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Application for Enrolment - Amazon S3 · PDF file application for enrolment anticipated starting date date applying vsn year level applying email: [email protected]

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  • 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

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