Trinity Catholic College Lismore€¦ · Calendar Year Enrolling for (eg 2016 / 2017): _...

Student Name: ____________________________ Year Level: ______________ Year: ___________

Trinity Catholic College Lismore

APPLICATION FOR ENROLMENT

1. Submit this completed application form with all requested documentation, including $60 Enrolment Application Fee, for consideration. If all requested documents and signatures are not attached, we are unable to proceed further. Please clarify in writing why you are unable to supply any documents or all signatories cannot sign this document.

2. An Enrolment Interview will be arranged following instruction from the Principal. 3. Following an interview, notification of a decision regarding your application will be communicated. 4. If a position is available, parents/carers accept this offer by returning the signed Acceptance Form and the

Acceptance Fee payment. This fee is non-refundable and is credited to school fees upon commencement. 5. A commencement date will be mutually arranged.

1 Dawson Street, Lismore

ENROLMENT PROCESS

STUDENT DETAILS Calendar Year Enrolling for (eg 2016 / 2017): _

Small/Passport size Year Level of Entry (eg Year 7, Year 9): Photo to be

attached. Current Year Level:

Current School:

Board of Studies Number (if enrolling in Years 10, 11, 12):

Legal Surname Preferred Surname

Legal Given Name/s Preferred Given Name/s

Date of Birth Gender Male Female

Residential Address

State Post Code

Country of Birth What date did the student arrive in Australia?

Residency Status Australian Citizen

Temporary Visa

New Zealand Citiz

Residence Deter

en Norfolk Islander

mination

Permanent Resident

Nationality Visa Class

Aboriginality Aboriginal

Torres Strait Islander

Evidence/Information of Indig

enous Ethnicity must be supplied

Main Language Spoken at Home

Other Language

Religion Current Parish

If Catholic - Sacramental Information (Copy of certificates must be supplied)

Baptism Confirmation Eucharist Reconciliation

Date

Parish

Siblings

Name

Gender

DOB

House (if attending/attended Trinity)

Current School

(if applicable)

Ex-Student of Trinity

(year left school)

Relevant Previous History Are there any special circumstances about the student seeking to be enrolled that the school should know prior to enrolment? (eg living apart from parental supervision, subject of bullying by others) Yes No

If yes please provide a brief description of the circumstances.

Application for Enrolment 2

FAMILY DETAILS Please indicate if a parent is deceased or separated: (If deceased please indicate the year)

Parent/Carer (a) Residing with Child

Parent/Carer (b) Residing with Child

Parent/Carer NOT Residing with Child

Title (eg Mr/Mrs/Ms/Dr)

Surname

Other Name(s)

Relationship to Child (eg mother, father)

Residential Address

Postal Address if different to above

Please indicate which information you would like

School Reports

Correspondence

School Reports

Correspondence

School Reports

Correspondence Email Correspondence Email Correspondence Email Correspondence Text Messages (absences) Text Messages (absences) Text Messages (absences)

Will you be responsible for School Fees?

Yes No

If yes, please complete & sign on Page 8

Yes No


Yes No


(Please note, all persons responsible for school fees must sign on Page 8)

Primary Email Address

Mobile Telephone No

Telephone No (home)

Telephone No (work)

Religion

Country of Birth

Aboriginality Aboriginal


Aboriginal


Aboriginal


Nationality

Country of Citizenship

Main language spoken at home (eg English, Italian etc)

Other language spoken

Ex-Student of Trinity, St Mary’s/Marist Brothers Lismore

Yes No

Yes No

Yes No


OCCUPATION GROUP Group 1 Group 2 Group 3 Group 4 Group 8

Senior management in large business organisation, government administration, defence & qualified professionals

Other business managers, arts/media/ sportspersons and associate professionals.

Tradesmen/women, clerks and skilled office, sales and service staff

Machine operators, hospitality staff, assistants, labourers and related workers.

Not in paid work in the last 12 months.

Parent/Carer (a) Residing with Child

Parent/Carer (b) Residing with Child

Parent/Carer NOT Residing with Child

Occupation Group (Select occupation group above)

Occupation

Employer/Business Name

Highest Qualification Completed (Mark one box only)

Bachelor Degree or above Advanced Diploma/Diploma Certificate 1 to IV (including Trade Certificate) No qualification beyond school



School Education Information (Mark one box only)

Year 12 or equivalent Year 11 or equivalent Year 10 or equivalent



Year 9 or equivalent or below (includes never attended)



OTHER FAMILY MATTERS

Are there any Specific Court Orders or Care and Protection Orders in place that affect the student?

Yes No

(If Y es copies of the Orders must be supplied)

Child lives with mother (% of time) Child lives with father (% of time)

EMERGENCY CONTACTS

Please nominate two people over the age of 18 years who may be contacted in the event of an emergency, if the school is unable to contact the parents/carers listed previously. Therefore, it is preferable that these Emergency Contacts are local and easily reached Please ensure that you

have discussed with these people their willingness to be emergency contacts.

CONTACT DETAILS (first preference)

Surname First Name

Relationship to student Telephone (mobile)

Telephone (home) Telephone (work)

CONTACT DETAILS (second preference)

Surname First Name

Relationship to student Telephone (mobile)

Telephone (home) Telephone (work)


STUDENT MEDICAL INFORMATION Parents must fully inform the College of any medical conditions pertaining to their child.

Student’s Medicare No Student’s Medicare card reference No

Expiry Date

Name of Private Health Fund if applicable

Private Health Fund Member Number

Doctor’s Name Telephone

Dentist’s Name Telephone

Ambulance Cover Yes No Is your child immunised according to the National Immunisation Program Schedule

Yes No

(If yes, a copy of the Immunisations received must be

supplied)

ALLERGIES AND ANAPHYLAXIS Does your child have an Allergy Yes No Has a Doctor diagnosed this

Allergy? Yes No

If your child has an Allergy please specify

Has your child been hospitalised with a severe Allergic reaction (eg Anaphylaxis) or any other Allergy?

Yes No

Is this a severe (life threatening) Allergy (eg Anaphylaxis)?

Yes No Does your child have an ASCIA Action Plan for Anaphylaxis/Allergic Reactions?

Yes No

(If yes, a copy of the Action Plan must be supplied)

Has your child been prescribed an adrenaline autoinjector (ie EpiPen/Anapen) Yes No

If your child has been prescribed an adrenaline autoinjector, you will need to provide the school with one (and renew prior to expiry date). Each time your child is prescribed a new adrenaline autoinjector the doctor should issue an updated ASCIA Action Plan for Anaphylaxis.

It is important that a copy of any updated plan is provided to the school.

OTHER MEDICAL CONDITIONS (EG ASTHMA, DIABETES, EPILEPSY) Does your child have Asthma?

Yes

No

If Yes please specify Occasional Mild Severe

Triggers for your child’s Asthma?

Has a doctor diagnosed Asthma? Yes No

Has your child been hospitalised with Asthma?

Yes

No

Does your child have a documented Asthma Action Plan from a doctor Yes No

(If Y es a copy of the Action

Plan must be supplied)

Specify any medical Condition other than Asthma.

Has a doctor diagnosed this medical condition? Yes No

Has your child been hospitalised with this condition?

Yes

No

Does your child have a documented action plan from a doctor (eg Diabetes action plan)

Yes No

(If Y es a copy of the Action Plan must be supplied)


MEDICATION

Does your child have permission for College authorities to administer a Paracetamol tablet? Yes No

Is your child taking regular medication (eg for Asthma, ADHD etc)? Yes No

(Please give details of the medication)

Parents of children who require their child to be administered prescribed medication at school must provide written permission and the medication should be well labelled.

ADDITIONAL LEARNING AND SUPPORT NEEDS

It is essential to supply current copies of any special reports or assessments on your child. These assessments are for the possible acquisition of Learning Support Funding which may be used to assist the education of your child.

Does your child have any of the following: Yes No

ADD/ADHD Behaviour Disorders Cognitive Impairment

Autism Spectrum Disorder Difficulties in Learning A Language Disorder

A Vision Impairment Intellectual Disability Acquired Brain Injury

A Physical Disability A Hearing Impairment Mental Health Issues

Other (please specify)

HEALTH AND SAFETY – STUDENT’S HISTORY RELEVANT TO RISK ASSESSMENT

To your knowledge, is there anything in your child’s history or circumstances (including medical history) which may pose a risk of any type to him or her, other students, or staff at this school? Yes No

If yes, please provide a brief description:

Does your child have any history of violent behaviour, including self-harm? Yes No

Does your child have any history of behavioural problems? Yes No

Has your child ever been suspended or expelled from any previous school? Yes No


PHOTOGRAPH/VIDEO PERMISSION FORM At certain times throughout the year, our students may have the opportunity to be photographed or filmed for our school publications, such as the school’s newsletter or website and social media, or to promote the school in newspapers and other media.

Trinity Catholic College Lismore, the Catholic Education Commission of NSW and the Lismore Diocese may also wish to use student photographs/videos in print and online promotional, marketing, media and educational materials.

We would like your permission to use your child's photograph/video for the above purposes. Please complete the permission form below and return to the school as soon as possible.

I give my permission for my child’s photograph/video and name to be published in (please tick):

The school website

Social media

Promotional materials

Newspapers and other media

� I authorise Trinity Catholic College Lismore to use the photograph/video in material available free of charge to schools and education departments around Australia for the College’s promotional, marketing, media and educational purposes.

� I give permission for a photograph/video of my child to be used by Trinity Catholic College Lismore, the Lismore Diocese or NSW CEC, in

the agreed publications without acknowledgement, remuneration or compensation.

� I understand and agree that if I do not wish to consent to my child’s photograph/video appearing in any or all of the publications above, or if I wish to withdraw this authorisation and consent, it is my responsibility to notify the College.

Licensed under NEALS: The photograph/video may appear in material which will be available to schools and education departments around Australia under the National Educational Access Licence for Schools (NEALS), which is a licence between education departments of the various States and Territories, allowing schools to use licensed material wholly and freely for educational purposes.

Name of Parent/Carer (please circle)

(Please print)

Signed (Parent/Carer) (please circle) Date:

*Student Signature: Date: *If student is aged 15+, student must also sign

Any personal information will be stored, used and disclosed in accordance with the requirements of the Privacy Act 1988 (Cth).

CHECKLIST OF DOCUMENTS REQUIRED FOR ALL ENROLMENT APPLICATIONS □ $60 Enrolment Application Fee □ Photocopy of Birth Certificate □ Photocopy of Indigenous Ethnicity (if applicable) □ Photocopy of Passport/Citizenship (if born outside

Australia) □ Photocopy/Proof of Visa (if applicable) □ Small passport size photograph (attach to Application) □ Photocopies of Catholic Sacraments (Baptism,

Communion, Reconciliation and Confirmation Certificates □ Photocopy of Immunisations received (if applicable) □ Photocopy of Medical Action Plan (eg Asthma, Diabetes,

Anaphylaxis etc) (if applicable)

□ Photocopy of Court Orders (if applicable) □ Photocopy of most recent Naplan results □ Photocopy of most recent School Report □ Stage 5 or Preliminary HSC Results (if applicable) □ Completed Trinity “Passport” – by student □ Completed Confidential Student Background Survey □ Learning and Support Needs History (if applicable) □ Current copies of any learning, physical, mental or

emotional health Assessments or Reports (if applicable)

□ Read Student’s Code of Behaviour – to be signed in front of the Interviewer at time of interview


SCHOOL FEE PAYMENT

Parents / Carers

Name(s): Signature:

Date:

Name(s):

Person 1

Person 2

Person 3

Relationship to student:

Postal Address:

Telephone:

Signature:

Date:


DECLARATION

Trinity Catholic College Lismore Confidential Background Survey for Student Support Services Name of Student: (please print) Full and frank disclosure of all information requested by the College throughout the enrolment period must be provided and it is a continuing obligation to keep the College informed of any changes as they occur which may affect the student’s well-being or progress at the

College, in accord with the Australian Privacy Principle No. 3 “Collection of Solicited Personal Information”. This includes any learning, physical, medical, social, or emotional needs, whether past or present. All known needs must be fully documented in the enrolment

process with supporting evidence provided. Failure to provide such information will jeopardise the enrolment. SPECIAL NEEDS 1) Does the student have any of the following disabilities:

- Mobility Yes / No - Vision Yes / No - Hearing Yes / No - Learning Yes / No - Emotional Yes / No - Anxiety Yes /No - Mental Health Yes / No - Other

2) Has the student had an Educational Psychologist Assessment? Yes / No If Yes, when?

3) Will the student require support for Learning Difficulties? Yes / No If Yes, when?

4) Has the student received intervention in any of the following? Speech Pathology Yes / No If Yes, when?

Occupational Therapy Yes / No If Yes, when?

Behaviour Management Yes / No If Yes, when?

Small group withdrawal Yes / No If Yes, when?

Reading Programs Yes / No If Yes, when?

Maths Programs Yes / No If Yes, when?

5) Has the student attended any Gifted and Talented Programs? Yes / No If Yes, when? 6) Does the student have a particular area of strength or ability? Yes / No If Yes, in what area? 7) Have you included a copy of all documentation relevant to your child’s

special and / or additional needs? Refer to previous questions Yes / No If No, when will it be available?

ENGLISH AS A SECOND LANGUAGE (ESL) 8) Country of Origin Number of years lived in Australia? 9) Did the student speak English before starting school? Yes / No / a little 10) Can the student speak a language other than English? Yes / No / a little 11) Can the student write a language other than English? Yes / No / a little 12) What language is mainly spoken at home? 13) Has the student ever attended an intensive Language School Yes / No If Yes, when? For how long? 14) Has the student ever attended ESL classes? Yes / No If Yes, where? When? ABORIGINALITY 15) Is the student of Aboriginal or Torres Strait Islander descent? Yes / No GENERAL 16) Is the student on medication? Yes / No If Yes, reason? 17) In what areas may the student require ongoing support at Trinity Catholic

College?

First Name: Surname:

Applying for Year: , 20

Information about You! The ‘School Passport’ is to help the Interviewer learn more about you and your interests before you meet. The statements you make on these pages can be as long or short as you like. Please complete it in your own handwriting.

You are very welcome to bring one or two samples of your work (returned to you at the end of the interview).

My birthday is on: My telephone number is:

Who I am ….

● I enjoy (interests and hobbies):

● People who know me well think I am:

● People who don’t know me well probably think I am:

● I help at home by:

● My friends’ names that might come to Trinity too, are:

● Other family members who attend Trinity Catholic College are:

● My jobs and / or responsibilities during my school years have been:

● I like the kind of teacher who:

● I feel best when the teacher:

● The way I learn best is:

● The things I enjoy most about school:

● I hope to:

● My goal in life is to:

● What I would like to know about Trinity is:

� I would like to come to Trinity because:

Trinity Catholic College is a Catholic Christian community where all students have certain rights and responsibilities which the staff and students respect.

Members of Staff also have rights and responsibilities. Co-operation between students and staff in a harmonious and non-threatening environment will make life at Trinity more enjoyable, memorable and productive for all.

Parents/carers also have rights and responsibilities. Parents/carers, as the first educators of their children, provide key input as to the kind of person their child becomes and working in partnership with the College will assist in the development of responsible young adults.

A condition of enrolment at Trinity is the attendance of students at all compulsory College activities.

In the signing of this Code of Behaviour in the enrolment process, students and parents/carers acknowledge the requirements as outlined, agree to uphold it, and understand that failure to comply may call a student’s enrolment into question.

The College expects students to: 1. Respect our Catholic Christian Heritage by: • Remembering that our Trinity base lies in the Gospel values of love, joy, compassion, peace, justice, and forgiveness. • Being involved and respectful in all prayers/liturgies and attending all compulsory retreats, reflection and encounter days. 2. Foster the Development of the College as a Community by: • Seeking out opportunities to be involved in optional College based activities such as Youth Ministry, Community Service and Student Leadership. • Attending all compulsory College activities and events including Foundation Day. • Being prepared to represent and support the College in Community events such as the annual Anzac March. 3. Contribute to your own good name and that of the College by: • Behaving in an appropriate manner when in public, dressed in uniform • Being polite and welcoming to visitors to the College • Consistently using good manners • Wearing the full correct uniform • Obeying the rules concerning legal and illegal drugs 4. Respect the Truth by: • Being honest • Accepting responsibility for your actions 5. Respecting the Staff by: • Complying with directions given by staff, including casual relief Teachers and non-teaching staff 6. Show care for Fellow Students by: • Respecting other students, their uniqueness and their rights • Encouraging others to do their best • Welcoming and assisting new students • Using personal electronic devices for communication in a responsible manner 7. Respect the property of others and that of the College by: • Asking permission before borrowing items • Not stealing, vandalising or defacing books or property • Returning borrowed property on time, including library books • Caring for Textbooks • Being prepared to pay for damage to property caused by carelessness 8. Demonstrating a Positive Approach to Learning by: • Working to the best of their ability • Bringing correct books and equipment to lessons • Actively participating in lessons • Being in the right place at the right time • Adhering to the ICT Acceptable Use Guidelines

Students are encouraged to strive toward becoming caring, self-disciplined, responsible members of the College community and to live the College motto:-

‘In Word and Deed’ Please read: Student applicant and parent / carer will be asked to sign their agreement to this at the time of an

interview

StudentCodeofBehaviourYears7-12

$60 Application Fee for Enrolment Enquiry to Trinity Catholic College Lismore

Please complete the form below to accompany the enrolment application form, together with the supporting documents requested. No application will proceed unless all documents and this payment is attached with the completed Enrolment Application Form. Thank you.

Name of applicant student:

Application for: Year Calendar Year (eg 2018)

Details for Payment:

Payment by Cheque: Enclosed

Payment by Credit Card:

Amount to be processed: $

Cardholder Name (please print CLEARLY)

Visa / MasterCard number / / /

Expiry date: /

Please note that this is a non-refundable fee. The College does not issue receipts; please check your account for

confirmation of processing.

1. The College collects personal information, including sensitive information about students and parents or carers before and during the course of a pupil’s enrolment at the College. This may be in writing or in the course of conversations. The primary purpose of collecting this information is to enable the College to provide schooling to the pupil and to enable them to take part in all the activities in the College.

2. Some of the information we collect is to satisfy the College’s legal obligations, particularly to enable the College to discharge its duty of care.

3. Laws governing or relating to the operation of a school require certain information to be collected and disclosed. These include relevant Education Acts, and public Health and Child Protection laws.

4. Health information about students is sensitive information within the terms of the Australian Privacy Principles under the Privacy Act. We may ask you to provide medical reports about students from time to time.

5. The College from time to time discloses personal and sensitive information to others for administrative and educational purposes, including to facilitate the transfer of a pupil to another school. This includes to other schools, government departments, Catholic Schools Offices, the Catholic Education Commission, local diocese and parish, medical practitioners and people providing services to the College, including specialist visiting teachers, sport coaches, volunteers and counsellors.

6. Personal information collected from students is regularly disclosed to their parents or carers.

7. The College may store personal information in the ‘cloud’ which may mean that it resides on servers which are situated outside Australia.

8. The College’s Privacy Policy sets out how parents or students may seek access to personal information collected about them. However, there will be occasions when access is denied. Such occasions would include where access would have an unreasonable impact on the privacy of others, where access may result in a breach of the School’s Duty of Care to the pupil, or where students have provided information in confidence.

9. The College’s Privacy Policy also sets out how you may complain about a breach of privacy and how the College will deal with such a complaint.

10. As you may know the College from time to time engages in fundraising activities. Information received from you may be used to make an appeal to you. It may also be disclosed to organisations that assist in the College’s fundraising activities [solely for that purpose]. We will not disclose your personal information to third parties for their own marketing purposes without your consent.

11. On occasions, information such as academic and sporting achievements, pupil activities and similar news is published in School Newsletters and magazines [and on our website]. Photographs of student activities such as sporting events, school camps and school excursions may be taken for publication in School newsletters and magazines and on our intranet. The College will obtain separate permissions from the Students’ parent or carer prior to publication if we would like to include photographs or other identifying material in promotional material for the school or otherwise make it available to the public such as on the internet.

12. We may include students’ and students’ parents/carers contact details in a class list and school directory

13. If you provide the College with the personal information of others, such as doctors or emergency contacts, we encourage you to inform them that you are disclosing that information to the College and why, that they can access that information if they wish and that the College does not usually disclose this information to third parties.

Enrolment Application Checklist Trinity Catholic College

• Every Student Applicant Requires An Application Form (including Siblings Of Current Students)

• Every Student Applicant is Interviewed at the discretion of the Principal An Interview appointment must to be Booked (including Siblings of Current Students)

• Every Application Must Be Submitted To The College for consideration by The Principal before an interview can be offered

• Please consider delay in postage deliveries and address all Applications to:

Attention: College Registrar Trinity Catholic College 1 Dawson Street

Lismore NSW 2480

• Every Application Must Be Completed Fully or it Will Be Returned for Completion (Unless completed, there can be no interview)

• Every Application Is To Be Signed and Completed By All Parties Where Indicated Please note that families who reside at the same residence are both required to sign on the reverse of

the Application Form. (If signatures cannot be obtained, please attach a letter outlining reason why.)

� Please read the ‘document checklist’ enclosed and Tick that you have attached All that is required Before you Send in your Application – please ensure all sections of the Application Form are filled in

• Interviews are conducted during school hours other than when specifically advised

If you have any questions please visit our website, www.trinitylismore.nsw.edu.au, telephone

6627 6600 or email [email protected]: attention The College Registrar

DOCUMENTS REQUIRED TO ACCOMPANY ALL APPLICATIONS Please do not include original documents – photocopies only

□ Photocopy of Birth Certificate

□ Photocopy of Indigenous Ethnicity (if applicable)

□ Photocopy of Passport/Citizenship (if born outside Australia)

□ Photocopy / Proof of Visa (if applicable)

□ Small passport size photograph (attach to Application)

□ Photocopies of Catholic Sacraments (Baptism, Communion, Reconciliation and Confirmation Certificates

□ Photocopy of Immunisation Records

□ Photocopy of Medical Action Plan (eg Asthma, Diabetes, Anaphylaxis etc) (if applicable)

□ Photocopy of Court Orders (if applicable)

□ Photocopy of most recent Naplan results

□ Photocopy of most recent School Report

□ Stage 5 or Preliminary HSC Results (if applicable)

□ Completed Trinity “Passport” – by student

□ Completed Confidential Student Background Survey

□ Learning and Support Needs History (if applicable)

□ Current copies of any learning, physical, mental or emotional health Assessments or Reports and / or Diagnoses (if applicable)

□ $60 Enrolment Application Fee

Please read the Student’s Code of Behaviour as part of the application process – a copy will be signed in front of the Interviewer at the time of the interview.

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Trinity Catholic College Lismore€¦ · Calendar Year Enrolling for (eg 2016 / 2017): _...

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