Hurstville Adventist School

Step 1 of 11

Is this a first time enrolment for this child? *

YesNo

Family Name *

Given Name(s) *

Preferred Name

Date of Birth *

Gender *

To commence Grade *

Days Attending - Mon-Fr (Prep Only)

In Term *

Year *

Student lives with *

If Other, Please Specify

Contact Person *

Residential Address *

Suburb/Town *

State *

Postcode *

Telephone Number *

Fax Number

Email Address *

Country of Birth *

Visa Number (Nationality not Australian)

Religious Denomination *

Church Attending *

Step 2 of 11

Student Profile

If your child is already attending school or preschool or Early Learning Centre, please complete the following.

School presently attending

Grade

Academically

Socially

Sporting Interests & Achievements *

Cultural Interests & Achievements *

Special Needs

Is your child in need of/currently recieving any of the following forms of support?

Details of special circumstances

Siblings

How many sisters does the applicant have? *

How many brothers does the applicant have? *

Applicant's place among siblings *

Step 3 of 11

Information for Government Census

Is English your child's second language? *

If yes, what language does he/she speak

Is the applicant of Aboriginal/Torres Strait islander descent? *

Step 4 of 11

Applicant's General Health Status

(Please supply detailed information on the HEALTH RECORD)

If Other, Please Specify

Current Medication

Any special learning or behavioural diagnoses

Child's Health Cover

Applicant's Medicare Number *

Child's number on card *

Private Health Insurance Provider

Fund No.

Step 5 of 11

Transport to School

Step 6 of 11

Parent/Guardian Details

Parent/Guardian 1

Relationship to Child *

MotherFatherGuardianOther

If Other, Please Specify

Title *

Family Name *

Full Given Name *

Date of Birth *

Nationality *

Marital Status *

Occupation *

Employer *

Home Address *

Postcode *

Home Phone *

Business Phone

Mobile Phone *

E-mail Address *

Religious Denomination *

If you are a Seventh-Day Adventist complete the following:

Church membership is held at

Church I regularly attend is

Parent/Guardian 2

Relationship to Child

MotherFatherGuardianOther

If Other, Please Specify

Title

Family Name

Full Given Name

Date of Birth

Nationality

Marital Status

Occupation

Employer

Home Address

Postcode

Home Phone

Business Phone

Mobile Phone

E-mail Address

Religious Denomination

If you are a Seventh-Day Adventist complete the following:

Church membership is held at

Church I regularly attend is

NOTE: As family structures can differ widely, please supply any details related to the particular circumstances of your family. 

Detail any legal arrangements of which the school should be aware. If necessary, supply a copy of relevant documentation under Other Documents in the Additional Documents section further in the form.

Step 7 of 11

Directions as to Correspondence

(The following information is requested to avoid errors in correspondence, mailing of accounts etc.)

Send School Newsletters and School Reports to *

Send Fee Accounts to *

Step 8 of 11

References

Please nominate two people who know your child and would provide a reference.

Referee 1

Referee 1 Name *

Phone Number *

Relationship to Applicant *

Referee 2

Referee 2 Name *

Phone Number *

Relationship to Applicant *

Step 9 of 11

Emergency Contacts

(Other than Parent/Guardian)

Contact 1

Full Name *

Relationship to Child *

Home Phone

Work Phone

Mobile Phone

Contact 2

Full Name *

Relationship to Child *

Home Phone

Work Phone

Mobile Phone

Step 10 of 11

Additional Documents

Application will not submit without requested documentation being attached. The documents can either be scanned or photographed for attaching. Please note that Kindy applications do not require a school report to be attached.

Proof of Identity (birth certificate) *Select File

:

Immunisation Records *Select File

:

Copy of current school report
(not applicable for Kindergarten enrolments)Select File

:

Enrolment Form