Glenroy College
Enrolment Enquiry Form
Date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Student Name
*
First given name
Second given name
Last Name
Date of Birth
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Gender
*
Female
Male
Self Described
Which year are you seeking to enrol the student?
*
7
8
9
10
11
12
Intended Start Date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Are you seeking to enrol at this school full time
*
Yes
No
Do you live in the school's zone?
*
Yes
No
Student's Permanent Home Address
*
Street Address
Street Address Line 2
Suburb
State
Postal Code
How often does this student live at this address?
*
Always
Mostly
Balanced (50%/50%)
Does the student have any siblings at this school?
*
Parent/ Carer Details - Adult A
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: 0400 000 000.
Email
*
example@example.com
Adult A Home Address
*
Street Address
Street Address Line 2
Suburb
State
Postal Code
How often does this student live at this address?
*
Always
Mostly
Balanced (50%/50%)
Occasionally
Never
Adult A relationship to student
*
Parent
Relative
Step-Parent
Friend
Foster Parent
Self
Parent/ Carer Details - Adult B
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: 0400 000 000.
Email
example@example.com
Adult B Home Address
Street Address
Street Address Line 2
Suburb
State
Postal Code
How often does this student live at this address?
Always
Mostly
Balanced (50%/50%)
Occasionally
Never
Adult B relationship to student
*
Parent
Relative
Step-Parent
Friend
Foster Parent
Self
If there are other children you wish to enrol, please return to the Glenroy College page and complete another form.
Declaration
Information is collected and handled in accordance with the Schools’ Privacy Policy, available here: www.education.vic.gov.au/Pages/schoolsprivacypolicy.aspx. Please also refer to the Victorian Government School Privacy Collection Notice for details on handling of personal and health information in schools: www.education.vic.gov.au/Pages/Schools'-Privacy-Collection-Notice.aspxI/ We confirm that: • I am/We are the person/people named as completing this form. • The information in this form is true and correct. • I/We agree to authorise this form by electronic means with an electronic signature.
Adult A -Please enter your full name below as an indication of your signature
*
First Name
Last Name
Adult B -Please enter your full name below as an indication of your signature
First Name
Last Name
Submit
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