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NOTE: Children may be enrolled in Kindergarten in one school only, either public or private.

NOTE: In the event that statements made in this application later prove to be false or misleading, a decision on this application may be reversed. Information supplied may need to be checked by the school.

(Enrolment Pack (Part A) - Application Form Version 3.0, updated June 2019 with immunisation.)
Declaration
The information and statements provided in this application for enrolment are true and accurate in relation to:
Name of child:*
First Middle Last
Name of person enrolling child:*
Title First Name Second Name Last Name
Relationship to child:*
Mobile Phone No:*
Telephone (Home):
Telephone (Work):
Was your child born in Australia?*
- Yes
- No
If your child was not born in Australia, you must provide evidence of:*
Check the boxes for the information you will provide and upload supporting documentation at Step 4.
- Date of entry into Australia
- Passport or travel documents
- Current visa subclass, Visa grant number, expiry date and previous visa subclass (if applicable}
If your child is a temporary visa holder, you must also provide:
Choose your option and upload supporting documentation at Step 4.
- Confirmation of placement or enrolment for an overseas fee-paying student or evidence of any permission to transfer provided by TAFE International WA, or;
- Evidence of the visa for which the student has applied if the student holds a bridging visa

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Personal Details
Given names of child:*
First Middle
Child's surname:*
Legal (if different)
Surname
Date of birth:*
Date Format: DD slash MM slash YYYY
Sex*
Male/Female/Other
- Male
- Female
Title*
Mr / Mrs / Ms / Other...
Given names of parent/responsible person:*
First Middle
Surname of parent/responsible person:*
Surname
Residential address:*
Must be completed.

Street Address Nearest intersecting street City/Town/Suburb State Postcode Country
Is your postal address different from residential address?*
- Yes
- No
Postal Address:*
PO Box No. City/Town/Suburb State Postcode Country

Must be completed.
Mobile Phone No:*
Telephone (Home):
Work (if convenient):
Email:*
Enter Email Confirm Email
Legal Details
Are there any Family Court Orders regarding the day to day or long term care, welfare and development of the child?*
- Yes
- No
If yes, please specify and upload supporting documentation at Step 4.
Specify court order(s):*
Is the child subject to access restriction?*
- Yes
- No
If yes, please specify below and upload supporting documentation at Step 3.
Specify child access restriction:*

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Documents to be provided for enrolment:
Please click each checkbox to indicate each document attached to this application form.
Documents Checklist:*
- Birth Certificate (original or certified copy) or extract or other identity documents if applicable. (Principals will refer to guidance 3.5.1 of the Enrolment Procedures where evidence is not provided).
- Australian Immunisation Register (AIR) Immunisation History Statement; or AIR Immunisation History Form; or Immunisation Certificate issued by the Chief Health Officer
- Copies of Family Court or any other court orders (if applicable}
- Proof of address (see Requested documentation in the attached Parent information).
- Information relating to suspensions or exclusions.
- Information relating to disability.
- Other
Other documents:*
List the name of each additional document.
Click the plus icon to add more than one document.
Documents Upload:
Drop files here or

Accepted file types: pdf, doc, docx, rtf, jpg, gif, png.
Date*
Date Format: DD slash MM slash YYYY
Parent/Guardian Signature:*
Consent*
Privacy policy goes here.
I agree to the privacy policy.
Email
This field is for validation purposes and should be left unchanged.

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Declaration

Name	Year Level