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Download application form - Annesley College

Download application form - Annesley College

Application for

Application for Admission Student Details Family name: Given names: Date of birth: (day)/ (month)/ (year) Preferred name: Language Background Major language spoken at home: Language of instruction at primary school: Language of instruction at secondary school: Previous English language study: Yes No Address: Postcode: If yes, what level is the student: Beginner Elementary Intermediate Advanced Home telephone number: (country code) (area code) Number Country of birth: Nationality: Religion: Resident of Australia: Yes No (If the child is not an Australian or New Zealand citizen, please enclose proof of temporary or permanent residency status). Enrolment Details Day student: Year level of entry: Boarder: Year of entry: Proposed school term commencement: 1 2 3 4 Present school: Number of years at present school: Present year level: Has the student previously attended a private school: Yes No If yes, name of school: Student Information I/We give permission for Annesley College to contact my/our daughter’s previous schools and obtain copies of her assessments and reports. Yes No Does your daughter have any learning needs which should be considered in providing her educational program? (eg. learning difficulties or disabilities, gifted and talented). Yes No Does your daughter have any physical disability, vision or hearing disability, extended periods of illness, sleeping difficulties or any other medical condition for which she requires special support? Yes No If you responded ‘yes’ to either of the last two questions, please provide documentation of any psychological or medical assessment. If your daughter is receiving ongoing support in another Kindergarten or School setting, please provide documentation from that institution. If such needs exist, an interview will be held prior to acceptance to clarify our mutual understanding and to ensure that we are able to provide an appropriate educational pathway. It is important that you share any relevant information about your daughter with us. Is this student Aboriginal or Torres Strait Islander origin? Aboriginal: Yes No Torres Strait Islander: Yes No If parents are divorced or separated, who does the student live with? Is there any Court Order or Agreement regarding either parent’s contact with, or responsibility for the child? Yes No If yes, please provide details/copies of relevant court orders.

Father or Guardian Details Family name: Title (Mr, Dr etc): Given names: Relationship to student: Address: Postcode: Marital status: Married Sole Parent Divorced Separated Please include both country & area codes for all contact numbers below: Home telephone: ( ) ( ) Work telephone: ( ) ( ) Mobile: ( ) ( ) Fax number: ( ) ( ) Email address: Occupation: Employer: Mother or Guardian Details Family name: Title (Mrs, Ms, Dr, Miss etc): Given names: Relationship to student: Address: Postcode: Mobile: ( ) ( ) Fax number: ( ) ( ) Email address: Occupation: Employer: International Students Only Passport number: Expiry: / VISA number: Expiry: / English assessment test enclosed: Yes No Guardianship All International Students under the age of 18 must have a guardian in Adelaide who is a mature person of good character. The guardian must be over 21 years of age. The guardian must fulfil the obligations of guardianship as required by DIAC. Guardian’s name in full: Address: Day telephone: ( ) ( ) Evening telephone: ( ) ( ) Mobile: Business address: Postcode: Marital status: Married Sole Parent Divorced Separated Please include both country & area codes for all contact numbers below: Home telephone: ( ) ( ) Relationship of the guardian to the student: Postcode: Work telephone: ( ) ( )

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