test page 1 Student Information2 Family Information3 Emergency Contact Details4 Additional Information Student InformationSTUDENT FIRST NAME*STUDENT SURNAME*PREFERRED NAMEGENDER*Select genderMaleFemaleRESIDENTIAL ADDRESS (NOT PO BOX)*DATE OF BIRTH* Date Format: DD slash MM slash YYYY Suburb*Postal Code*RELIGIOUS DENOMINATIONReligious Denomination*Religious DenominationCatholicOtherN/AOtherParishParish SuburbParish PriestDATE OF RECEPTION OF SACRAMENTSBaptism Date Format: DD slash MM slash YYYY Reconciliation Date Format: DD slash MM slash YYYY First Communion Date Format: DD slash MM slash YYYY Confirmation Date Format: DD slash MM slash YYYY ATTACH CERTIFICATE OF SACRAMENTS* Drop files here or 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 IF ABORIGINAL SELECT IF ABORIGINAL SELECT IF TORRES STRAIT ISLANDER SELECT IF TORRES STRAIT ISLANDER Aboriginal/Torres Strait Group of OriginSELECT IF BORN OUTSIDE AUSTRALIA SELECT IF BORN OUTSIDE AUSTRALIA Date of Arrival* Date Format: DD slash MM slash YYYY Number of Years in Australia*Visa Number (e.g. 457)*Attach passport & Visa* Drop files here or Main language spoken at home*Current School*CURRENT SCHOOL DETAILS*Current Year Level* Family InformationSelect Female Parent or Guardian:Female ParentFemale GuardianFirst Name*Surname*Country of Citizenship*Address*Suburb*Postal Code*Email (personal email preferred)* Home NumberWork NumberMobile Number*ABSENTEE SMS ALERT Absentee sms alert Please use this number as the preferred number to notify me of my child’s absence from school. Religious Denomination*SelectCatholicOtherN/AOtherEmployment Information*Employer*Select Male Parent or Guardian:Male ParentMale GuardianFirst Name*Surname*Country of Citizenship*Address*Suburb*Postal Code*Email (personal email preferred)* Phone NumbersWork NumberMobile Number*ABSENTEE SMS ALERT Absentee sms alert Please use this number as the preferred number to notify me of my child’s absence from school. Religious Denomination*SelectCatholicOtherN/AOtherEmployment 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 ANY OTHER CONDITIONS ENFORCED BY LAWUnder 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 GraduatedHousePCGNameYear Level / Year GraduatedHousePCGNameYear Level / Year GraduatedHousePCGNameYear Level / Year GraduatedHousePCGSELECT IF NEW APPLICANT HAS SIBLING(S) ATTENDING OTHER SCHOOLS SELECT IF NEW APPLICANT HAS SIBLINGS ATTENDING OTHER SCHOOLS Name*Year Level*School*NameYear LevelSchoolNameYear LevelSchoolNameYear LevelSchool Emergency Contact Details (Other than a parent / guardian)First Name (Emergency Contact)*Surname*Address*Phone NumberWork NumberSuburb*Postal Code*Mobile Number*RELATION TO STUDENT*SELECT ANOTHER EMERGENCY CONTACT SELECT ANOTHER EMERGENCY CONTACT Name*Surname*Address*Phone NumberWork NumberSuburb*Postal Code*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?DISCLOSUREYesNo 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. NameThis field is for validation purposes and should be left unchanged.
