JAMES COOK PRIMARY SCHOOL ENROLMENT FORM

JAMES COOK PRIMARY SCHOOL
ENROLMENT DOCUMENTATION REQUIREMENTS
BIRTH CERTIFICATE (available from Births, Deaths, Marriages)IMMUNISATION CERTIFICATE FROM MEDICARE (available from Immunisation Registry)PASSPORT/ VISA IF NOT BORN IN AUSTRALIAAUTHORITY TO ENROLCOURT ORDERS IF APPLICABLE
IMPORTANT NOTE TO PARENT/GUARDIAN:

Please complete the attached Enrolment Form, ensuring that accurate information is supplied in ALL sections. If you are a separated family and the Student lives between houses, please complete an Additional/Alternative family form, which is available from the school.

Questions marked with an * are asked as a requirement of the Commonwealth Government. All schools across Australia are required to collect the same information.

If English is not your child's main language, please ensure that you write their native language in the 'Main Family Language Spoken at home' section at the bottom of the second page. This information affects their 'English as a Second Language' tuition entitlement.

The Parental Occupation Group Codes outlined in this enrolment form are to be used when providing family occupation details for enrolled students. This information is used for determining Government funding allocations to our school and it is imperative that they are an accurate reflection of your current employment circumstances.

Medical information such as anaphylaxis, allergy or asthma plans signed by a doctor can be included with this documentation.

A copy of your child’s last school report (if applicable).

Your child’s enrolment will be conditional until all documents have been received.
DEPARTMENT OF EDUCATION AND TRAINING –JAMES COOK PRIMARY SCHOOL INFORMATION for PARENTS, GUARDIANS and CARERS
(including privacy collection notice)
Please read this information before completing the enrolment form.

The Enrolment Form asks you for personal and health information about your child and your family. This information is collected to enable our school to educate your child and support your child’s social and emotional wellbeing and health. Our school is also required by legislation, such as the Education and Training Reform Act 2006, to collect some of this information.

Our school relies on you to provide health information about any medical condition or disability that your child has, medication your child may take while at school, any known allergies and contact details of your child’s doctor. If you do not provide all relevant health information, this may put your child’s health at risk.

Our school requires current, relevant information about all parents, guardians and carers so that we can take account of family arrangements. Please provide our school with copies of all current parenting plans AND court orders regarding parenting arrangements. Please provide copies of court orders or plans when they change. If you wish to discuss any matters regarding family arrangements in confidence, please contact the principal.

Protecting your privacy and sharing information
The information about your child and family collected through this Enrolment Form will only be shared with school staff who need to know to enable our school to educate or support your child, or to fulfil legal obligations including duty of care, anti-discrimination law and occupational health and safety law. The information collected will not be disclosed beyond the Department of Education and Training without your consent, unless such disclosure is lawful. For more about information-sharing and privacy, see our school’s privacy policy: https://www.education.vic.gov.au/Pages/schoolsprivacypolicy.aspx

Our school’s use of online tools (including apps and other software) to collect and manage information
Our school may use online tools, such as apps and other software, to effectively collect and manage information about your child for teaching and learning purposes, parent communication and engagement; student administration; and school management purposes. When our school uses these online tools, we take steps to ensure that your child’s information is secure. If you have any concerns about the use of these online tools, please contact us.

Emergency contacts
Emergency contacts are those people you nominate for the school to contact during an emergency. Please ensure your nominated emergency contact agrees to you providing their contact details to our school and that they have read the paragraph above. It is important that you inform them that their contact details may be disclosed beyond the Department if lawful.

Student background information
The enrolment form requests information about country of birth, aboriginality, language spoken at home and parent occupation. This information enables the Department to allocate appropriate resources to our school. The Department also uses this information to plan for future educational needs in Victoria and shares some information with the Commonwealth government to monitor, plan and allocate resources.

Immunisation status
Your child’s immunisation status assists our school to manage health risks for children. The Department may also provide this information to the Department of Health and Human Services to assess immunisation rates in Victoria, but not in a way which identifies you.

Visa status
Our school also requires this information to process your child’s enrolment.

Updating your child’s personal and health information
Please inform our school if, and when, there are any updates to any of the personal or health information you provide on the Enrolment Form.

Accessing your child’s records
Our school provides ordinary school communications and school reports to students and parents, guardians and carers who have legal decision-making responsibility for the student. Requests for any other type of student records may be made through a Freedom of Information (FOI) application. Please contact our school and we can advise you how to do this.

Student transfers between Victorian government schools
When our students transfer to another Victorian government school, our school will transfer the student’s personal and health information to that next school. This may include copies of student’s school records, including any health information. Transferring this information assist the next school to provide the best possible education and support to students.
IMPORTANT INFORMATION REGARDING ENROLMENT

AUTHORITY TO ENROL
Dear Parents of Prospective Enrolments,

The Department of Education and Training regulations are quite specific in regard to the enrolment of students in Government Schools.

The regulations state that the school can only accept the enrolment of a child where it has been determined that both parents have agreed to the child being enrolled at the school.

In the absence of a second legal parent’s approval, a Statutory Declaration, clearly stating that the custodial parent has the authority to enrol the child, MUST be submitted prior to the enrolment being accepted.

Where parents are separated or no longer living together, details of any Court Orders that impact on the relationship between the family and the school MUST be provided to the school prior to the enrolment being accepted.

You MUST also provide a copy of the child’s Birth Certificate & Immunisation Certificate prior to the enrolment being accepted.
Anne Burgess

Principal
I have the authority to enrol my child in line with the Department of Education and Training regulations outlined above.
CHILD'S BIRTH NAME:*
Parent A Full Name:*
Parent A Signature:*

Clear
Parent B Full Name:
Parent B Signature:

Clear
Date:*

DayMonthYear
Date
PARENTAL OCCUPATION GROUP CODES

The codes outlined below are to be used when providing family occupation details for enrolled students. This information is used for determining funding allocations to schools.
GROUP N Unemployed for more than 12months

GROUP A Senior management in large business organisation, government administration and defence, and qualified professionals

Senior Executive / Manager / Department Head in industry, commerce, media or other large organisation
Public Service Manager (Section head or above), regional director, health / education / police / fire services administrator
Other administrator (school principal, faculty head / dean, library / museum / gallery director, research facility director)
Defence Forces Commissioned Officer
Professionals - generally have degree or higher qualifications and experience in applying this knowledge to design, develop or operate complex systems; identify, treat and advise on problems; and teach others: Health, Education, Law, Social Welfare, Engineering, Science, Computing professional Business (management consultant, business analyst, accountant, auditor, policy analyst, actuary, valuer) Air/sea transport (aircraft / ship’s captain / officer / pilot, flight officer, flying instructor, air traffic controller)

GROUP B Other business managers, arts/media/sportspersons and associate professionals

Owner / Manager of farm, construction, import/export, wholesale, manufacturing, transport, real estate business
Specialist Manager (finance / engineering / production / personnel / industrial relations / sales / marketing)
Financial Services Manager (bank branch manager, finance / investment / insurance broker, credit / loans officer)
Retail sales / Services manager (shop, petrol station, restaurant, club, hotel/motel, cinema, theatre, agency)
Arts / Media / Sports (musician, actor, dancer, painter, potter, sculptor, journalist, author, media presenter, photographer, designer, illustrator, proof reader, sportsman/woman, coach, trainer, sports official)
Associate Professionals - generally have diploma / technical qualifications and support managers and professionals: Health, Education, Law, Social Welfare, Engineering, Science, Computing technician / associate professional Business / administration (recruitment / employment / industrial relations / training officer, marketing / advertising specialist, market research analyst, technical sales representative, retail buyer, office / project manager) Defence Forces senior Non-Commissioned Officer

GROUP C Tradesmen/women, clerks and skilled office, sales and service staff

Tradesmen/women generally have completed a 4 year Trade Certificate, usually by apprenticeship. All tradesmen/women are included in this group
Clerks (bookkeeper, bank / PO clerk, statistical / actuarial clerk, accounting / claims / audit clerk, payroll clerk, recording / registry / filing clerk, betting clerk, stores / inventory clerk, purchasing / order clerk, freight / transport / shipping clerk, bond clerk, customs agent, customer services clerk, admissions clerk)
Skilled office, sales and service staff: Office (secretary, personal assistant, desktop publishing operator, switchboard operator) Sales (company sales representative, auctioneer, insurance agent/assessor/loss adjuster, market researcher) Service (aged / disabled / refuge / child care worker, nanny, meter reader, parking inspector, postal worker, courier, travel agent, tour guide, flight attendant, fitness instructor, casino dealer/supervisor)

GROUP D Machine operators, hospitality staff, assistants, labourers and related workers

Drivers, mobile plant, production / processing machinery and other machinery operators
Hospitality staff (hotel service supervisor, receptionist, waiter, bar attendant, kitchen hand, porter, housekeeper)
Office assistants, sales assistants and other assistants: Office (typist, word processing / data entry / business machine operator, receptionist, office assistant) Sales (sales assistant, motor vehicle / caravan / parts salesperson, checkout operator, cashier, bus / train conductor, ticket seller, service station attendant, car rental desk staff, street vendor, telemarketer, shelf stacker) Assistant / aide (trades’ assistant, school / teacher's aide, dental assistant, veterinary nurse, nursing assistant, museum / gallery attendant, usher, home helper, salon assistant, animal attendant)
Labourers and related workers Defence Forces - ranks below senior NCO not included above Agriculture, horticulture, forestry, fishing, mining worker (farm overseer, shearer, wool / hide classer, farm hand, horse trainer, nurseryman, greenkeeper, gardener, tree surgeon, forestry/ logging worker, miner, seafarer / fishing hand). Other worker (labourer, factory hand, storeman, guard, cleaner, caretaker, laundry worker, trolley collector, car park attendant, crossing supervision
STUDENT ENROLMENT INFORMATION

PERSONAL DETAILS OF STUDENT
Date of enrolment*

DayMonthYear
Date
Year level (please use 00 for Prep)*
Title (Miss, Ms, Mrs, Mr)*
Student Name*

First NameLast Name
Student Middle Name
If applicable
Student Preferred Name
if applicable
Sex*

MaleFemale
Student Birth Date*

DayMonthYear
Date
Student Mobile Number

Area CodePhone Number
Primary family HOME address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary family MAILING address (if different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Family Home Telephone Number*

Area CodePhone Number
Primary Family Mobile Number*

Area CodePhone Number
List any other family members attending this school:This question is asked as a requirement of the Commonwealth Government. All schools across Australia are required to collect the same information.
PRIMARY FAMILY DETAILS

NOTE: The ‘PRIMARY’ Family is: “the family or parent the student mostly lives with”.If you are a separated family and the student lives between houses, please complete an Additional / Alternative family which are available from the school.These additional forms are designed to cater for varying family circumstances.
ADULT A DETAILS (PRIMARY CARER):
Adult A Legal Full Name*

First NameLast Name
Title (Ms, Mrs, Mr, Dr, etc)*
What is Adult A's occupation?*
Who is Adult A's employer?*
In which country was Adult A born?*
What language/s does Adult A speak at home?*
Is an interpreter required?*

YesNo
What is the highest year of primary or secondary school Adult A has completed?*

Year 12 or equivalentYear 11 or equivalentYear 10 or equivalentYear 9 or equivalent or below
What is the level of the highest qualification that Adult A has completed?*

Bachelor degree or aboveAdvanced diploma/DiplomaCertificate I to IV (including trade certificate)No non-school qualification
What is the occupation group of Adult A? (Please select the appropriate parental occupation from the list above)*
Adult A Work Telephone Number

Area CodePhone Number
Adult A Mobile Number*

Area CodePhone Number
Adult A's Email Address*
example@example.com
Adult A's preferred method of contact*

MailEmailPhone
ADULT B DETAILS:
Adult B Legal Full Name

First NameLast Name
Title (Ms, Mrs, Mr, Dr, etc)*
What is Adult B's occupation?*
Who is Adult B's employer?*
In which country was Adult B born?*
What language/s does Adult B speak at home?*
Is an interpreter required?*

YesNo
What is the highest year of primary or secondary school Adult A has completed?*

Year 12 or equivalentYear 11 or equivalentYear 10 or equivalentYear 9 or equivalent or below
What is the level of the highest qualification that Adult A has completed?*

Bachelor degree or aboveAdvanced diploma/DiplomaCertificate I to IV (including trade certificate)No non-school qualification
What is the occupation group of Adult B? (Please select the appropriate parental occupation group from the list above)*
Adult B Work Telephone Number*

Area CodePhone Number
Adult B Mobile Number*

Area CodePhone Number
Adult B's Email Address*
example@example.com
Adult B's preferred method of contact*

MailEmailPhone
What is the main language spoken at home?*
Are you interested in being involved in school group participation activities? (eg School Council, excursions, etc)*

Adult AAdult BBothNeither
PRIMARY FAMILY DOCTOR DETAILS:
Doctor's Name*
Individual or Group Practice*

IndividualGroup
Doctor's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you have a current Ambulance Subscription?*

YesNo
Medicare Number*
PRIMARY FAMILY EMERGENCY CONTACTS:

Please enter up to 4 contacts. These must not be student's primary carers.
Name: contact name* Relationship to student: relationship*
Contact Number: Area Code* Phone Number*
Language Spoken: language*
Name: contact name Relationship to student: relationship
Contact Number: Area Code Phone Number
Language Spoken: language
Name: contact name Relationship to student: relationship
Contact Number: Area Code Phone Number
Language Spoken: language
Name: contact name Relationship to student: relationship
Contact Number: Area Code Phone Number
Language Spoken: language
OTHER PRIMARY FAMILY DETAILS
Relationship of Adult A to student*

ParentStep ParentAdoptive ParentFoster ParentHost FamilyRelativeFriendOther
Relationship of Adult B to student*

ParentStep ParentAdoptive ParentFoster ParentHost FamilyRelativeFriendOther
The student lives with the Primary Family:*

AlwaysMostlyBalancedOccasionally
DEMOGRAPHIC DETAILS OF STUDENT
In which country was the student born? *
If student was born outside of Australia, what was their date of arrival or date of return to Australia?

DayMonthYear
Date
If student was born outside of Australia, what is their Residential Status?

PermanentTemporary
If student was born outside of Australia, what is the Basis of Australian Residency?

Eligible for Australian PassportHolds Australian PassportHolds Permant Residency Visa
Visa Subclass
Visa Expiry Date

DayMonthYear
Date
International Student ID
Does the student speak a language other than English at home?*

No, English onlyOther
Does the student speak English?*

YesNo
Is the student of Aboriginal or Torres Strait Islander origin?*

NoYes, AboriginalYes, Torres Strait IslanderYes, Both Aboriginal & Torres Strait Islander
What is the student's living arrangements?*

At home with TWO Parents/GuardiansAt home with ONE Parent/GuardianState Arranged Out of Home CareHomeless YouthIndependant
Usual mode of transport to school*

WalkingBicycleDrivenPublic BusTrainTaxiOther
Distance to school in kilometres*
SCHOOL DETAILS
Date of first enrolment in an Australian School*

DayMonthYear
Date
Name of previous school or kindergarten*
Years of previous education*
What was the language of the student's previous education?*
Does the student have a Victorian Student Number (VSN)?*

Yes (please specify number below)Yes, but the VSN is unknownNo. The student has never been issued a VSN.
VSN Number
Years of interruption to education*
Is the student repeating a year?*

YesNo
STUDENT ACCESS OR ACTIVITY RESTRICTIONS DETAILS
Is the student at risk?*

YesNo
Is there an Access Alert for the student?*

Yes (please complete the following questions and present a current copy of the document to the school)No (please move to the immunisation/medical condition details questions)
Access Type

Parenting OrderParenting PlanIntervention OrderProtection OrderInformal Carer Stat DecDHHS AuthorisationWitness Protection Program OrderOther
Describe any Access Restriction
Is there an Activity Alert for the student?*

Yes (please describe below)No
Activity Alert Restriction
STUDENT MEDICAL DETAILS

MEDICAL CONDITION DETAILS
Does the student suffer from any of the following impairments?*

HearingSpeechVisionMobilityNone of the above
Does the student suffer from Asthma? (if no, please go to the Other Medical Conditions section)*

YesNo
Asthma Medical Condition Details

Answer the following questions ONLY if the student suffers from any Asthma medical conditions
If the student suffers from Asthma, please indicate if they suffer from any of the follwoing symptoms:

CoughDifficulty breathingWheezeExhibits symptoms after exertionTight chest
If the student suffers from Asthma and displays any of the above symptoms please:

Inform doctorInform Emergency ContactAdminister MedicationOther
Has the Asthma Management Plan been provided to school?

YesNo
Does the student take medication for their Asthma?

YesNo
Name of medication taken
Is the medication taken regularly by the student (preventative) or only in response?

PreventativeResponse
Indicate the usual dosage taken and how frequently the medication is taken
Medication is usually administered by:

StudentFirst Aid OfficerTeacherOther
Medication is stored:

with studentin the First Aid roomOther
Other Medical Conditions
Does the student have any other medical condition?*

Yes (please specify below)No
Other Medical Condition Details
If the student displays any of the symptoms above please:

Inform doctorInform Emergency ContactAdminister medicationOther
Does the student take medication?

YesNo
Name of medication taken
Is the medication taken regularly by the student (preventative) or only in response?

PreventativeResponse
Indicate the usual dosage taken and how frequently the medication is taken
Medication is usually administered by:

StudentFirst Aid OfficerTeacherOther
Medication is stored:

with studentin the First Aid roomOther
STUDENT DOCTOR DETAILS

The following details should only be provided if this student has a Doctor and/or Medicare number different to the Primary Family
Doctor's Name
Individual or Group Practice

IndividualGroup
Doctor's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Medicare Number
STUDENT EMERGENCY CONTACTS

This section should ONLY be filled out if THIS student has emergency contacts other than the Prime Family
Name: contact name Relationship to student: relationship
Contact Number: Area Code Phone Number
Language Spoken: language
Name: contact name Relationship to student: relationship
Contact Number: Area Code Phone Number
Language Spoken: language
MEDICAL AUTHORITY
In the event of illness or injury to my child whilst at school, on an excursion, or travelling to or from school; I authorise the Principal or teacher-in-charge of my child, where the Principal or teacher-in-charge is unable to contact me, or it is otherwise impracticable to contact me to:*

consent to my child receiving such medical or surgical attention as may be deemed necessary by a medical practitioneradminister such first aid as the Principal or staff member may judge to be reasonably necessaryNone of the above
I consent to my child taking part in any school local walking excursions. Parents will be notified by the school before all walking excursions*

YesNo
Thank you for taking the time to complete this Student Enrolment form. We understand that the information you have provided is confidential and will be treated as such, but the details are required to enable staff to properly enrol your child at our school.

I certify that the information contained within this form is correct.
Signature of Parent/Guardian (ADULT A)*

Clear
Date*

DayMonthYear
Date
Signature of Parent/Guardian (ADULT B)*

Clear
Date*

DayMonthYear
Date
CONSENT FORM TO CONDUCT HEAD LICE INSPECTIONS

Permission to cover the duration of the student’s schooling at James Cook Primary School (5136)
Throughout your child’s schooling, the school will be arranging head lice inspections of students.

The management of head lice infection works best when all children are involved in our screening program.

The school is aware that this can be a sensitive issue and is committed to maintaining student confidentiality and avoiding stigmatisation.

The inspections of students will be conducted by a trained person approved by the principal and school council.

Before any inspections are conducted the person conducting the inspections will explain to all students what is being done and why and it will be emphasised to students that the presence of head lice in their hair does not mean that their hair is less clean or well kept than anyone else’s. It will also be pointed out that head lice can be itchy and annoying and if you know you have got them, you can do something about it.

The person conducting the inspections will check through each student’s hair to see if any lice or eggs are present.

People authorised by the school principal may also visually check your child’s hair for the presence of head lice, when it is suspected that head lice may be present. They do not physically touch the child’s head during a visual check.

In cases where head lice are found, the person inspecting the student will inform the student’s teacher and the principal. The school will make appropriate contact with the parents/guardians/carers.

Please note that health regulations requires that where a child has head lice, that child should not return to school until appropriate treatment has commenced. The school may request the completion of an ‘action taken form’, which requires parents/guardians/carers to nominate if and when the treatment has started.
Name of child attending the school*

First NameLast Name
Parent/guardian/carer's full name*

First NameLast Name
I hereby give my consent for the above names child to participate in the school's head live inspection program for the duration of their schooling at this school.*

YesNo
Signature*

Clear
Date*

DayMonthYear
Date
Please inform the school if guardianship/custody changes for your child, as this form will need to be re-signed to reflect these changes. Please also inform the school in writing if you no longer wish to provide consent for the school to undertake head lice inspections for your child.
Should be Empty:

JAMES COOK PRIMARY SCHOOL

ENROLMENT DOCUMENTATION REQUIREMENTS

IMPORTANT INFORMATION REGARDING ENROLMENT

Anne Burgess

PARENTAL OCCUPATION GROUP CODES

STUDENT ENROLMENT INFORMATION

PRIMARY FAMILY DETAILS

ADULT A DETAILS (PRIMARY CARER):

ADULT B DETAILS:

PRIMARY FAMILY DOCTOR DETAILS:

PRIMARY FAMILY EMERGENCY CONTACTS:

OTHER PRIMARY FAMILY DETAILS

DEMOGRAPHIC DETAILS OF STUDENT

SCHOOL DETAILS

STUDENT ACCESS OR ACTIVITY RESTRICTIONS DETAILS

STUDENT MEDICAL DETAILS

Asthma Medical Condition Details

Other Medical Conditions

STUDENT DOCTOR DETAILS

STUDENT EMERGENCY CONTACTS

MEDICAL AUTHORITY

CONSENT FORM TO CONDUCT HEAD LICE INSPECTIONS