processig machiery ad other machiery operators. Hospitality staff [hotel service supervisor, receptioist, waiter, bar attedat, kitchehad, porter, housekeeper] Office assistats, sales assistats ad other assistats Office [typist, word processig/data etry/busiess machie operator, receptioist, office assistat] Sales [sales assistat, motor vehicle/carava/parts salesperso, checkout operator, cashier, bus/trai coductor, ticket seller, service statio attedat, car retal desk staff, street vedor, telemarketer, shelf stacker] Assistat/aide [trades assistat, school/teacher s aide, detal assistat, veteriary urse, ursig assistat, museum/gallery attedat, usher, home helper, salo assistat, aimal attedat] Labourers ad related workers Defece Forces raks below seior NCO ot icluded above Agriculture, horticulture, forestry, fishig, miig worker [farm overseer, shearer, wool/hide classer, farm had, horse traier, urseryma, greekeeper, gardeer, tree surgeo, forestry/loggig worker, mier, seafarer/ fishig had] Other worker [labourer, factory had, storema, guard, cleaer, caretaker, laudry worker, trolley collector, car park attedat, crossig supervisor] Group 3: Tradesme/ wome, clerks ad skilled office, sales ad service staff Tradesme/wome geerally have completed a 4 year Trade Certificate, usually by appreticeship. All tradesme/wome are icluded i this group Clerks [bookkeeper, bak/po clerk, statistical/actuarial clerk, accoutig/claims/audit clerk, payroll clerk, recordig/registry/filig clerk, bettig clerk, stores/ ivetory clerk, purchasig/order clerk, freight/ trasport/shippig clerk, bod clerk, customs aget, customer services clerk, admissios clerk] Skilled office, sales ad service staff Office [secretary, persoal assistat, desktop publishig operator, switchboard operator] Sales [compay sales represetative, auctioeer, isurace aget/assessor/loss adjuster, market researcher] Service [aged/disabled/refuge/child care worker, ay, meter reader, parkig ispector, postal worker, courier, travel aget, tour guide, flight attedat, fitess istructor, casio dealer/supervisor] Group 2: Other busiess maagers, arts/media/ sportspersos ad associate professioals Ower/maager of farm, costructio, import/export, wholesale, maufacturig, trasport, real estate busiess Specialist maager [fiace/egieerig/productio/ persoel/idustrial relatios/sales/marketig] Fiacial services maager [bak brach maager, fiace/ivestmet/isurace broker, credit/loas officer] Retail sales/services maager [shop, petrol statio, restaurat, club, hotel/motel, ciema, theatre, agecy] Arts/media/sports [musicia, actor, dacer, paiter, potter, sculptor, jouralist, author, media preseter, photographer, desiger, illustrator, proof reader, sportsma/woma, coach, traier, sports official] Associate professioals geerally have diploma/techical qualificatios ad support maagers ad professioals Health, Educatio, Law, Social Welfare, Egieerig, Sciece, Computig techicia/associate professioal Busiess/admiistratio [recruitmet/employmet/ idustrial relatios/traiig officer, marketig/advertisig specialist, market research aalyst, techical sales represetative, retail buyer, office/project maager] Defece Forces seior -Commissioed Officer Group 1: Seior maagemet i large busiess orgaisatio, govermet admiistratio ad defece, ad qualified professioals Seior executive/maager/departmet head i idustry, commerce, media or other large orgaisatio Public service maager (Sectio head or above), regioal director, health/educatio/police/fire services admiistrator Other admiistrator [school pricipal, faculty head/dea, library/museum/gallery director, research facility director] Defece Forces Commissioed Officer Professioals geerally have degree or higher qualificatios ad experiece i applyig this kowledge to desig, develop or operate complex systems; idetify, treat ad advise o problems; ad teach others Health, Educatio, Law, Social Welfare, Egieerig, Sciece, Computig professioal Busiess [maagemet cosultat, busiess aalyst, accoutat, auditor, policy aalyst, actuary, valuer] Air/sea trasport [aircraft/ship s captai/officer/pilot, flight officer, flyig istructor, air traffic cotroller] 3
Family Details Studet s Family ame / First ame: Name for correspodece* (e.g. Mr ad/or Mrs Smith) Studet's address durig term If this is the same as the correspodece address at the left, please just tick this box Address for correspodece (RMB/P.O. Box) Address Street Number/Property Name Street Number/Property Name Street Name Street Name Suburb/Tow Suburb/Tow Post Code Post Code Home Telephoe Number Home Telephoe Number Family Email Address If the studet has a secod residetial address durig school term, please provide this to the school. Office use oly Family Code Out of area Y/N * -residetial paret should complete details o page 11 4
Emergecy Cotact Emergecy Cotact Please omiate a perso who may be cotacted i the evet of a emergecy, if parets caot be cotacted. Ideally, the cotact perso should be someoe who lives i the eighbourhood of the school. Emergecy Cotact Name (e.g. Mr ad Mrs Smith) time Telephoe Number Mobile Telephoe Number (if available) Relatioship to family (e.g. Neighbour, Ucle, Aut) Alterative Emergecy Cotact Please omiate a alterative perso who may be cotacted i the evet of a emergecy, if parets caot be cotacted. Ideally, the cotact perso should be someoe who lives i the eighbourhood of the school. Emergecy Cotact Name (e.g. Mr ad Mrs Smith) time Telephoe Number Mobile Telephoe Number (if available) Relatioship to family (e.g. Neighbour, Ucle, Aut) 5
Family Iformatio Paret / Carer 1 (e.g. Father) residig at the same address as the studet For paret ot residig at the same address, please complete the Other Paret sectio o page 11. Title (e.g. Mr, Mrs, Ms) Family Name Paretal School Educatio What is the highest year of primary or secodary school the studet s Paret / Carer 1 has completed? For persos who have ever atteded school, mark Year 9 or equivalet below (mark oe box oly) Year 12 or equivalet Year 11 or equivalet Year 10 or equivalet Year 9 or equivalet or below What is the highest qualificatio this paret/carer has completed? (mark oe box oly) Bachelor degree or above Give Names Advaced Diploma/Diploma Certificate I to IV (icludig trade certificate) o-school qualificatio I which coutry was this paret/carer bor? time Telephoe Number (if available) Mobile Telephoe Number (if available) Paretal Occupatio Does this paret/carer speak a laguage other tha Eglish at home?, Eglish oly, laguage other tha Eglish spoke If, what laguages are spoke at home? Mai laguage What is the occupatio group of the Studet s Paret/Carer 1? Please select the appropriate paretal occupatio group from the list provided o page 3. If the perso is ot curretly i paid work but has a job or retired i the last 12 moths, please use the perso s last occupatio. If the perso has ot bee i paid work i that last 12 moths, please write 8 i the box. (write 1, 2, 3, 4 or 8) Other Other (icludig Eglish) Please write the exact laguage spoke. For example, Catoese or Madari, ot simply Chiese. Please do ot write the atioality such as Idia, specify the laguage spoke e.g. Hidi or Pujabi. Iterpreters may be made available durig school iterviews. Would a iterpreter be required? 6
Family Iformatio Paret / Carer 2 (e.g. Mother) residig at the same address as the studet For paret ot residig at the same address, please complete the Other Paret sectio o page 11. Title (e.g. Mr, Mrs, Ms) Family Name Paretal School Educatio What is the highest year of primary or secodary school the studet s Paret / Carer 2 has completed? For persos who have ever atteded school, mark Year 9 or equivalet below (mark oe box oly) Year 12 or equivalet Year 11 or equivalet Year 10 or equivalet Year 9 or equivalet or below What is the highest qualificatio this paret/carer has completed? (mark oe box oly) Bachelor degree or above Give Names Advaced Diploma/Diploma Certificate I to IV (icludig trade certificate) o-school qualificatio I which coutry was this paret/carer bor? time Telephoe Number (if available) Mobile Telephoe Number (if available) Paretal Occupatio Does this paret/carer speak a laguage other tha Eglish at home?, Eglish oly, laguage other tha Eglish spoke If, what laguages are spoke at home? Mai laguage What is the occupatio group of the Studet s Paret/Carer 2? Please select the appropriate paretal occupatio group from the list provided o page 3. If the perso is ot curretly i paid work but has a job or retired i the last 12 moths, please use the perso s last occupatio. If the perso has ot bee i paid work i that last 12 moths, please write 8 i the box. (write 1, 2, 3, 4 or 8) Other Other (icludig Eglish) Please write the exact laguage spoke. For example, Catoese or Madari, ot simply Chiese. Please do ot write the atioality such as Idia, specify the laguage spoke e.g. Hidi or Pujabi. Iterpreters may be made available durig school iterviews. Would a iterpreter be required? 7
Studet details Studet Details Family Name Is the studet of Aborigial or Torres Strait Islader?, Aborigial, Torres Strait Islader, both Aborigial ad Torres Strait Islader Give Names Previous schoolig Preferred First Names Sex Date of birth Please provide the ame ad details of ay school where the studet has previously bee erolled (NSW, iterstate or overseas) startig with the most recet. If more space is eeded, attach a page marked Previous Schoolig. For erolmets other tha Kidergarte please provide the ame of the school where the studet was erolled at the ed of the last school year Name of school Male Female Moth Year Coutry of Birth Locatio of School Years atteded Religio (if oe, please write o religio) Does the studet speak a laguage other tha Eglish at home?, Eglish oly, laguage other tha Eglish spoke If, what laguages does the studet speak at home? Mai laguage Other Other (icludig Eglish) For Kidergarte erolmets, what type of care did this studet have prior to erollig at school? (Choose the type accessed i the year prior to school) Log day care Family day care Occasioal Care Pre-school Other formal care Iformal care e.g. paret, relative, playgroup, other carer Extet of prior to school care Up to 6 hours per week Up to 12 hours per week 12 hours to fulltime each week Write the ame of the pre-school or log day care or other prior to school service Please write the exact laguage spoke. For example, Catoese or Madari, ot simply Chiese. Please do ot write the atioality such as Idia, specify the laguage spoke e.g. Hidi or Pujabi. What was the first date of erolmet at a Australia school? Moth Year 8
Studet details Office use oly Date of erolmet at this school Curret scholastic year i which the studet is erolled (K-12) Roll Class (e.g. 3 SMITH, 9R2) Moth Year Medical Details Doctor s Name/Medical Cetre Street Number House Group Street Name Studet Details cotiued What is the studet s residecy status? Australia Citize NZ Citize rfolk Islader Permaet Residet Temporary Visa Holder Suburb/Tow Post Code Phoe umber If bor overseas, what date did the studet arrive i Australia? Medicare Number Moth Year If the studet is a permaet or temporary visa holder please provide the followig iformatio: Curret Visa class I give my permissio for the school to seek iformatio from the Doctor listed i this Erolmet Form about how to maage ay allergy or medical coditio experieced by the studet For pricipal holders write P i the last box, for subordiate holders write S. Curret Visa sub-class Visa expiry date Moth Year Is the studet a iteratioal full fee-payig studet o Visa sub class 571? Tell the pricipal before your child starts school if he or she has ay allergies or other medical coditios. This is essetial. You should also let the school kow as soo as you are aware of ay ew allergies or other medical coditios. Allergies Please specify ay allergies suffered by the studet (e.g. peauts/isect stigs) Other Medical Coditios Office use oly Authority to Erol (ATE) expiry date Moth Year Please specify ay other medical coditios of which the school should be aware (e.g. asthma, diabetes, epilepsy) Medicatio Please specify ay prescribed medicatio to be take by the studet 9
Studet details Special Circumstaces Are there ay circumstaces about the studet seekig to be erolled that the school should kow prior to erolmet? (e.g. mature age, pregacy, livig apart from paretal supervisio, medical coditio, subject of a court order, State arraged out of home care ) If yes, provide a brief descriptio of the circumstaces Has the studet ay past history of violet behaviour? If yes, please provide details Did this ivolve beig suspeded or expelled from ay previous school? Relevat previous history The NSW Departmet of Educatio ad Traiig has a resposibility to assess ad maage ay risk of harm to its staff ad studets. To your kowledge, is there aythig i the studet s history or circumstaces (icludig medical history) which might pose a risk of ay type to the studet, other studets, or staff at this school? If yes, provide brief descriptio of studet s medical or other history which might pose a risk of ay type to the studet, other studets, or staff at this school. If yes, was this for (please tick): a b c Actual violece to ay perso? Illegal drugs? Possessio of weapo or ay item used to cause harm or ijury? d Threats of violece or itimidatio of staff, studets, or others at the school? Are you aware of ay other icidets of the kid listed above that have ivolved the studet outside of the school settig? If yes, please provide a brief outlie of these matters. Please provide cotact details of health professioals or other relevat bodies that have kowledge of these issues. 10
Other Paret For o-residetial paret (see ote * below) Title (e.g. Mr, Ms, Mrs) Family Name Give Name Relatioship to studet Telephoe Number Mobile Telephoe Number (if available) Address for correspodece RMB/P.O. Box Street Number/Property Name Street Name Applicat s Declaratio I dealig with this applicatio, it may be ecessary for the school, or aother part of the Departmet of Educatio ad Traiig, to look at documets held by previous schools, health care professioals or other govermet agecies. This iformatio will be collected, used ad stored cosistet with the Privacy ad Persoal Iformatio Protectio Act ad Health Records ad Privacy Act 2002. The coset of the ower of the iformatio, while ot always ecessary, is appreciated ad will speed up the assessmet of the applicatio. Coset to access documets I coset to the Departmet of Educatio ad Traiig gaiig access to relevat iformatio about the studet to be erolled held by previous schools, health care professioals or other govermet agecies. I uderstad the school may approach these bodies directly. The iformatio they request may iclude iformatio related to ay of the questios I have aswered above. Declaratio of accuracy I declare that the iformatio provided i this Applicatio to Erol is, to the best of my kowledge ad belief, accurate ad complete. I recogise that, should statemets i this applicatio later prove to be false or misleadig, ay decisio made as a result of this applicatio may be reversed. Suburb/Tow Post Code Sigature of Applicat Prit ame * Copies of ay family law, AVOs or other relevat court orders must be provided, if applicable Date 11
Office use oly Itegratio umber Cesus report Y/N Does the studet eed to be assessed for Eglish as a Secod Laguage (ESL) support? Y/N If yes, what ESL phase is the studet? (N, 1, 2, 3, T) Is the studet receivig ESL support? Y/N The origial documets listed below must be sighted ad photocopied All studets: Birth certificate or idetity documets I additio, for studets who are ot Australia citizes: Passport or travel or travel documetatio o. Coutry of issue Trasfer Certificate, if applicable Moth Year Curret visa ad previous visas (if applicable) Immuisatio certificate/history statemet sighted (Primary studets oly) I additio, for temporary visa holders: Complete Icomplete Ay family law, AVOs or other relevat court order (if applicable) Moth Year To receive academic reports Y/N Authority to erol Pricipal s Certificatio With regard to risk assessmet Pricipal s ame Deputy Director-Geeral s memo DN06/00168 oted Legal Issues Bulleti.40 oted Pricipal s sigature Applicatio to Erol accepted Date Studet placed i school s admissio register o Moth Year 12