2089 – 2109 Elizabeth Drive, Cecil Park NSW 2178
(02) 9826 2885 of�[email protected]
irfancollege.nsw.edu.au
/IrfanCollegeNSW twitter.com/IrfanCollegeNSW 1
Application for Enrolment
ANTICIPATED STARTING DATE
DATE APPLYING VSN
YEAR LEVEL APPLYING
Email: [email protected]
Please read “Condition of Enrolment” and “Enrolment Policy” on pages 7 and 8 before signing this document
Please complete all sections in BLOCK CAPITALS.
FAMILY KEY
PHOTO (2 X PASSPORT SIZE)
ENTERED INTO THE SYSTEM
BIRTH CERTIFICATE
DATE
COPY OF MOST RECENT REPORT
TEST CONDUCTED
PASSPORT (VISA PAGES)
SCHOOL FEES INVOICED
CUSTODY RESTRICTIONS
DATE
IMMUNISATION CERTIFICATE
DATE MARK
APPLICATION FEE PAID
BUILDING FUND PAID
FORM RECEIVED AND SIGNED BY
ACCEPTED
SIGNATURE
COMMENCE CLASSES ON
REASONREJECTED
DATE
DATE
INVOICE NO.
INVOICE NO.
INITIAL
INITIAL
BATCH NO.
BATCH NO.
INITIAL
INITIAL
PRINCIPAL’S SIGNATURE DATE
PHOTO
OFFICE USE ONLY
2
THE STUDENT IS
SECTION 1 - STUDENT INFORMATION
GIVEN NAME
LANGUAGE/S SPOKEN AT HOME
SURNAME MIDDLE NAME
GENDER
DOES THE STUDENT REQUIRE ESL?
DATE OF BIRTH
DATE ARRIVED IN AUSTRALIA
(If Applicable)
GRADE
COUNTRY OF BIRTH
VISA NUMBER
(If Applicable)
YEAR
TOWN/SUBURB
INTENDED TYPE OF TRAVEL
STREET NUMBER & NAME
POST CODE HOME PHONE ( )
WHICH LANGUAGE DO YOU WANT YOUR CHILD TO STUDY AS A LOTE? (Language Other Than English)
APPLICATION DATE ANTICIPATED START YEARYEAR LEVEL APPLYING
HAVE YOU PREVIOUSLY MADE ANY OTHER APPLICATIONS TO IRFAN COLLEGE? (If Yes, please give details)
AN AUSTRALIAN CITIZEN
WALK
YES
YES
MALE
AN ABORINAL
A PERMANENT RESIDENT
A TORRES STRAIT ISLANDER
A TEMPORARY RESIDENT
SCHOOL BUS PUBLIC TRANSPORTCAR
NO
NO
FEMALE
PREVIOUS SCHOOL (If Applicable)
ARE THERE ANY OTHER APPLICANTS? (If Yes, please give details)
APPLICANT’S POSITION IN FAMILY? (e.g. 1st/2nd Child)
DOES THE APPLICANT HAVE ANY SIBLINGS CURRENTLY ATTENDING IRFAN COLLEGE? (If Yes, please give details)
YES
YES
NO
NO
NAME OF OTHER APPLICANTS NAME OF OTHER APPLICANTS
NAME OF SIBLINGS (Attach separate sheet if needed) AGE
GRADE GRADE
GRADE
ARABIC TURKISH
3
SECTION 2 - PARENT/GUARDIAN INFORMATION
TITLE
TITLE
TITLE
TITLE
GIVEN NAME(S)
GIVEN NAME(S)
GIVEN NAME(S)
GIVEN NAME(S)
HOME PHONE
HOME PHONE
HOME PHONE
HOME PHONE
RELATION TO CHILD
RELATION TO CHILD
RELATION TO CHILD
RELATION TO CHILD
EMAIL ADDRESS
EMAIL ADDRESS
EMAIL ADDRESS
EMAIL ADDRESS
EMPLOYER’S NAME
EMPLOYER’S NAME
EMPLOYER’S NAME
EMPLOYER’S NAME
SURNAME
SURNAME
SURNAME
SURNAME
MOBILE
MOBILE
MOBILE
MOBILE
RELIGION
RELIGION
RELIGION
RELIGION
OCCUPATION
OCCUPATION
OCCUPATION
OCCUPATION
FATHER
LEGAL GUARDIAN 1 (If Applicable)
MOTHER
LEGAL GUARDIAN 2 (If Applicable)
COUNTRY OF BIRTH
COUNTRY OF BIRTH
COUNTRY OF BIRTH
COUNTRY OF BIRTH
ADDRESS
ADDRESS
ADDRESS
ADDRESS
POSTAL ADDRESS (If different to above)
POSTAL ADDRESS (If different to above)
POSTAL ADDRESS (If different to above)
POSTAL ADDRESS (If different to above)
POST CODE
POST CODE
POST CODE
POST CODE
POST CODE
POST CODE
POST CODE
POST CODE
4
BILLING DETAILS
OTHER INFORMATION
SECTION 2 - PARENT/GUARDIAN INFORMATION (Continued)
WHO DOES THE CHILD LIVE WITH? MOTHER BOTH GUARDIANFATHER
ARE THERE ANY CUSTODY RESTRICTIONS? (If Yes, present relevant documents) YES NO
TOWN/SUBURB
STREET NUMBER & NAME
POST CODE
SURNAME NAME
WHAT PROMPTED YOU TO
APPLY AT IRFAN COLLEGE?
(You may tick more than one box)
HOW DID YOU LEARN
ABOUT OUR SCHOOL?
REPUTATION OF SCHOOL
FAMILY, FRIENDS OR RELATIVES
ACADEMIC EXPECTATIONS
WORD OF MOUTH
RELIGIOUS REASONS
ADVERTISEMENT
CULTURAL REASONS
INTERNET
OTHER (Please specify)
OTHER (Please specify)
WHAT IS THE HIGHEST YEAR LEVEL OF EDUCATION/QUALIFICATION THE PARENT/
GUARDIAN HAS COMPLETED?
WHAT IS THE HIGHEST YEAR LEVEL OF EDUCATION/QUALIFICATION THE PARENT/
GUARDIAN HAS COMPLETED?
WHAT IS THE HIGHEST YEAR LEVEL OF EDUCATION/QUALIFICATION THE PARENT/
GUARDIAN HAS COMPLETED?
WHAT IS THE HIGHEST YEAR LEVEL OF EDUCATION/QUALIFICATION THE PARENT/
GUARDIAN HAS COMPLETED?
DOES THE FATHER SPEAK A LANGUAGE/S
OTHER THAN ENGLISH AT HOME?
DOES THE MOTHER SPEAK A LANGUAGE/S
OTHER THAN ENGLISH AT HOME?
DOES THE GUARDIAN SPEAK A
LANGUAGE/S OTHER THAN ENGLISH
AT HOME?
DOES THE GUARDIAN SPEAK A
LANGUAGE/S OTHER THAN ENGLISH
AT HOME?
BACHELOR DEGREE
OR ABOVE
BACHELOR DEGREE
OR ABOVE
BACHELOR DEGREE
OR ABOVE
BACHELOR DEGREE
OR ABOVE
YES (Please specify)
YES (Please specify)
YES (Please specify)
YES (Please specify)
ADVANCED DIPLOMA/
DIPLOMA
ADVANCED DIPLOMA/
DIPLOMA
ADVANCED DIPLOMA/
DIPLOMA
ADVANCED DIPLOMA/
DIPLOMA
CERT I - IV (INCLUDES
TRADE CERT)
CERT I - IV (INCLUDES
TRADE CERT)
CERT I - IV (INCLUDES
TRADE CERT)
CERT I - IV (INCLUDES
TRADE CERT)
YR 12 OR EQUIVALENT
YR 12 OR EQUIVALENT
YR 12 OR EQUIVALENT
YR 12 OR EQUIVALENT
YR 11 OR EQUIVALENT
YR 11 OR EQUIVALENT
YR 11 OR EQUIVALENT
YR 11 OR EQUIVALENT
YR 10 OR EQUIVALENT
YR 10 OR EQUIVALENT
YR 10 OR EQUIVALENT
YR 10 OR EQUIVALENT
YR 9 OR EQUIVALENT
YR 9 OR EQUIVALENT
YR 9 OR EQUIVALENT
YR 9 OR EQUIVALENT
NON-SCHOOL
QUALIFICATION
NON-SCHOOL
QUALIFICATION
NON-SCHOOL
QUALIFICATION
NON-SCHOOL
QUALIFICATION
NO
NO
NO
NO
FATHER
MOTHER
LEGAL GUARDIAN 2 (If Applicable)
LEGAL GUARDIAN 1 (If Applicable)
5
DO YOU FEEL YOUR CHILD MAY NEED TO BE REFERRED TO SCHOOL COUNSELLOR?
(Irfan College reserves the legal rights to counsel your child with or without your consent depending on the needs basis)
HAS YOUR CHILD EVER BEEN COUNSELLED?
SECTION 3 – MEDICAL INFORMATION
MEDICARE NUMBER
HEALTH CARE NUMBER
CLINIC ADDRESS
ADDRESS
POST CODE
POST CODE
NAME OF FAMILY DOCTOR
CONTACT PERSON
TYPE OF SERVICE
DOES YOUR CHILD ATTEND ANY SPECIALIST SERVICES
(for eg. Speech Therapist, Behaviour Management, etc)?
CONTACT PHONE
PHONE
NAME OF SERVICE
ARE YOU COVERED BY AMBULANCE FOR EMERGENCY? (If Yes, provide Ambulance Cover Number)
DOES THE CHILD SUFFER FROM ASTHMA?
DOES THE CHILD HAVE ANY ALLERGIES?
YES, MY AMBULANCE COVER NUMBER IS
NO
NO
NO
YES (Please attach an action plan)
YES (Please attach an action plan)
ACTION PLAN ATTACHED?
ACTION PLAN ATTACHED?
ANY DISABILITY OR IMPAIRMENTS? (If Yes, please give details)
IS THE APPLICANT ON ANY LONG TERM MEDICATION? (If Yes, please give details)
YES
YES
YES (Please give details below)
YES
YES
NO
NO
NO
NO
NO
DOES THE CHILD SUFFER FROM ANY OF THE FOLLOWING? (If so, please provide the Action Plans)
EPILEPSY ANAPHYLAXIS NONE OTHER Please specify:DIABETES
EMERGENCY CONTACT 1 (Must be other than Parents/Legal Guardian) EMERGENCY CONTACT 2 (Must be other than Parents/Legal Guardian)
CONTACT NUMBER CONTACT NUMBER
RELATION TO CHILD RELATION TO CHILD
FULL NAME FULL NAME
6
SECTION 4 – STUDENT BEHAVIOUR
YES NOHAS YOUR CHILD EVER BEEN SUSPENDED OR EXPELLED FROM SCHOOL? (If Yes, please explain why)
SECTION 5 – AUTHORISATION
PARENT/GUARDIAN FULL NAME
PARENT/GUARDIAN FULL NAME
PARENT/GUARDIAN FULL NAME
In the event of any accident, illness or injury to my child, I authorise the Director or Principal to consent to any emergency medical /
hospital / ambulance care or treatment deemed necessary by a qualified medical practitioner and I agree to meet all expenses incurred.
Such consent includes, blood transfusions and surgical operation.
I give permission to the College Nurse to check my child’s hair for head lice, at appropriate times
SIGNATURE
SIGNATURE
SIGNATURE
DATE
DATE
DATE
Photos of students are sometimes taken for in-house and promotional use. If photographs are taken for local papers, only given names are
published. This excludes formal class photographs.
I DO NOT AGREE FOR PHOTOGRAPHS OF MY CHILD TO BE U
