Information Is Being Collected for the Primary Purpose of Creating a Waiting List of Applicants

Information is being collected for the primary purpose of creating a waiting list of applicants. The use of this information will be governed by the Privacy Amendment Act 2000 and the Loreto College Coorparoo Privacy Policy. Loreto Coorparoo Ltd T: (07) 3394 9999 F: (07) 3847 1254 E: [email protected] W: www.loreto.qld.edu.au 415 Cavendish Road Coorparoo Qld 4151 PO Box 1726 Coorparoo DC Qld 4151 ABN 26 609 863 943 Adelaide Ballarat Brisbane Melbourne Perth Sydney ENROLMENT FOR YEAR LEVEL (please circle) 7 8 9 10 11 12 in 20 ____ STUDENT INFORMATION PERSONAL DETAILS Student’s Surname Given Names Home Address BACKGROUND INFORMATION Date of Birth Religion To which Parish does the family belong: Baptism Reconciliation Eucharist Confirmation Sacraments (Please circle) Please forward a copy of each certificate to the College as they become available CURRENT SCHOOL School Name Year Level CULTURAL BACKGROUND Country of Birth Country of Citizenship Australian Resident Yes No Student’s year of arrival in Australia (if applicable) Country of Passport Issue A copy of the visa must be attached (If not Australian) Indigenous Status No Yes, Aboriginal Yes, Torres Strait Islander Is the student of Aboriginal or Torres Strait Islander origin? Yes, Both Aboriginal and Torres Strait Islander Language Spoken at Home SIBLINGS (If more than 3 siblings please attach further details) Sibling 1 Sibling 2 Sibling 3 Surname Given Name/s Relationship to Student Date of Birth School Name (If at school) Resides with Student? OFFICE USE ONLY Student Number Family Number Date Input: MEDICAL BACKGROUND AND NEEDS OF STUDENT MEDICAL CONDITIONS It is essential that you provide us with any medical information which would help us to care for your daughter Allergies: Hearing: Anaphylactic: Speech: Asthma: Heart: Diabetes: Sight: Epilepsy: Any Other: Medications Medications currently taken: Reason for medication: Please describe and indicate if your child has a long term medical condition. STUDENT NEEDS Has your daughter received any learning support? Yes No Has your daughter been verified at her current school with a primary disability? If so, please tick the appropriate box: Autistic Spectrum Disorder Hearing Impairment Intellectual Disability Vision Impairment Physical Impairment Speech & Language Impairment Social/Emotional Disorder If your daughter has a primary disability as indicated above full documentation needs to be attached and updates forwarded to the College as they become available. Does your daughter have multiple disabilities? If so, please describe. Does your daughter have any conditions that may impact on her learning? If so, please tick the appropriate box: Auditory Processing Disorder Attention Deficit Hyperactivity Disorder Disruptive Behaviour Disorder Learning Disability (eg dyslexia, dysgraphia) Is there anything that would preclude your daughter’s full participation in College activities? Please tell us so that we can plan any adaptations to her program. If so, please describe. PARENT/FAMILY INFORMATION PARENT 1 Surname Given Names Title Occupation Residential Address Mailing Address Email Home Phone Mobile Work Phone Relationship to Student Religion Receive Communication? Yes No Country of Birth Receive Absentee SMS? Yes No PARENT 2 Surname Given Names Title Occupation Residential Address Mailing Address Email Home Phone Mobile Work Phone Relationship to Student Religion Receive Communication? Yes No Country of Birth Receive Absentee SMS? Yes No OTHER PARENT/CAREGIVER Surname Given Names Title Occupation Residential Address Mailing Address Email Home Phone Mobile Work Phone Relationship to Student Religion Receive Communication? Yes No Country of Birth Receive Absentee SMS? Yes No EMERGENCY CONTACT Surname Given Names Title Occupation Home Phone Mobile GENERAL DETAILS As required by the Ministerial Council for Education, Early Childhood Development and Youth Affairs Occupation PARENT 1 PARENT 2 OTHER PARENT/CARER Occupation Type Group 1 Group 2 Group 1 Group 2 Group 1 Group 2 What is the occupation group of Group 3 Group 4 Group 3 Group 4 Group 3 Group 4 the parent/caregiver? Not in paid work in last 12 Not in paid work in last 12 Not in paid work in last 12 (please refer to Appendix 1) months months months Highest School Level Year 12 or equivalent Year 12 or equivalent Year 12 or equivalent What is the highest year of Year 11 or equivalent Year 11 or equivalent Year 11 or equivalent primary or secondary school the Year 10 or equivalent Year 10 or equivalent Year 10 or equivalent parent/caregiver has completed? Year 9 or equivalent or below Year 9 or equivalent or below Year 9 or equivalent or below – which includes never – which includes never – which includes never attended attended attended Highest Qualification Bachelor Degree or above Bachelor Degree or above Bachelor Degree or above Completed Advanced Diploma / Diploma Advanced Diploma / Diploma Advanced Diploma / Diploma What is the level of the highest Certificate I to IV – including Certificate I to IV – including Certificate I to IV – including qualification the parent/caregiver trade certificate trade certificate trade certificate has completed? No non-school qualification No non-school qualification No non-school qualification LEGAL INFORMATION Name the Legal Guardian/s of this student: Please indicate any legal issues of which the College should be aware (e.g. family court orders, parental agreements, guardianship orders, child protection orders, etc). A copy of the relevant documentation will be required to be held by the school should enrolment be accepted. ADDITIONAL INFORMATION Please indicate any additional information which may assist with this enrolment application. FAMILY CONNECTION WITH LORETO If a daughter of a past pupil: Mother’s maiden name Which Loreto College? Year left Date of Birth Father’s name: Which Loreto College? Year left Date of Birth If a sister of a past pupil: Sister’s maiden name Which Loreto College? Year left Date of Birth Is your daughter a sister of a current Loreto student/applicant? Name House of mother/father BARRY MORNANE MULHALL WARD and/or sister? (Please circle) Other Loreto connection PLEASE ANSWER THE FOLLOWING QUESTIONS TO FURTHER SUPPORT YOUR DAUGHTER’S APPLICATION Why do you wish your daughter to attend Loreto College? Please outline your family’s degree of involvement in Catholic or Eastern Orthodox community, parish or school and/or comment on why you are wanting your daughter to attend a Catholic school. DECLARATION IN SUPPORT OF MY APPLICATION TO LORETO COLLEGE COORPAROO I declare that I support the College in its religious and faith dimensions and its operational aims. I further declare that if I am successful in my application for enrolment of my daughter I will meet all my financial responsibilities in relation to payment of school fees. SIGNATURE of Parent(s)/Guardian(s): ________________________________ Date: ___________________ ________________________________ Date: ___________________ APPLICATION FEE A non-refundable Application for Enrolment fee of $150 (including GST) is payable. Options for payment are: 1. Cheque payable to Loreto College 2. Online - www.loreto.qld.edu.au/payments/make-a-payment Select payment Option 3 ‘Enrolment Payment’ then ‘Enrolment Fee’ Please record your Receipt No. here: ____________________ 3. MASTERCARD VISA BANKCARD CARDHOLDER’S NAME: Expiry: __________ CCV: ___________ Signature: _________________________________ CHECKLIST Application: Enclosed copies of: Completed the Application for Enrolment Birth Certificate Declaration in Support of Application signed by Sacramental Certificates both parents Application Fee – cheque/online/credit card Primary Disability documentation, eg IEP, specialist medical reports (if applicable) Latest school reports and NAPLAN It is essential that a copy of your daughter’s latest school report, together with copies of her sacramental certificates are enclosed with the application so the enrolment process can continue. APPENDIX 1 - LIST OF PARENTAL OCCUPATIONS Group 1: Senior management in large business organisation, government administration and defence, and qualified professionals Senior executive/manager/department head in industry, commerce, media or other large organisation. Public service manager (Section head or above), regional director, health/education/police/fire services administrator Other administrator [school principal, faculty head/dean, library/museum/gallery director, research facility director] Defence Forces Commissioned Officer Professionals generally have degree or higher qualifications and experience in applying this knowledge to design, develop or operate complex systems; identify, treat and advise on problems; and teach others. Health, Education, Law, Social Welfare, Engineering, Science, Computing professional Business [management consultant, business analyst, accountant, auditor, policy analyst, actuary, valuer] Air/sea transport [aircraft/ship’s captain/officer/pilot, flight officer, flying instructor, air traffic controller] Group 2: Other business managers, arts/media/sportspersons and associate professionals Owner/manager of farm, construction, import/export, wholesale, manufacturing, transport, real estate business Specialist manager [finance/engineering/production/personnel/industrial relations/sales/marketing] Financial services manager [bank branch manager, finance/investment/insurance broker, credit/loans officer] Retail sales/services manager [shop, petrol station, restaurant, club, hotel/motel, cinema, theatre,

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