confidential application form provider number ... - Loyola College

CONFIDENTIAL
APPLICATION FORM
PROVIDER NUMBER 00558F
FULL FEE PAYING OVERSEAS STUDENT
Loyola College
325 Grimshaw Street
Watsonia Vic 3087
Telephone: (03) 9434 4466
Facsimile: (03) 9432 2476
Website: www.loyola.vic.edu.au
NAME
APPLICATION FOR ADMISSION INTO YEAR LEVEL
IN
SURNAME: ________________________CHRISTIAN NAMES: _______________________
ADDRESS: __________________________________________________P’CODE:_______
TELEPHONE NO: _________________DATE OF BIRTH:__________ MALE/FEMALE________
RELIGION: ___________________BAPTISIMAL DATE & PLACE: __________________________
NATIONALITY: ________________________________________
FATHER/GUARDIAN
FULL NAME:____________________________
DATE OF BIRTH: ________________________
COUNTRY OF BIRTH: ____________________
RELIGION: _____________________________
OCCUPATION: _________________________
MARITAL STATUS:
MARRIED/SEPARATED/DIVORCED/WIDOWER
BUSINESS TELEPHONE: _____________________
EMAIL:
MOTHER/GUARDIAN
FULL NAME: ___________________________
DATE OF BIRTH: _______________________
COUNTRY OF BIRTH: ___________________
RELIGION: ____________________________
OCCUPATION: _________________________
MARITAL STATUS:
MARRIED/SEPARATED/DIVORCED/WIDOW
BUSINESS TELEPHONE: _____________________
EMAIL:
Correspondence to be addressed to: ________________________________________(eg Mr & Mrs A Smith)
NO. IN FAMILY: BOYS _____
BROTHER/SISTERS BEING EDUCATED
GIRLS_____
IN AUSTRALIA:
LANGUAGES SPOKEN AT HOME: Name: Institution:
1. __________________________ 1. ______________ ____________________
2. __________________________ 2. ______________ ____________________
3. __________________________ 3. ______________ ____________________
4. PROFICIENCY IN SPOKEN ENGLISH:______________________________________________
_______________________________________________________________________________
Please see over

SPECIAL NEEDS:
Is there any other information relevant to the application (eg physical disabilities, special needs,
behavioural problems, etc): YES/NO. If yes, please explain______________________________
_____________________________________________________________________________
_____________________________________________________________________________
EDUCATIONAL STANDARD:
Current School: ________________________________________________________________
Year Level: ____________ Subjects being studied: ____________________________________
_____________________________________________________________________________
(Please attach statement on why you wish to study in Australia and copies of recent school reports)
PARENTAL AGREEMENT: If our child is enrolled at the College we agree to observe the
regulations regarding uniform and conduct. We undertake the responsibility for payment of all
school fees charged. We have read and understand the fees and refund policy and other
information provided below.
SIGNED:_________________________ ____________________________ ________________
(Mother) (Father) (Date)
IN TWO PARENT HOUSEHOLDS BOTH PARENTS ARE TO SIGN
1. Fees:
ENROLMENT INFORMATION
FULL FEE PAYING OVERSEAS STUDENTS
For students in Years 7 – 12 AUD $14,850 PER ANNUM plus Building Levy $ 670
2. School Fees Refund Policy: A non-refundable Enrolment Fee of AUD $100 is charged. School fees are
payable twice per year. Half of the total fee is to be paid one month before the first day of attendance and
the second payment is made on the first day of the second semester. There is no refund of the first
payment and refunds of the second payment are calculated on a pro-rata basis and only paid in cases of
extreme financial hardship or personal emergency necessitating the student’s withdrawal from the
College. Refund will only follow from thorough investigation and may occur some weeks after the
student’s withdrawal.
3. Indemnity Procedures: Loyola College is insured for the refund of overseas student’s fees in the case of
financial failure of the College. This policy is with Catholic Church Insurances and is reviewed each year in
January.
4. Student Grievances: Student grievances in any matter are to be directed firstly to the relevant Head of
House. If not resolved, grievances may then be made in turn to the Director of Students 7-9 or 10-12, the
Principal and finally to a Parish Priest member of the Loyola College Board.
5. School Counselling and Support Services: Student orientation is by personal arrangement with the
relevant Head of House. Assistance with study skills, curriculum matters and personal welfare is arranged
through the Mentor teacher and the Head of House. Counselling for personal matters is available through
the Loyola College Community Counsellor (Mr Justin West) and tertiary education advice is available
through the Careers Advisor (Mrs. Louise Hogan).
_______________________________________________________________________________________
FOR OFFICE USE ONLY:
AUD $100 Enrolment Fee Received – Receipt No.__________Date __________