Enrolment Forms – Student Application Form (ID 8)

EXPRESSION OF INTEREST FOR ENROLMENT

Academic Year of Entry in 20__(Required)

This enquiry is for my child entering(Required)

Students Name(Required)

First Last

Preferred Name (if applicable):

(Please note that names on all official school records will appear as on the Birth Certificate eg. School Reports)

Date of Birth:(Required)

Gender:(Required)

Religious Denomination:

Language Spoken at Home:(Required)

Aboriginal/Torres Strait Islander:(Required)

Nationality:(Required)

Country of Citizenship:(Required)

Present School (if applicable):

Location:

Current Year Level

FAMILY DEMOGRAPHICS

Student resides with -(Required)

Both Parents

Mother

Father

Both Parents - shared custody

Other Carer/s

Siblings -

please include children that have either previously attended (P), are currently attending (C) or are a prospective (F) student of Immaculate Heart College:

Name

Date of Birth

P C F

Proposed Enrolment Date

Other family/relatives currently/ previously attended

PARENT/CARER INFORMATION

Person/s Responsible for the Payment of Fees:

Name:(Required)

First Last

Signature (insert full name):(Required)

Name:

First Last

Signature (insert full name):

PARENT OR CARER 1

Full Name:(Required)

Prefix First Middle Last

Residential Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Postal Address (if different from above):

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone:

Mobile Phone:(Required)

Email:(Required)

Nationality:(Required)

Country of Birth:(Required)

Occupation:

Employer:

Work Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Work Phone:

Religious Denomination:

Parish:

PARENT OR CARER 2

Full Name:

Prefix First Middle Last

Residential Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Postal Address (if different from above):

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone:

Mobile Phone:

Email

Nationality:

Country of Birth:

Occupation:

Employer:

Work Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Work Phone:

Religious Denomination:

Parish:

CUSTODY/GUARDIANSHIP

Name of person(s) with legal guardianship of the student:

Any other conditions enforced by law?

Please ensure you notify the College Office immediately if any of the details on this form change.

A non-refundable $60 application fee applies; please email remittance or a copy of the bank transfer to enrolments@ihc.wa.edu.au

Account Name: Immaculate Heart College BSB: 633-000 Account Number: 162 609 192 Ref: child's full name

Student Application Form

EXPRESSION OF INTEREST FOR ENROLMENT

FAMILY DEMOGRAPHICS

PARENT/CARER INFORMATION

PARENT OR CARER 1

PARENT OR CARER 2

CUSTODY/GUARDIANSHIP

A non-refundable $60 application fee applies; please email remittance or a copy of the bank transfer to enrolments@ihc.wa.edu.au

Vision statement

Mission statement

Contact