Enrolment Form

校区选择（CAMPUS）*

NAZARETHBERWICK

中文姓名 Chinese Name

英文姓名 English Name*

名(英) First Name姓(英) Surname

出生地 Birth Place

出生日期 Date of Birth*

DayMonthYear

性别*

男 Male女 Female

家庭住址 Home Address*

街道 Street Address

区 City州 State / Province

邮编 Postal / Zip Code国家 Country

日校年级 Grade

日校名称 Day School

Is your child currently enrolled at another community language school to learn the same language?*

否 No是 Yes （请注明 Please Specify）

请注明

Has your child ever been enrolled at another community language school to learn the same language?*

否 No是 Yes （请注明 Please Specify）

请注明

姓名 Full Name*

名 First Name姓 Last Name

手机 Mobile*

邮箱 Email*

姓名 Full Name*

名 First Name姓 Last Name

手机 Mobile*

邮箱 Email*

姓名 Full Name

名 First Name姓 Last Name

紧急联系号码 Emergency contact

与学生的关系 relation to student

学生居澳签证类别 (请打勾) Student's Australian Residency Status (PLEASE TICK)

澳洲公民/永久居民 Child is Australian Citizen/Permanent Resident?全费国际学生 Child is full-fee paying International Student?其它签证类别 ( 请注明签证编号） If other, please specify with Visa No.

请注明

全费国际学生 Child is full-fee paying International Student & 其它签证类别 If other, 居澳年限 Years in Australia：

您的孩子是否有任何疾病病史 (如哮喘，癫痫，过敏)? Does your child suffer from any medical condition? (eg. Asthma, epilepsy, allergies, etc)*

否 No是 YES (请提供家庭医生制定的应急处理方式,provide medical plan by GP)

请注明

您的孩子是否正在服用任何药物 Is your child currently on any medication？*

否 No是 YES （请注明，please specify）

请注明

报读年级

缴费金额

缴费方式

现金转账（转账日期）

Date

注册缴费（一年一次、半年两次）

半年全年其他（请注明）

请注明

收据号码

经办人

填表日期

TERMS AND CONDITIONS

▪ 退费事项：书本费和手续费不退。
 If a refund is requested, the administration fee and material fee is non-refundable. 
 
 ▪ 不建议学生携带贵重物品到学校，如有丢失，责任自负。
Students are not to bring valuable items to school. If damaged or lost, they are to take full responsibility. 
 
 ▪ 如联系地址或电话变更，家长必须及时通知学校 。
Parents/ Guardians are to notify the school of any detail changes. 
 
PRIVACY COLLECTION NOTICE - 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 the community language school and Department of Education and Training  (Department) 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  without your consent, unless such disclosure is lawful. For more about information-sharing and privacy, see the  Department’s privacy policy at: http://www.education.vic.gov.au/Pages/privacy.aspx 
 
Your personal information we collect or currently hold will be used for the purpose of administering our school and  monitoring and improving the student's performance as well as the performance of our school. Your personal  information may only be disclosed to your parent/guardian (if you are a minor) and as may be required or authorised  by or under an Australian or a court/tribunal order. 
 
 We may use your personal information to keep you informed of upcoming events and/or to offer you our products  or services that we believe may interest you. If you do not want to receive such communications from us, please  contact us. If you have any query or complaint regarding our approach to compliance with the Australian Privacy  Principles and/or wish to access or correct your personal information held by JNU MELBOURNE CHINESE SCHOOL,  please contact our office staff. 
 
PARENT/GUARDIAN PRIVACY CONSENT AND DECLARATION 
 
I confirm that the information provided on this enrolment form is true and correct and I acknowledge and agree to  the terms and conditions of enrolment accompanying this enrolment form. I consent to: 
 
 • the collection of my child’s health and personal information by the community language school; 
 
• the community language school disclosing my child’s personal information contained in this enrolment form  to the Department of Education and Training for data verification and funding purposes; 
 
• the Principal or teacher (where the Principal or teacher in charge is unable to contact me) to administer such  first aid to my child as the Principal or staff member may consider to be reasonably necessary including  disclosing personal and health information to professional third parties in the event of a medical emergency.

Acknowledge*

I acknowledge that I have read and agreed to the terms and conditions

Parent/Guardian Signature（Please print）*

Date*

JNU暨华语言文化学校学生报名表

学生信息 Student Details

父亲信息 Father's Details/ Guardian 1

母亲信息 Mother's details/ Guardian 2

紧急联系号码 Emergency Contact Details (only complete if different from parent/guardian details)

健康信息 Medical Information

以下信息由学校工作人员填写 OFFICE USE ONLY