Family Name* (student family name)

First Name* (as provided to Day School)

Middle Name/s (optional)

Gender*

MaleFemale

Date of Birth*

Year Level in 2026 at Mainstream School*

PrepYr 1Yr 2Yr 3Yr 4Yr 5Yr 6Yr 7Yr 8Yr 9Yr 10Yr 11Yr 12

Mainstream School in 2026 (Prep - Year 12)*

—Please choose an option—Abbotsford Primary SchoolAcademy of Mary ImmaculateAdass Israel SchoolAlbany Rise Primary SchoolAlbert Park CollegeAlbert Park Primary SchoolAlia CollegeAlphington Grammar SchoolAlphington Primary SchoolAmsleigh Park Primary SchoolAndale SchoolAntonio Park Primary SchoolAquinas CollegeArmadale Primary SchoolAshburton Primary SchoolAshwood SchoolAshwood High SchoolAspendale Gardens Primary SchoolAspendale Primary SchoolAthol Road Primary SchoolAthol Road Primary School East CampusAuburn High SchoolAuburn Primary SchoolAuburn South Primary SchoolAurora SchoolAvila CollegeBalwyn High SchoolBalwyn North Primary SchoolBalwyn Primary SchoolBeaumaris North Primary SchoolBeaumaris Primary SchoolBelmore SchoolBentleigh Secondary CollegeBentleigh West Primary SchoolBerendale SchoolBerengarra SchoolBerengarra School - Pathways CampusBerry Street School - Noble Park CampusBeth Rivkah Ladies CollegeBialik CollegeBlack Rock Primary SchoolBlackburn English Language SchoolBlackburn English Language School MaroondahBlackburn High SchoolBlackburn Lake Primary SchoolBlackburn Primary SchoolBox Hill High SchoolBox Hill North PrimaryBox Hill Senior Secondary CollegeBrandon Park Primary SchoolBrighton Beach Primary SchoolBrighton Grammar SchoolBrighton Grammar School - Primary CampusBrighton Primary SchoolBrighton Secondary CollegeBundalaguah PrimaryBungaree Primary SchoolBurwood East Primary SchoolBurwood East Special Developmental SchoolBurwood Heights PrimaryCairnlea Park Primary SchoolCamberwell Anglican Girls' Grammar SchoolCamberwell Grammar SchoolCamberwell High SchoolCamberwell Primary SchoolCamberwell South Primary SchoolCamelot Rise Primary SchoolCanterbury Girls Secondary CollegeCanterbury Primary SchoolCarey Baptist Grammar SchoolCarey Baptist Grammar School - Donvale CampusCarlton Gardens Primary SchoolCarlton North Primary SchoolCarlton Primary SchoolCarnegie Primary SchoolCarrum Downs Secondary CollegeCarrum Primary SchoolCarwatha College P-12Casey Grammar SchoolCatholic Regional CollegeCaulfield Grammar SchoolCaulfield Grammar School - Malvern CampusCaulfield Grammar School - Wheelers Hill CampusCaulfield Junior CollegeCaulfield Park Community SchoolCaulfield Park Community School Oakwood CampusCaulfield Primary SchoolCaulfield South Primary SchChandler Park PrimaryChandler Park Primary School MaralingaChelsea Heights Primary SchoolChelsea Primary SchoolCheltenham East Primary SchoolCheltenham Primary SchoolCheltenham Secondary CollegeChrist Church Grammar SchoolChrist Our Holy Redeemer SchoolChrist the King Anglican CollegeChrist the King Primary SchoolChrist the King SchoolChristian Brothers' CollegeChristian Brothers College Balaclava CampusClarinda Primary SchoolClayton North Primary SchoolClayton South Primary SchoolClifton Hill Primary SchoolCoatesville Primary SchoolCobden Technical SchoolCohuna Consolidated SchoolCohuna Secondary CollegeCoimadai Primary SchoolColbinabbin Primary SchoolColdstream Primary SchoolColeraine Primary SchoolCollingwood CollegeCollingwood College Collingwood Alternative SchoolCollingwood English Language SchoolConcord SchoolCongupna Primary SchoolCoolaroo South Primary SchoolCornish CollegeDandenong High SchoolDandenong High School Cleeland CampusDandenong High School Doveton CampusDandenong North Primary SchoolDandenong Primary SchoolDandenong Ranges Steiner SchoolDandenong South Primary SchoolDandenong Valley Special Developmental SchoolDandenong West Primary SchoolDe La Salle CollegeDe La Salle College - Kinnoull CampusDeutsche Schule MelbourneDistance Education Centre VictoriaDivrei EminehDoncaster Gardens Primary SchoolDoncaster Primary SchoolDoncaster Secondary CollegeEast Bentleigh Primary SchoolEast Doncaster Secondary CollegeElsternwick Primary SchoolElwood CollegeElwood Primary SchoolEmerson SchoolEmerson School-Emerson Middle SchoolEmmaus CollegeErasmus SchoolEssex Heights Primary SchoolFairfield Primary SchoolFairhills High SchoolFairhills Primary SchoolFintona Girls' SchoolFintona Girls' School - Junior SchoolFirbank Grammar SchoolFirbank Grammar School - Turner House Jnr SchoolFitzroy Community SchoolFitzroy High SchoolFitzroy North Primary SchoolFitzroy Primary SchoolFlemington Primary SchoolForest Hill CollegeForest Street Primary SchoolFountain Gate Primary SchoolFountain Gate Secondary CollegeFrank Dando Sports AcademyFrank W Cheshire Education CentreGalilee Regional Catholic Primary SchoolGardenvale Primary SchoolGarfield Primary SchoolGeelong Grammar School - Toorak CampusGenazzano FCJ CollegeGladesville Primary SchoolGlen Eira CollegeGlen Eira College - Glen Eira English Language CentreGlen Huntly Primary SchoolGlen Iris Primary SchoolGlen Waverley Primary SchoolGlen Waverley Secondary CollegeGlen Waverley South Primary SchoolGlenallen SchoolGlendal Primary SchoolGleneagles Secondary CollegeGlenferrie Primary SchoolGreensborough Primary SchoolGreensborough Secondary CollegeGreythorn Primary SchoolGruyere Primary SchoolGuardian Childcare and EducationHaileybury – Berwick CampusHaileybury – Brighton CampusHaileybury – Keysborough CampusHallam Primary SchoolHallam Senior Secondary CollegeHampton Park Primary SchoolHampton Park Secondary CollegeHampton Primary SchoolHarkaway Primary SchoolHarrisfield Primary SchoolHartwell Primary SchoolHawkesdale P12 CollegeHawthorn Secondary CollegeHawthorn West Primary SchoolHeany Park Primary SchoolHeatherhill Primary SchoolHeatherton Christian CollegeHeatherwood SchoolHeritage CollegeHeritage College Officer CampusHighvale Primary SchoolHighvale Secondary CollegeHillsmeade Primary SchoolHolmes Secondary SchoolHoly Eucharist SchoolHoly Family Primary SchoolHoly Family SchoolHoly Name SchoolHoly Rosary SchoolHoly Saviour Primary SchoolHoly Spirit SchoolHoly Trinity Primary SchoolHughesdale Primary SchoolHuntingdale Primary SchoolHuntingtower SchoolImmaculate Heart of Mary Primary SchoolInglewood Primary SchoolIvanhoe East Primary SchoolIvanhoe Girls' Grammar SchoolIvanhoe Grammar SchoolIvanhoe Primary SchoolJacana School for AutismJells Park Primary SchoolJohn Monash Science SchoolJohn Paul CollegeKamaruka Education CentreKananook Primary SchoolKaringal Heights Primary SchoolKaringal Primary SchoolKaroo Primary SchoolKatamatite Primary SchoolKatandra SchoolKennington Primary SchoolKensington Community High SchoolKensington Primary SchoolKew East Primary SchoolKew High SchoolKew Primary SchoolKeysborough Primary SchoolKeysborough Secondary CollegeKeysborough Secondary College Acacia CampusKilbreda CollegeKillester CollegeKilsyth Primary SchoolKilvington Grammar SchoolKingsbury Primary SchoolKingsley Park Primary SchoolKingston Heath Primary SchoolKingsville Primary SchoolKingswood CollegeKingswood Primary SchoolKnox Central Primary SchoolKnox Gardens Primary SchoolKnox Park Primary SchoolKoonung Secondary CollegeKorowa Anglican Girls' SchoolLaburnum Primary SchoolLalbert Primary SchoolLancaster Primary SchoolLancefield Primary SchoolLandsborough Primary SchoolLara Lake Primary SchoolLara Primary SchoolLara Secondary CollegeLardner and District Primary SchoolLarmenier Special SchoolLaunching Place Primary SchoolLaurimar Primary SchoolLauriston Girls' SchoolLauriston Girls' School - BlairholmeLauriston Girls' School - Howqua CampusLavalla Catholic College - Presentation CampusLe Page Primary SchoolLearning Cooperative LtdLeibler Yavneh CollegeLighthouse Christian CollegeLighthouse Christian College CranbourneLindenow Primary SchoolLindenow Primary School - Woodglen campusLindenow South Primary SchoolLinton Primary SchoolLivingstone Primary SchoolLloyd Street Primary SchoolLoreto - Mandeville HallLynall Hall Community SchoolLynall Hall Community School Richmond CampusLynall Hall Community School The Island CampusLyndale Greens Primary SchoolLyndale Secondary CollegeLysterfield Primary SchoolMacKillop Specialist SchoolMacRobertson Girls High SchoolMahogany Rise Primary SchoolMalmsbury Primary SchoolMalvern Central SchoolMalvern Primary SchoolMalvern Valley Primary SchoolManchester Primary SchoolMaramba Primary SchoolMaranatha Christian SchoolMarcellin CollegeMarlborough Primary SchoolMaroona Primary SchoolMary Immaculate SchoolMary MacKillop Primary SchoolMastery Schools VictoriaMazenod CollegeMcClelland CollegeMckinnon Primary SchoolMckinnon Secondary CollegeMelba Secondary CollegeMelba Secondary College Croydon CampusMelbourne Girls CollegeMelbourne Girls Grammar - Morris HallMelbourne Girls Grammar SchoolMelbourne Grammar SchoolMelbourne Grammar School - Grimwade HouseMelbourne Grammar School - WadhurstMelbourne High SchoolMelbourne Montessori SchoolMentone Girls' Grammar SchoolMentone Girls Secondary CollegeMentone Grammar SchoolMentone Park Primary SchoolMentone Primary SchoolMerri Creek Primary SchoolMethodist Ladies' CollegeMethodist Ladies' College - Marshmead CampusMiddle Park Primary SchoolMitcham Primary SchoolMonash Special Developmental SchoolMont Albert Primary SchoolMontague Continuing Education CentreMonterey Secondary CollegeMontrose Primary SchoolMoomba Park Primary SchoolMoonambel Primary SchoolMoonee Ponds Primary SchoolMoonee Ponds West Primary SchoolMoorabbin Primary SchoolMoorooduc Primary SchoolMooroolbark CollegeMooroolbark East Primary SchoolMooroopna North Primary SchoolMooroopna Park Primary SchoolMooroopna Primary SchoolMooroopna Secondary CollegeMorang South Primary SchoolMordialloc Beach Primary SchoolMordialloc CollegeMoriac Primary SchoolMossfiel Primary SchoolMossgiel Park Primary SchoolMother of God Primary SchoolMother of God SchoolMother Teresa Catholic Primary SchoolMount Blowhard Primary SchoolMount Carmel Christian SchoolMount Clear CollegeMount Clear Primary SchoolMount Dandenong Primary SchoolMount Duneed Regional Primary SchoolMount View Primary SchoolMount Waverley North Primary SchoolMount Waverley Heights Primary SchoolMount Waverley Primary SchoolMount Waverley Secondary CollegeMountain Gate Primary SchoolMulgrave Primary SchoolMullauna Secondary CollegeMurrumbeena Primary SchoolNambrok Denison Primary SchoolNaranga Special SchoolNazareth CollegeNazareth Primary SchoolNeerim District Rural PrimaryNeerim District Secondary CollegeNeerim South Primary SchoolNepean Special SchoolNew Generation CollegeNewham Primary SchoolNoble Park English Language SchoolNoble Park English Language School Casey CampusNoble Park English Language School Springvale CampusNoble Park Primary SchoolNoble Park Secondary CollegeNorth Melbourne Primary SchoolNossal High SchoolOakleigh GrammarOakleigh Primary SchoolOakleigh South Primary SchoolOld Orchard Primary SchoolOrchard Grove Primary SchoolOrmond Primary SchoolOur Holy Redeemer SchoolOur Lady Help of Christians SchoolOur Lady of Good Counsel Parish SchoolOur Lady of Lourdes SchoolOur Lady of Mercy CollegeOur Lady of Perpetual Help SchoolOur Lady of Perpetual Succour SchoolOur Lady of Sion CollegeOur Lady of the Assumption SchoolOur Lady of the Immaculate Conception SchoolOur Lady of the Nativity SchoolOur Lady of the Pines SchoolOur Lady of the Sacred Heart CollegeOur Lady of the Sacred Heart SchoolOur Lady of the Southern Cross Catholic PrimaryOur Lady of the Way SchoolOur Lady Star of the Sea Primary SchoolOur Lady's Primary SchoolOzford CollegePark Orchards Primary SchoolPark Ridge Primary SchoolParkdale Primary SchoolParkdale Secondary CollegeParkhill Primary SchoolParktone Primary SchoolParkville CollegeParkville College-Malmsbury CampusPatterson River Secondary CollegePinewood Primary SchoolPort Melbourne Primary SchoolPort Melbourne Secondary CollegePort Phillip Specialist SchoolPresbyterian Ladies' CollegePresentation College WindsorPreshil - The Margaret Lyttle Memorial SchoolRegency Park Primary SchoolResurrection Primary SchoolResurrection SchoolRichmond Primary SchoolRichmond West Primary SchoolRipponlea Primary SchoolRoberts McCubbin Primary SchoolRosewood Downs Primary SchoolRossbourne SchoolRowellyn Park Primary SchoolRowville Primary SchoolRowville Secondary CollegeRowville Secondary College-Eastern CampusRuyton Girls' SchoolSacre CoeurSacred Heart CollegeSacred Heart Girls' CollegeSacred Heart Parish SchoolSacred Heart Primary SchoolSacred Heart SchoolSalesian CollegeSandringham CollegeSandringham College Beaumaris Year 7-10 CampusSandringham College SandringhamSandringham East Primary SchoolSandringham Primary SchoolScoresby Primary SchoolScoresby Secondary CollegeScotch CollegeSeaford North Primary SchoolSeaford Park Primary SchoolSeaford Primary SchoolSerpell Primary SchoolShelford Girls' GrammarSherbrooke Community SchoolSholem Aleichem CollegeSiena College LtdSilverton Primary SchoolSimonds Catholic CollegeSimonds Catholic College - St Brigid's VCE CampusSirius CollegeSirius College - Dandenong CampusSirius College - Ibrahim Dellal CampusSirius College - Meadow Fair CampusSolway Primary SchoolSophia Mundi Steiner SchoolSouth Melbourne Park Primary SchoolSouth Oakleigh Secondary CollegeSouth Yarra Primary SchoolSouthern Autistic SchoolSouthmoor Primary SchoolSouthwood Boys Grammar SchoolSpring Parks Primary SchoolSpring Parks Primary School Valley CampusSpringvale Park Special Developmental SchoolSpringvale Rise Primary SchoolSpringvale Rise Primary School Springvale Road CampusSt Agnes' Primary SchoolSt Aloysius CollegeSt Aloysius' SchoolSt Ambrose's Primary SchoolSt Andrews Christian CollegeSt Andrews Primary SchoolSt Andrew's SchoolSt Anne's Parish SchoolSt Anne's Primary SchoolSt Anne's SchoolSt Anthony's Primary SchoolSt Anthony's SchoolSt Augustine's Primary SchoolSt Augustine's SchoolSt Bede's CollegeSt Bede's Parish SchoolSt Benedict's Parish SchoolSt Bernadette's Primary SchoolSt Bernadette's SchoolSt Bridget's Primary SchoolSt Brigid's Primary SchoolSt Brigid's SchoolSt Catherine's Catholic Primary SchoolSt Catherine's SchoolSt Cecilia's Parish SchoolSt Christopher's SchoolSt Clare's SchoolSt Colman's SchoolSt Dominic's SchoolSt Elizabeth's SchoolSt Finbar's SchoolSt Francis De Sales Catholic Primary SchoolSt Francis de Sales SchoolSt Francis of Assisi Catholic Primary SchoolSt Francis of Assisi Primary SchoolSt Francis of the Fields Catholic Primary SchoolSt Francis' SchoolSt Francis Xavier CollegeSt Francis Xavier College - Junior CampusSt Francis Xavier Primary SchoolSt Francis Xavier SchoolSt Francis Xavier's Parish Primary SchoolSt Gerard's Primary SchoolSt James CollegeSt James' Parish Primary SchoolSt James' SchoolSt James the Apostle SchoolSt Joachim's Catholic Primary SchoolSt Joan of Arc SchoolSt John Bosco's SchoolSt John the Baptist SchoolSt John Vianney's Primary SchoolSt John Vianney's SchoolSt John's Primary SchoolSt John's Regional CollegeSt John's SchoolSt Joseph's CollegeSt Joseph's Flexible Learning CentreSt Joseph's Parish Primary SchoolSt Joseph's Primary SchoolSt Joseph's SchoolSt Jude the Apostle SchoolSt Justin's Primary SchoolSt Kevin's CollegeSt Kevin's College GlendaloughSt Kevin's College WaterfordSt Kevin's Parish SchoolSt Kevin's Primary SchoolSt Kevin's SchoolSt Kilda Park Primary SchoolSt Kilda Primary SchoolSt Leonards Primary SchoolSt Leonard's CollegeSt Louis de Montfort's Primary SchoolSt Luke the Evangelist SchoolSt Luke's Primary SchoolSt Luke's SchoolSt Margaret Mary's SchoolSt Margaret's Primary SchoolSt Margaret's SchoolSt Margaret's School - Berwick Grammar CampusSt Mark's Primary SchoolSt Mark's SchoolSt Mary MacKillop Primary SchoolSt Mary Magdalen's SchoolSt Mary of the Angels CollegeSt Mary's College for Hearing Impaired StudentsSt Mary's College for Hearing Impaired Students-DandenongSt Mary's Primary SchoolSt Mary's SchoolSt Mary's School - Campus 2St Mary's School-St Kilda EastSt Michael's Grammar SchoolSt Michael's Primary SchoolSt Michael's SchoolSt Patrick's Primary SchoolSt Patrick's SchoolSt Paul Apostle North SchoolSt Paul's CollegeSt Paul's Kealba Catholic SchoolSt Paul's Primary SchoolSt Peter's CollegeSt Peter's SchoolSt Philip's SchoolSt Roch's Parish SchoolSt Scholastica's Primary SchoolSt Stephen's SchoolSt Thomas Aquinas Catholic SchoolSt Thomas More SchoolSt Thomas More's Primary SchoolSt Thomas More's SchoolSt Thomas' Primary SchoolSt Thomas' SchoolSt Thomas the Apostle SchoolSt Vincent de Paul SchoolStar of the Sea CollegeStella Maris Catholic Primary SchoolStella Maris Primary SchoolStonnington Primary SchoolStott's CollegeStrathcona Baptist Girls' Grammar SchoolStrathcona Baptist Girls' Grammar School - HawthornStrathcona Baptist Girls' Grammar School - JuniorSts Peter and Paul's SchoolSunnyside KindergartenSurrey Hills Primary SchoolSwinburne Senior Secondary CollegeSyndal South Primary SchoolTaylors Senior CollegeTemplestowe CollegeTemplestowe Heights Primary SchoolTempleton Primary SchoolThe Currajong SchoolThe King David SchoolThe King David School - Kooyong Road CampusThe Knox SchoolThe Melbourne City SchoolThornbury High SchoolThornbury Primary SchoolTintern Girls Grammar SchoolTintern Schools Senior CollegeTinternvale Primary SchoolToorak Primary SchoolTrinity Anglican College WodongaTrinity Catholic Primary SchoolTrinity Catholic SchoolTrinity Grammar SchoolTucker Road Bentleigh Primary SchoolTyers Primary SchoolValkstone Primary SchoolVermont Primary SchoolVermont Secondary CollegeVermont South Special SchoolVictoria University Secondary CollegeVictorian College For The DeafVictorian College Of The Arts Secondary SchoolViewbank CollegeViewbank Primary SchoolWallan Primary SchoolWallan Secondary CollegeWaverley Christian CollegeWaverley Meadows Primary SchoolWellington Secondary CollegeWesley CollegeWesley CollegeWesley College - Clunes CampWesley College Elsternwick CampusWesley College Glen Waverley CampusWestall Primary SchoolWestall Secondary CollegeWestall Secondary CollegeWestall English Language CentreWheelers Hill Primary SchoolWheelers Hill Secondary CollegeWooranna Park Primary SchoolXavier CollegeXavier College - Burke HallXavier College - Kostka HallYandoit Primary SchoolYarra Primary SchoolYarra Road Primary SchoolYarra Valley Grammar SchoolYarrabah SchoolYarralinda SchoolYarraman Oaks Primary SchoolYarraville Special Developmental SchoolYarraville West Primary SchoolYeshivah and Beth Rivkah CollegesYesodei Hatorah CollegeYesodei HaTorah College Secondary Campus

School Suburb*

—Please choose an option—-Please select the above school Suburb-AbbotsfordAlbert ParkAlphingtonArmadaleAscot ValeAshburtonAshwoodAspendaleAspendale GardensAttwoodAuburnAuroraAvondale HeightsAvonsleighBalaclavaBalwynBalwyn NorthBandooraBangholmeBayswaterBayswater NorthBeaconsfieldBeaumarisBelgraveBelgrave HeightsBelgrave SouthBellfieldBennettswoodBentleighBentleigh EastBerwickBitternBlack RockBlackburnBlackburn NorthBlackburn SouthBlairgowrieBonbeachBox HillBox Hill NorthBox Hill SouthBraesideBraybrookBriar HillBrightonBrighton EastBroadmeadowsBrookfieldBrooklynBullaBulleenBundooraBurnleyBurnsideBurnside HeightsBurwoodBurwood EastCairnleaCalder ParkCamberwellCampbellfieldCanterburyCarlton NorthCarltonCarnegieCarrumCarrum DownsCaulfieldCaulfield EastCaulfield NorthCaulfield SouthChadstoneChelseaChelsea HeightsCheltenhamChirnside ParkClarindaClaytonClayton SouthClematisClifton HillCoburg NorthColdstreamCollingwoodCremorneDandenongDandenong NorthDandenong SouthDeer ParkDelaheyDerrimutDiamond CreekDingley VillageDocklandsDoncasterDoncaster EastDonvaleDoreenDovetonEaglemontEast MelbourneEdithvaleElsternwickElthamEltham NorthElwoodEmeraldEndeavour HillsEppingEssendon FieldsEssendon NorthEssendon WestEssendonEumemmerringFairfieldFawknerFerntree GullyFerny CreekFitzroyFitzroy NorthFlemingtonFootscrayForest HillFrankstonFrankston NorthFrankston SouthGardenvaleGladstone ParkGlen HuntlyGlen IrisGlen WaverleyGowanbraeGreenvaleGuys HillHadfieldHallamHamptonHampton EastHampton ParkHarkawayHawthornHawthorn EastHeatherdaleHeathertonHeathmontHeidelbergHeidelberg HeightsHeidelberg WestHighettHillsideHoppers CrossingHoustonHughesdaleHuntingdaleHurstbridgeIvanhoeIvanhoe EastJacanaJunction VillageKallistaKaloramaKaringalKealbaKeilorKeilor DownsKeilor EastKeilor LodgeKeilor NorthKeilor ParkKensingtonKerrimuirKewKew EastKeysboroughKilsythKilsyth SouthKings ParkKingsburyKingsvilleKnoxfieldKooyongKurunjangLaburnumLavertonLaverton NorthLysterfieldLysterfield SouthMacclesfieldMcCraeMcKinnonMacleodMaidstoneMalvernMalvern EastMaribyrnongMeadow HeightsMelbourneMentoneMenzies CreekMerndaMicklehamMiddle ParkMilgate Park EstateMonbulkMont AlbertMont Albert NorthMontmorencyMontroseMoonee PondsMoorabbin AirportMoorabbinMordiallocMorningtonMount DandenongMount ElizaMount EvelynMount MarthaMount WaverleyMulgraveMurrumbeenaNoble ParkNoble Park NorthNorth MelbourneNorth RichmondNorth WarrandyteNorthcoteNorwoodNotting HillNunawadingOakleighOakleigh EastOakleigh SouthOrmondPakenhamPanton HillPark OrchardsParkdaleParkvillePascoe Vale SouthPascoe ValeThe PatchPatterson LakesPennydalePort MelbournePortseaPrahranPrestonPrinces HillRavenhallResearchReservoirRichmondRipponleaRockbankRowvilleRoxburgh ParkSt AlbansSt HelenaSt KildaSt Kilda EastSt Kilda WestSandhurstSandringhamScoresbySeabrookSeafordSeaholmeSeddonSherbrookeSkyeSomertonSomervilleSouth KingsvilleSouth MelbourneSouth YarraSouthbankSpotswoodSpringvaleSpringvale SouthSurrey HillsSydenhamSyndalTally HoTarneitTaylors HillTecomaTemplestoweTemplestowe LowerThe BasinThomastownThornburyToorakTootgarookTottenhamTravancoreTremontTruganinaTullamarineUpfieldUpper Ferntree GullyViewbankWantirnaWantirna SouthVermontVermont SouthWaterwaysWatsonia NorthWattle GlenWaverley ParkWerribeeWerribee SouthWest FootscrayWest MelbourneWestgarthWheelers HillWildwoodWilliams LandingWindsorWyndham ValeYallambieYarrambatYarravilleYuroke

Residential Address (Number, Street Name, Suburb, Postcode)*

Has the child attended another Greek School in the past? *

YesNo

Father's Name*

Mobile phone

Email

Mother's Name*

Mobile phone*

Mother's Email*

Primary contact person* :

MotherFather

Does the student suffer from any allergies?

NoYes

__________________________________________________________________

 Any other Medical Condition?

NoYes

__________________________________________________________________

 Do you have Ambulance Insurance Cover?

NoYes

Emergency Contact Details*

Full Name:

Phone # :

SCHOOL MEDIA*:

I give permission for my child to participate in any appropriate school media activities. This permission includes the right to be photographed or filmed in a school activity by the school, press or television networks. Photos or videos could be published in any or all of the following: school newsletter, school website, newspapers or other print media. I understand and agree that if I wish to withdraw this authorization it will be my responsibility to inform the school in writing, using this form.

YesNo

MEDICAL EMERGENCIES*:

I understand that in case of an emergency such as an injury or the child becomes ill during school hours, I give permission to the school to call an ambulance or a medical practitioner to cater for my child’s medical needs, where I cannot be contacted. Zenon cannot be held responsible for tending to student health issues if these have not been disclosed to the school by the parents.

YesNo

Select preferred Greek-School Day *:

- You can always change to a different session at any time

Saturday 9:30amMonday 4:30pmFriday 5:00pm

Any special requests or comments you may wish to convey to Zenon Administration (optional)

Name of person completing this form*:

Parent/Guardian Privacy Consent and Declaration

I confirm that the information provided on this enrolment form is true and correct and I acknowledge and agree to the terms and conditions of enrolment.
I consent to:
- the collection of my child’s health and personal information by the community language school;
- the school disclosing my child’s personal information contained in this enrolment form to the Department of Education and Training for data verification and funding purposes;
- the Principal or teacher (where the Principal or teacher in charge is unable to contact me) to administer such first aid to my child as the Principal or staff member may consider to be reasonably necessary including disclosing personal and health information to professional third parties in the event of a medical emergency.

I have read and accept the Terms and Conditions

I Accept

I choose this payment method *:

—Please choose an option—Up front (total amount paid by Jan 28)By two instalments (First by Jan 28, Second by June 28)

Where did you first hear about Zenon*:

Online searchSocial MediaA friendA family memberAd in the paperStreet signPast Zenon studentExisting Zenon studentOther