Through Christ – learning, living, loving;mind, body, soul
Parent/Guardian Email Address
Title MrMrsMissDrMsProfRev
Given Names
Surname
Relationship to Student FatherMotherGuardian/Other
Martial Status MarriedSingleDefactoSeparatedDivorcedWidowed
Mobile
Home Phone
Residential Address
Suburb
State
Post Code
Country AustraliaNorfolk IslandAustralian External Territories, necNew Zealand-----United StatesCanadaMexicoUnited KingdomAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArmeniaArubaAustraliaAustriaAzerbaijanAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaireBosnia and HerzegovinaBotswanaBouvet Island (Bouvetoya)BrazilBritish Indian Ocean Territory (Chagos Archipelago)British Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCuraçaoCyprusCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKazakhstanKenyaKiribatiKoreaKoreaKuwaitKyrgyz RepublicLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Netherlands)Slovakia (Slovak Republic)SloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSpainSri LankaSudanSurinameSvalbard & Jan Mayen IslandsSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Virgin IslandsU.S. Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe
Country of Birth Not StatedAustraliaNorfolk IslandAustralian External Territories, necNew Zealand-----United StatesCanadaMexicoUnited KingdomAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArmeniaArubaAustraliaAustriaAzerbaijanAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaireBosnia and HerzegovinaBotswanaBouvet Island (Bouvetoya)BrazilBritish Indian Ocean Territory (Chagos Archipelago)British Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCuraçaoCyprusCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKazakhstanKenyaKiribatiKoreaKoreaKuwaitKyrgyz RepublicLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Netherlands)Slovakia (Slovak Republic)SloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSpainSri LankaSudanSurinameSvalbard & Jan Mayen IslandsSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Virgin IslandsU.S. Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe
Nationality
Other language spoken (leave blank if none)
Religion
Occupation
Employer
Current or past employee at Peace Lutheran Primary School YesNo
Past student of Peace Lutheran Primary School YesNo
School Education Year 9 or equivalent or belowYear 10 or equivalentYear 11 or equivalentYear 12 or equivalent
Non-School Education Bachelor degree or aboveAdvanced diploma/DiplomaCertificate I IV (including trade)No non-school qualification
Occupation Group: Group 1 (Senior management in large business organisation, government administration and defence, and qualified professionals.)Group 2 (Other business managers, arts/media/sportspersons and associate professionals.)Group 3 (Tradesmen/women, clerks and skilled office, sales and service staff.)Group 4 (Machine operators, hospitability staff, assistants, labourers and related workers.)Group 8 (Not in paid work in last 12 months.)
Christian Name(s)
Preferred Name
Gender MaleFemale
Residential Address: (Must be a street address, not a PO Box)
City
Postal Code
Home Telephone Number
Is this a silent number? YesNo
Postal Address
Date of Birth
Birthplace
Is this a student in State care? YesNo
If yes, please specify: Period of State Care From To
Primary Email Address (for newsletter etc)
Australian Permanent Resident YesNo
Please tick if your child is of AboriginalTorres StraitPacific Islander descent
Language spoken at home EnglishOther
Religious Denomination
Home Congregation
Which year level will this student enter upon enrolment? PrepYr 1Yr 2Yr 3Yr 4Yr 5Yr 6
In the year
Previous school (if applicable)
Names of other students from this family currently enroled or enroling at this school in the future:
1. Name Date of Birth
2. Name Date of Birth
3. Name Date of Birth
4. Name Date of Birth
Are there any court parenting orders concerning residence, contact, child maintenance, education, health, or other specific issues relating to this student? NoYes ( Please attach a copy of any orders)
If parents are separated or divorced, which parent has legal custody of student? FatherMotherJointOther
Student Resides With: FatherMotherJointLegal Guardians
Who should the School communicate with regarding day to day matters? FatherMotherJointLegal Guardians
Please Select Joint responsibility for mother and fatherFather onlyMother onlyOther
Consent to the publication of photographs and student work. This seeks your consent to the reproduction of:
Photographs taken during the student’s schooling.
Samples of student’s work where the student also consents
Student photographs and/or work samples in school publications, such as the school newsletter, facebook, website, brochures etc
I give consent to the school to publish photographs and student work in school publications
YesNo
I/We give permission for my/our child to participate in excursions and off campus activities associated with their course of study that are held during class time.
I understand and accept that:
Students will travel in a bus to any off campus activities (unless otherwise advised)
Appropriate supervision ratios will be in place and that teachers will exercise their duty of care
Students will be expected to follow the School’s code of behaviour
Students will wear the appropriate uniform (this will be the formal uniform with formal hat unless otherwise advised. Students will not be permitted to attend the activity unless in appropriate uniform.
Special Instructions
Note: The school will advise you in writing of off-campus activities. For overnight activities, a separate permission form will be used.
Please note: This consent for media and general excursions is valid for the duration of your child’s enrolment at Peace. You acknowledge that you understand and agree that if you wish to withdraw your consent, it will be your responsibility to inform the school in writing
Name
Year Level
Age
Please fill out this form even if it isn’t applicable to your child.
Our School offers a broad range of curricular and co-curricular activities. It is important to us that we, as a school, can meet the educational needs of each child. For this reason, all parents are required to complete the following form which will facilitate the enrolment process and enable us to determine the resources required to meet each individual student’s needs.
1. Has your child ever received Learning Support / Special Assistance? YesNo
If yes, how many hours per day?
How many hours per week?
2. Has your child ever repeated a year? YesNo
When?
3. Has your child ever been accelerated? YesNo
4. Does your child have a disability? YesNo
If yes, please identify the nature of the disability. IntellectualSocial/EmotionalNon-verbal learning disordersPhysicalAutism Spectrum DisorderHearingVisionSpecific Learning DisorderADHDA.D.D.Speech LanguageOther
If Other, specify:
5. Has your child received support or been assessed by any of the following specialists? YesNo
If yes, please specify: Guidance OfficerDevelopmental OptometristPaediatricianSpeech PathologistOccupational TherapistPsychologist/CounsellorOther
Do you have a report from the above specialist/s? (If yes, please attach copies of reports to the application) YesNo
6. Does your child have any social difficulties? YesNo
If yes, please specify
7. Has your child ever required behaviour support in the school setting? YesNo
I/we authorise the school to seek medical/dental attention, call an ambulance or to hospitalise my/our son/daughter when considered necessary. I/we further authorise the school that if an emergency occurs requiring surgery, anaesthetic, oxygen, blood transfusion, medication and I am unable to be contacted within a reasonable time, the school has the authority to agree to medically recommended treatment by an accredited medical practitioner on my behalf.
Emergency Contacts: Who may we contact if a parent or guardian cannot be reached in an emergency?
1. Contact Name
Relationship to Student
Phone No. 1
Phone No. 2
Address
2. Contact Name
Does your child have any allergies (including food allergies) or intolerances the School should be aware of, e.g. nut allergy? YesNo
(If Yes), please specify (including the severity)
Does your child have any other medical conditions the School should be aware of? (e.g. Diabetes / previous operations) YesNo
(If Yes), please provide details
Does your child take medication on a regular basis? YesNo
If Yes, what type of medication does your child take and how often?
Has your child been immunised? FullyIncompleteNot Immunised
Please note: You must provide evidence of vaccinations when first enroling in Peace Lutheran School.
Do you have a religious belief, cultural background or special circumstance that you would like the school to be aware of in order to support your child/children. (eg dietary needs)
Please state your main reasons for wishing to enrol your child at Peace Lutheran School:
Parents wishing to apply for their child to be enroled at Peace Lutheran Primary School are asked to:
a) Complete and sign this application; and b) Include the enrolment application fee of $50; and c) Forward the application form and enrolment application fee to the school.
Please note that the enrolment fee is an administration fee and is non-refundable. For Prep enrolments, you will be asked to confirm an enrolment interview time. For enrolment at other year levels you will be contacted for an enrolment interview. Waiting lists can occur and preference may be given to families who are Lutheran or have current siblings (as per constitution). Following a successful interview an Enrolment Contract will be posted and confirmation of your acceptance will be required accompanied by a Confirmation Fee of $150.00. This fee is charged per family Upload files & Documents
