Application for Enrolment - Heathmont College

January 2021

Student Details * Required
Family Name Given Name
Gender * Required
- Male
- Female
Address * Required
Street Address City State Post Code Country
Date of Birth - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY
Country of Birth * Required
School Currently Attending * Required
School Phone Number * Required
Current Year Level * Required
Please enter a number from 3 to 12.
Year Level Coordinators Name * Required
Student Welfare Coordinators Name * Required
Have you notified the school of your intention to seek enrolment at Heathmont College? * Required
- Yes
- No
Do you authorise Heathmont College to contact your current school for information? * Required
- Yes
- No
Signature * Required
Reason for Application * Required
Year Level at which placement is required * Required
Subjects you wish to study if enrolling in VCE
Name of Parent / Guardian * Required
Family Name Given Name
Phone (Mobile)
Phone (Business)
Email * Required
Signature of Parent / Guardian * Required
Date - must be dd/mm/yyyy format * Required
DD slash MM slash YYYY
Please indicate if an interpreter is required for the interview * Required
- Yes
- No
If you answered yes, which language?
Attach 2 School Reports * Required
Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, jpeg, Max. file size: 16 MB, Max. files: 2.
Attach Birth Certificate * Required
Accepted file types: jpg, gif, png, pdf, doc, docx, jpeg, Max. file size: 16 MB.
Attach Immunisation Records * Required
Accepted file types: jpg, gif, png, pdf, doc, docx, jpeg, Max. file size: 16 MB.
Attach Proof of Address (Utilities Bill, Rates Notice etc) * Required
Accepted file types: jpg, gif, png, pdf, doc, docx, jpeg, Max. file size: 16 MB.