INTENTION TO ENROL - YEARS 1

MOUNT ELIZA NORTH PRIMARY SCHOOL NOTICE OF INTENTION TO ENROL YEAR LEVELS OTHER THAN PREP
PLEASE RETURN THIS FORM WITHIN 2 WEEKS OF COMPLETING TOUR
ANTICIPATED ENROLMENT DATE:*

DayMonthYear
Date
1. STUDENT DETAILS*

First NameLast Name
DATE OF BIRTH*

DayMonthYear
Date
CURRENT SCHOOL*
CURRENT YEAR LEVEL *
2. STUDENT DETAILS

First NameLast Name
DATE OF BIRTH

DayMonthYear
Date
CURRENT SCHOOL
CURRENT YEAR LEVEL
3. STUDENT DETAILS

First NameLast Name
DATE OF BIRTH

DayMonthYear
Date
CURRENT SCHOOL
CURRENT YEAR LEVEL
ADDRESS:
RESIDENTIAL ADDRESS*
POST CODE*
POSTAL ADDRESS: "AS ABOVE" IF SAME AS RESIDENTIAL)
POST CODE
FAMILY DETAILS
ADULT A*

First NameLast Name
RELATIONSHIP TO CHILD/CHILDREN*
PHONE*
Format: (000) 000-0000.
EMAIL*
example@example.com
ADULT B*

First NameLast Name
RELATIONSHIP TO CHILD/CHILDREN*
PHONE*
Format: (000) 000-0000.
EMAIL*
example@example.com
ANY FURTHER INFORMATION YOU WISH TO PROVIDE PLEASE DETAIL BELOW
PLEASE READ SCHOOL ENROLMENT POLICY INFORMATION

If you require further assistance please do not hesitate to contact our school office. Ph: 03 9787 6611

6 Moseley Drive Mount Eliza 3930 Phone: 03 9787 6611 Email: mount.eliza.north.ps@edumail.vic.gov.au Web: www.menps.vic.edu.au
Should be Empty:

MOUNT ELIZA NORTH PRIMARY SCHOOL NOTICE OF INTENTION TO ENROL YEAR LEVELS OTHER THAN PREP