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

BRUNSWICK SINHALA LANGUAGE SCHOOL (BSLS) 2025 STUDENT RE / ENROLMENT FORM
STUDENT DETAILS:

Note: It is important that student details match those held at the student’s mainstream school so that the community language school can receive government funding.
Family name:*
First name:*
Middle name(s):
Date of birth:*

DayMonthYear
Gender:*

FemaleMaleOther
Birth Certificate Number (Ensure this is an authentic Australian or Sri Lankan birth certificate number. Avoid using random or fictitious numbers.) *
Home Address*

Home Address

Suburb

CityState / Province

Post Code
STUDENT SCHOOL DETAILS
Mainstream School Name Or Kindergarten Name*
Student’s mainstream year level 2025:*
Victorian Student Number (VSN) (where known)*:*The VSN is a nine-digit number

Street Address

Street Address Line 2

CitySuburb
Year in which you are seeking to enrol this student at the Brunswick Sinhala School*
Student currently attending any other language school*

YesNo
If yes please provide the name of the language school
Student Australian Residency Status*

Australian citizen/Permanent residentFee-paying international studentOther-If Other, please talk to School Principal
Parent/Guardian Details
Name of Parent/Guardian 01:*

First NameLast Name
Relationship to Student*
Contact Number *
Please enter a valid phone number.
Email*
example@example.com
Do you have "WORKING WITH CHILDREN" Certificate?*

YesNo
If “yes” CARD NO
Expires on

DayMonthYear
Skills that can be offered
Name of Parent/Guardian 02:*

First NameLast Name
Relationship to Student*
Contact Number *
Please enter a valid phone number.
Email*
example@example.com
Do you have "WORKING WITH CHILDREN" Certificate?*

YesNo
If “yes” CARD NO
Expires on

DayMonthYear
Skills that can be offered
STUDENT MEDICAL DETAILS & CONSENT
Medicare /Health Insurance Number*
Current Ambulance Subscription or Heath care card*

YesNo
Family Doctors Details. (address & contact details)*
Does your child suﬀer from any medical condition? (e.g. asthma, epilepsy, allergies, etc.)?*

YesNo
If Yes, please specify and provide a medical plan (e.g. asthma, anaphylaxis, etc.)
Is your child currently on any medication?*

YesNo
If Yes, please specify:
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
EMERGENCY CONTACT DETAILS (OTHER THAN PARENTS)
Emergency contact *

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 and Department of Education and Training (Department) to educator 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*

YesNo (Please contact school principle)
PARENT/GUARDIAN PRIVACY CONSENT AND DECLARATION
I consent to: -
1. The collection of my child’s health and personal information by the community language school.
2. 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.
3. 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.
4. Provide consent to receive E-mails, share information with Department of Education and other promotional materials and event
details of the BSLS via website, e-mail, SMS and other electronic and non - electronic media.
5. I agree publishing my child’s photographs /work as outlined above and will notify BSLS, if I decide to withdraw this consent
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
During the school year, there are many occasions and events where staﬀ may photograph, ﬁlm, or recordstudents participating in school activities and events. We do this for many reasons including to celebratestudent 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 disclosedby 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 safelyand that any photos, video, or recordings (“images”) of students are not publicly posted (e.g. to a socialmedia 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 youhave, please contact the community language school.I consent to my child being photographed or audio/visually recorded participating in class or schoolactivities 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:

AgreeDisagree (talk to School Principal)
Should be Empty:

BRUNSWICK SINHALA LANGUAGE SCHOOL (BSLS) 2025 STUDENT RE / ENROLMENT FORM

STUDENT DETAILS:

STUDENT SCHOOL DETAILS

Parent/Guardian Details

STUDENT MEDICAL DETAILS & CONSENT

EMERGENCY CONTACT DETAILS (OTHER THAN PARENTS)

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