Enrolment Form (FOR TABLE NOTIFICATION TESTING) 1Student Information2Family Information3Emergency Contact Details4Additional Information Student InformationSTUDENT FIRST NAME STUDENT MIDDLE NAME STUDENT SURNAME* PREFERRED NAME GENDER*Select genderMaleFemaleRESIDENTIAL ADDRESS (NOT PO BOX)* DATE OF BIRTH* DD slash MM slash YYYY Suburb* Postal Code* RELIGIOUS DENOMINATIONReligious Denomination*Religious DenominationCatholicOtherN/AOther Parish Parish Suburb Parish Priest DATE OF RECEPTION OF SACRAMENTSBaptism DD slash MM slash YYYY Reconciliation DD slash MM slash YYYY First Communion DD slash MM slash YYYY Confirmation DD slash MM slash YYYY ATTACH CERTIFICATE OF SACRAMENTS* Drop files here or Select files Max. file size: 64 MB. Immunisation Record:Please attach a copy of your Australian Immunisation Register (AIR) Australian Immunisation History Statement as part of your application. Refer to https://www.healthywa.wa.gov.au/Articles/A_E/Australian-Immunisation-Register for additional information.Immunisation Record:* Drop files here or Select files Max. file size: 64 MB. YEAR LEVELCalendar Year of Entry* Select school year*Select school yearYear 7Year 8Year 9Year 10Year 11Year 12Country of birth* ATTACH BIRTH CERTIFICATE* Drop files here or Select files Max. file size: 64 MB. SELECT IF ABORIGINAL SELECT IF ABORIGINAL SELECT IF TORRES STRAIT ISLANDER SELECT IF TORRES STRAIT ISLANDER Aboriginal/Torres Strait Group of Origin SELECT IF BORN OUTSIDE AUSTRALIA SELECT IF BORN OUTSIDE AUSTRALIA Date of Arrival* DD slash MM slash YYYY Number of Years in Australia* Visa Number (e.g. 457)* Attach passport & Visa* Drop files here or Select files Max. file size: 64 MB. Main language spoken at home* Current School* CURRENT SCHOOL DETAILS* Current Year Level* Attach scanned copy of most recent school report* Drop files here or Select files Max. file size: 64 MB. Family InformationSelect Female Parent or Guardian: Female Parent Female Guardian Title*MissMsMrsFirst Name* Surname* Country of Citizenship* Address* Suburb* Postal Code* Email (personal email preferred)* Home Number Work Number Mobile Number e.g. (04XXXXXXXX)* ABSENTEE SMS ALERT Yes Absentee sms alert Please use this number as the preferred number to notify me of my child’s absence from school.Religious Denomination*SelectCatholicOtherN/AOther Employment Information* Employer* Select Male Parent or Guardian: Male Parent Male Guardian First Name* Surname* Country of Citizenship* Address* Suburb* Postal Code* Email (personal email preferred)* Phone Numbers Work Number Mobile Number e.g. (04XXXXXXXX)* ABSENTEE SMS ALERT Yes Absentee sms alert Please use this number as the preferred number to notify me of my child’s absence from school.Religious Denomination*SelectCatholicOtherN/AOther Employment Information* Employer* SELECT IF THERE IS CUSTODY OR GUARDIANSHIP WITH THIS STUDENT SELECT IF THERE IS CUSTODY OR GUARDIANSHIP WITH THIS STUDENT Name of person(s) with legal guardianship of the student* IF APPLICABLE A COPY OF ANY PARENTING OR RESTRAINING ORDER Drop files here or Select files Max. file size: 64 MB. ANY OTHER CONDITIONS ENFORCED BY LAW Under the provisions of the Family Law Reform Act 1995 biological parents are regarded as having full parental responsibility unless a Parenting Plan or Court Order is presented stating otherwise.SELECT IF PARENT OR SIBLINGS OF NEW APPLICANT ARE PAST OR PRESENT STUDENTS OF LA SALLE COLLEGE SELECT IF PARENT OR SIBLINGS OF NEW APPLICANT WHO ARE PAST OR PRESENT STUDENTS OF LA SALLE COLLEGE Name* Year Level / Year Graduated House PCG Name Year Level / Year Graduated House PCG Name Year Level / Year Graduated House PCG Name Year Level / Year Graduated House PCG SELECT IF NEW APPLICANT HAS SIBLING(S) ATTENDING OTHER SCHOOLS SELECT IF NEW APPLICANT HAS SIBLINGS ATTENDING OTHER SCHOOLS Name* Year Level* School* Name Year Level School Name Year Level School Name Year Level School Emergency Contact Details (Other than a parent / guardian)First Name (Emergency Contact)* Surname* Address* Suburb* Postal Code* Phone Number Work Number Mobile Number* RELATION TO STUDENT* SELECT ANOTHER EMERGENCY CONTACT SELECT ANOTHER EMERGENCY CONTACT Name* Surname* Address* Suburb* Postal Code* Phone Number Work Number Mobile Number* RELATION TO STUDENT* Agreement DISCLOSURE Do you agree that the information supplied in the Student Information and Family Information sections can be provided to the relevant Parish Priest?DISCLOSURE Yes No I/We understand and accept that the completion of this application/enrolment form does not guarantee an enrolment interview. Successful applicants will be determined in accordance with the school’s enrolment criteria. I/We understand and accept that attendance at an interview does not guarantee an enrolment offer being made. I/We understand that enrolment of a student in one Catholic school does not guarantee the enrolment of that student in any other Catholic school. I/We have completed this application form fully and to the best of my/our knowledge. Further, I/we acknowledge and accept that if it can be demonstrated that we have withheld information relevant to the application/enrolment process, especially in relation to this student’s Parenting Orders, then the enrolment may be refused or terminated on this ground. I/We have read and fully understand and agree that enrolment in a Catholic school means that we and our child will participate fully in all required aspects of the educational program of the school including the Religious Education programme. I/We have read and fully understand and agree to the terms and conditions set out in CEWA's School Fees Setting and Collection Policy. I/We agree to abide by the policies and directions of the school and the Catholic Education Commission of Western Australia as they are enacted from time to time. AGREEMENT* SELECT IF YOU AGREE TO ALL THE ABOVE TERMS. CAPTCHACommentsThis field is for validation purposes and should be left unchanged.
