Application for Enrolment

Student Details *

First Given Name: Second Given Name: (if applicable) Surname:

Date of Birth *

Gender *

Male
Female
Self Described

Which year are you seeking to enrol this student? *

Intended Start Date *

Are you seeking to enrol the student at this school full time? *

Yes
No

If No, how many days a week would the student be attending the school?

If No, provide a reason why you are seeking part-time enrolment:

Other school name:

Days/Week:

Has enrolment been accepted?

Yes
No

Do you live in the school zone? *

Go to www.findmyschool.vic.gov.au to find your local school.

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 neighborhood school for either address. Please provide proof of permanent residence to the school as part of your application. The school will let you know what proof is required. For more information, please refer to the Residential Address Checklist, available at: www.education.vic.gov.au/Documents/parents/going-to-school/100-point-addresschecklist.pdf. When assessing your application, 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 occupancy, for example if a rental property is a studio or one bedroom unit.

No. & Street Addreess Suburb State Postcode

How often does this student live at this address? *

Always
Mostly
Balanced (50%)

If the student lives at another address during the school week, please provide further details including the address, who they reside with, and how many days a week the student lives there:

Does the student have any siblings at this school? *

Yes
No

If Yes, list siblings name and current year level.

School Currently Attending *

School Phone Number *

Current Year Level *

Please enter a number from 3 to 12.

Year Level Coordinators Name

Student Welfare Coordinators Name

Have you notified the school of your intention to seek enrolment at Heathmont College? *

Yes
No

Do you authorise Heathmont College to contact your current school for information? *

Yes
No

Reason for Application

Subjects you wish to study if enrolling in VCE

Parent /Carer 1 Details *

This form should be completed by parents or carers who are responsible for enrolling their child in school. It is the responsibility of the person completing this form to consult with all other adults that need to be involved in the enrolment process. If required information is not provided or there is a dispute between parents about a child’s enrolment, the enrolling principal is required to consider the student's education and wellbeing when deciding whether to defer or accept the enrolment.

Surname: First Given Name

Contact Mobile Number: *

Contact Home Phone:

Contact Email Address: *

Correspondence Address: *

Student lives with Adult 1 *

Always
Mostly
Balanced (50%)
Occasionally

Adult 1 Relationship to Student *

Parent
Step Parent
Foster Parent
Host Family
Relative
Friend
Self
Other

Parent /Carer 2 Details

Surname: First Given Name

Contact Mobile Number:

Contact Home Phone:

Contact Email Address:

Correspondence Address:

Student lives with Adult 2

Always
Mostly
Balanced (50%)
Occasionally

Adult 2 Relationship to Student

Parent
Step Parent
Foster Parent
Host Family
Relative
Friend
Self
Other

Signature of Enrolling Adult 1 *

I confirm that: • I am the person named as completing this form. • The information in this form is true and correct. • I agree to authorise this form by electronic means with an electronic signature.

Date *

Signature of Enrolling Adult 2 (if applicable)

I confirm that: • I am the person named as completing this form. • The information in this form is true and correct. • I agree to authorise this form by electronic means with an electronic signature.

Please indicate if an interpreter is required for the interview *

Yes
No

If you answered yes, which language?

Attach 2 School Reports *

Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, jpeg, Max. file size: 100 MB, Max. files: 2.

hCaptcha *

Enrolment transfer from secondary school to Heathmont College.