BRUNSWICK SINHALA LANGUAGE SCHOOL (BSLS) Established in 1992 ABN 48510159629 STUDENT RE / ENROLMENT FORM

BRUNSWICK SINHALA LANGUAGE SCHOOL (BSLS) Established in 1992 / ABN 48510159629 STUDENT RE / ENROLMENT FORM
STUDENT PERSONAL DETAILS:

Important: Names on this form must be the same as the names known by or used at the main stream school.
Student Name*

First NameMiddle NameLast Name
Birth Date*

DayMonthYear
Gender:*

FemaleMale
STUDENT RESIDENTIAL DETAILS
Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Australian Residency status*

Australian citizen/Permanent residentFee-paying international studentOther (If Other, please talk to school principal)
STUDENT SCHOOL DETAILS
Mainstream School Name*
Suburb/Post code*

Street Address

Street Address Line 2

CitySuburb

Post code
Mainstream school class level*
BSLS Class Level 2024*
Student currently attending any other language school*

YesNo
If yes please provide the name of the language school
Student previously attended any other language school*

YesNo
If yes please provide the name of the language school
STUDENT MEDICAL DETAILS & CONSENT
Medicare /Health Insurance Number*
Current Ambulance Subscription or Heath care card*

YesNo
Family Doctors Details. (address & contact details)*
Does the student have any severe medical condition or allergy reaction? (if yes, please request and fill out the Allergy form )*

YesNo
Medical Declaration.(In the event that the parents are unable to be contacted.) In the event of illness, injury to my child while at school, an excursion or travelling to or from school during the excursion, I authorize principle/president or a senior staff member to, attend to emergency medical treatment as this necessary by the medical practitioner.*

YesNo
Does the student up to date with immunisation*

YesNo
NAME & GRADE OF SIBLING(S) ATTENDING THE SCHOOL

	Name	Year Level 2024
Sibling 1
Sibling 2
Sibling 3

PARENT/GUARDIAN INFORMATION & MEMBERSHIP DETAILS FOR BRUNSWICK SRI LANKAN COMMUNITY GROUP INC.
Parent/Guardian Name Father/ Male Guardian*

First NameLast Name
Relationship to Student*
Contact Number *
Please enter a valid phone number.
Email*
example@example.com
Resident Status*

Australian CitizenPermanent ResidentOther
Skills that can be offered*
Other
Do you have "WORKING WITH CHILDREN" Certificate?*

YesNo
If “yes” CARD NO
Expires on

MonthDayYear
Parent/Guardian Name Mother/ Female Guardian*

First NameLast Name
Relationship to Student*
Contact Number *
Please enter a valid phone number.
Email*
example@example.com
Resident Status*

Australian CitizenPermanent ResidentOther
Skills that can be offered*
Other
Do you have "WORKING WITH CHILDREN" Certificate?*

YesNo
If “yes” CARD NO
Expires on

DayMonthYear
EMERGENCY CONTACT DETAILS
Emergency contact 1*

First NameLast Name
Relationship to Student
Phone Number*
Emergency contact 2*

First NameLast Name
Relationship to Student
Phone Number*
PRIVACYCOLLECTION 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 to educate or support your child, or to fulﬁl legal obligations including duty of care, anti-discrimination law, and occupational health and safety law. This includes using the contact information provided if there are any emergencies or medical issues. Residency status is checked to ensure that your child is eligible for funding. Your child’s name, date of birth, and mainstream school name/s will be shared with the Department of Education (the Department) to conﬁrm funding eligibility. The information collected will not be disclosed beyond the community language school or the Department without your consent unless such disclosure is lawful. For more about information- sharing and privacy, see the Department’s privacy policy at https://www.vic.gov.au/department-of-education-privacy-policy. If you have any queries about the handling of your information by the community language school or to correct and update your information please contact the school.*

I agreeI do not agree (Please talk to School Principal)
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 for the purposes mentioned in this form;
● the community language school disclosing my child’s personal information contained in this enrolment form (name, date of birth, and mainstream school name), to the Department of Education for data veriﬁcation and funding purposes

I understand that the Principal or teacher (where the Principal or teacher in charge is unable to contact me) is allowed to disclose personal and health information to professional third parties in the event of a medical emergency, in accordance with Victorian privacy law.
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 agree to use my printed name as legal representation of my signature for this application just
the same as a pen-and-paper signature.
Name of Parent /Guardian*
Date*

DayMonthYear
Date
Photographing, Filming and Recording Students at Brunswick Sinhala School- Annual Consent Form and Collection Notice
You may withdraw your consent at any time however please note that it may not be possible for the school to amend past publications or to withdraw images that are already in the public domain. During the school year, there are many occasions and events where staﬀ may photograph, ﬁlm, or record students participating in school activities and events. We do this for many reasons including to celebrate student participation and achievement or to communicate with our parents and school community.This notice applies to photographs, videos, or recordings of students that are collected, used, and disclosed by the school. We ask that any parents/carers or other members of our school community photographing, ﬁlming, or recording students at school events (e.g. concerts, sports events, etc) do so respectfully and safely and that any photos, video, or recordings (“images”) of students are not publicly posted (e.g. to a social media account) without the permission of the relevant parent/carer. If you do not understand any aspect of this notice, or you would like to talk about any concerns you have, please contact the community language school. I consent to my child being photographed or audio/visually recorded participating in class or school activities for the use and purposes of sharing ● with other families in the school that will only be sent to school families in my child’s class. ● in the school newsletter. ● on the school website, in CLS marketing, or on CLS social media sites. Please select one of the two options:*

I agree to the community language school using photos, videos, or recordings of my child asdescribed above.I do not agree to the community language school using photos, videos, or recordings of my child as described above.
Should be Empty:

BRUNSWICK SINHALA LANGUAGE SCHOOL (BSLS) Established in 1992 / ABN 48510159629 STUDENT RE / ENROLMENT FORM

STUDENT PERSONAL DETAILS:

STUDENT RESIDENTIAL DETAILS

STUDENT SCHOOL DETAILS

STUDENT MEDICAL DETAILS & CONSENT

NAME & GRADE OF SIBLING(S) ATTENDING THE SCHOOL

PARENT/GUARDIAN INFORMATION & MEMBERSHIP DETAILS FOR BRUNSWICK SRI LANKAN COMMUNITY GROUP INC.

EMERGENCY CONTACT DETAILS

PRIVACYCOLLECTION NOTICE-PROTECTING YOUR PRIVACY AND SHARING INFORMATION

PARENT/GUARDIAN PRIVACY CONSENT AND DECLARATION

Photographing, Filming and Recording Students at Brunswick Sinhala School- Annual Consent Form and Collection Notice