Fillable APPLICATION FOR PROSPECTIVE STUDENT ENROLMENT (Australian Correspondence Schools)

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APPLICATION FOR PROSPECTIVE STUDENT ENROLMENT (Australian Correspondence Schools)

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Education (General Provisions) Act 2006 Section 155(1) Approved from SEF – 1 V7. Page 1 of 13
APPLICATION FOR PROSPECTIVE STUDENT ENROLMENT
IMPORTANT INFORMATION
(Please use BLOCK letters and a blue or black pen to complete this form)
Please refer to the Application to enrol in Queensland State School information sheet at the end of this form when completing this application.
Failure or refusal to complete those sections of the form marked with an (*) or to provide required documentation may result in a refusal to process your application.
Sections of the form not marked (*) are optional. However, failure to complete these sections may result in the school not being eligible for important Federal and State
Government funding reliant on such information. Parents of all students in Australia have been asked to provide information on their family background as part of a
national initiative towards providing an education system that is fair to all students, regardless of their background. The required information includes the Indigenous status
and language background of the student, and the education, occupation and language background of the parents.
If you have any questions about the enrolment form or process, or require assistance completing this form, including translation services, please contact the school in the
first instance.
PRIVACY STATEMENT
The Department of Education and Training (DET) is collecting the information on this form for the purposes outlined in the Education (General Provisions) Act 2006
(EGPA 2006), and in particular for:
i. assessing whether your application for enrolment should be approved
ii. meeting reporting obligations required by law or under Federal – State funding arrangements
iii. administering and planning for providing appropriate education, training and support services to students
iv. assisting departmental staff to maintain the good order and management of schools, and to fulfil their duty of care to all students and staff
v. communicating with students and parents.
This collection is authorised by ss. 155 and 428 of the EGPA 2006. DET will disclose personal information from this form to the Queensland Curriculum and Assessment
Authority when opening student accounts, in compliance with Part 3 of the Education (Queensland Curriculum and Assessment Authority) Act 2014 (Qld). Personal
Information from this form will also be supplied to Centrelink in compliance with ss.194 and 195 of the Social Security (Administration ) Act 1999 (Cth). De-identified
information concerning parents’ school and non-school education, occupation group and main language other than English and students’ country of birth, main language
other than English, sex and Indigenous status, is supplied to the Australian Government Department of Education in compliance with Federal – State funding agreements.
Personal information collected on this form may also be disclosed to third parties where authorised or required by law. Your information will be stored securely. If you wish
to access or correct any of the personal information on this form or discuss how it has been dealt with, please contact your child’s school in the first instance. If you have a
concern or complaint about the way your personal information has been collected, used, stored or disclosed, please also contact your child’s school in the first instance.
ENTITLEMENT TO ENROL
Under the EGPA 2006, an applicant for enrolment at a state school must be enrolled if they are entitled to enrolment. While not exhaustive, the following matters may
affect an applicant’s entitlement to enrolment at a state school:
• failure to adequately complete this enrolment form
• if the school has an Enrolment Management Plan or an Enrolment Eligibility Plan (enrolment is subject to eligibility under the plan)
• the applicant is a prospective mature aged student (the applicant can only apply for enrolment at a mature age state school and will be subject to a satisfactory criminal
history check, or as a student in a program of distance education. All prospective mature age students must have a remaining allocation of state education.)
• the applicant is not of correct age for enrolment (relates to Preparatory Year and Years 1 to 6)
• the applicant has been excluded or cancelled from enrolment or is subject to suspension from a state school at the time of the application
• the school is a state special school and the applicant does not meet the criteria for enrolment in a special school
• the school principal reasonably believes that the applicant presents an unacceptable risk to the safety or wellbeing of members of the school community (application is
referred to Director-General)
• the proposed enrolment requires approval as part of a flexible arrangement under s.183 of the EGPA 2006, and the arrangement has not yet been approved
• the prospective student is not an Australian resident or citizen or the child of an Australian permanent resident or citizen (visa restrictions may apply, fees may be
charged, in some cases legislation requires that the applicant must obtain approval from the Chief Executive via Education Queensland International (EQI) to enrol).
APPLICANT FAMILY NAME:
APPLICANT GIVEN NAMES:
APPLICATION FOR ENTRY INTO:
Grade: 9 10 11 12
Year:
7
2021
8
2022
ENROLMENT CATEGORY(IES)
UNDER WHICH YOU WISH TO
APPLY:
Local Catchment Academic Sport __________________________
Cultural (Visual Art) Cultural (Instrumental Music) ______________________
OFFICE USE ONLY
Date Enrolled
___/___/___
Year Level
EQ ID:
Independent Student
Yes No
Roll Class
Birth certificate/passport sighted, copied and DOB
confirmed.
Birth certificate
number
Is the prospective student over 18 years at time of enrolment? Yes No
If yes, is the prospective student exempt from the mature age student process? Yes No
If no, has the prospective mature age applicant consented to a criminal history check? Yes No
School House
EAL/D
Support
Yes No To be determined
FTE
Associated
Unit
Visa and
associated
documents
sighted
Yes No
EQI Category
SV – Student Visa / TV – Temporary Visa / DS – Dependant – Parent on Student Visa / EX – Exchange Student / DE – Distance
Education
APPROVED: YES NO SIGNATURE DATE: / /
OFFICE USE ONLY
ENROLMENT NO:
CATEGORY APP:
ID NO:
OFFICE USE ONLY
RECEIVED:
/
/ 2021
RECEIPT:
Education (General Provisions) Act 2006 Section 155(1) Approved from SEF – 1 V7. Page 2 of 13
PROSPECTIVE STUDENT DEMOGRAPHIC DETAILS
Legal family name*:
(as per birth certificate)
Legal given names*:
(as per birth certificate)
Preferred family name:
Preferred given name:
Sex*:
Male Female
Date of birth*:
____/____/____
Copy of birth certificate
available to show school
staff*:
Yes No
Enrolment will not be approved without enrolling staff sighting the prospective
student’s birth certificate. An alternative to birth certificate will be considered where
it is not possible to obtain a birth certificate (e.g. prospective student born in
country without birth registration system. Passport or visa documents will suffice).
This does not include failure to register a birth or reluctance to order a birth
certificate.
For international students approved for enrolment by EQI, a passport or visa will be
acceptable.
For prospective mature
age students, proof of
identity supplied and
copied*:
Yes No
Prospective mature age applicants must provide photographic identification which
proves their identity:
Current driver licence; or
Adult proof of age card; or
Current passport
* Please refer to ‘Application to enrol in a Queensland State School’ (attached).
APPLICATION DETAILS
Has the prospective student
ever attended a Queensland
state school?
Yes No
If yes, provide name of school and approximate date of enrolment.
____________________________________________________
What year level is the
prospective student seeking
to enrol in?
Please provide the appropriate year level.
Proposed start date
____/____/____
Please provide the proposed starting date for the prospective student at this
school.
Does the prospective student
have a sibling attending this
school or any other
Queensland school?
Yes No
If yes, provide
name of sibling,
year level, date of
birth, and school.
Name
Year Level
Date of Birth
____/____/____
School
Does the prospective student
have any other siblings?
Yes No
If yes, provide
name of siblings
and date of birth.
Name
Date of Birth
____/____/____
Name
Date of Birth
____/____/____
PROSPECTIVE STUDENT ADDRESS DETAILS*
Principal place of residence address
Address Line 1
Address Line 2
Suburb/Town
State
Postcode
Mailing Address (if it is the same as principal place of residence, write ‘AS ABOVE’).
Address Line 1
Address Line 2
Suburb/Town
State
Postcode
Email
Education (General Provisions) Act 2006 Section 155(1) Approved from SEF – 1 V7. Page 3 of 13
FAMILY DETAILS
Parents/Carers
Parent/Carer 1
Parent/Carer 2
Family Name*
Given Names*
Title
Mr Mrs Ms Miss
Dr
Mr Mrs Ms Miss
Dr
Sex
Male Female
Male Female
Relationship to prospective student*
Is the parent/carer an emergency
contact?
Yes No
Yes No
1
st
Phone contact number*
Work / Home / Mobile Work / Home / Mobile
2
nd
Phone contact number*
Work / Home / Mobile Work / Home / Mobile
3
rd
Phone contact number*
Work / Home / Mobile Work / Home / Mobile
Email
Employer name
Employer address Line 1
Employer address Line 2
Occupation
What is the occupation group of the
parent/carer?
(Refer to Page 8 for details)
(Please select the parental occupation group from the list provided at the end of this form. If you are not currently in paid
work but have had a job in the last 12 months or have retired in the last 12 months, please use your last occupation. If you
have not been in paid work in the last 12 months, enter ‘8’.)
Country of birth
Country of residence
Does Parent/Carer 1 or Parent/Carer 2
speak a language other than English at
home? (If more than one language, indicate the
one that is spoken most often)
No, English only
Yes, other – please specify
______________________________________
Needs interpreter? Yes No
No, English only
Yes, other – please specify
_____________________________________
Needs interpreter? Yes No
Is the parent/carer an Australian citizen?
Yes No
Yes No
Is the parent/carer a permanent resident
of Australia?
Yes No
Yes No
Address Line 1
Address Line 2
Suburb/Town
State
Postcode
Postcode
Mailing Address (if it is the same as principal place of residence, write ‘AS ABOVE’)
Address Line 1
Address Line 2
Suburb/Town
State
Postcode
Postcode
Parent/Carer school education
What is the highest year of primary or secondary
school Parent/Carer 1 has completed? (For people
who have never attended school, mark ‘Year 9 or equivalent or
below’)
What is the highest year of primary or
secondary school Parent/Carer 2 has
completed? (For people who have never attended school,
mark ‘Year 9 or equivalent or below’)
Year 9 or equivalent or below
Year 10 or equivalent
Year 11 or equivalent
Year 12 or equivalent
Education (General Provisions) Act 2006 Section 155(1) Approved from SEF – 1 V7. Page 4 of 13
Parent/Carer non-school education
What is the level of the highest qualification
Parent/Carer 1 has completed?
What is the level of the highest qualification
Parent/Carer 2 has completed?
Certificate I to IV (including Trade Certificate)
Advanced Diploma/ Diploma
Bachelor degree or above
No non-school qualification
PROSPECTIVE STUDENT ORIGIN DETAILS
Origin
Queensland / interstate / overseas
Origin type
Childcare centre or Kindergarten/Prep/Primary / Secondary / VET / other
Previous school/other
location
Previously employed
Yes No
Full-Time Part-Time
INDIGENOUS STATUS
Is the prospective student
of Aboriginal or Torres
Strait Islander origin?
No Aboriginal Torres Strait Islander Both Aboriginal and Torres Strait Islander
RELIGION – RELIGIOUS INSTRUCTION*
From Year 1, the prospective student may participate in
religious instruction if it is available.
If you tick ‘No’ or if the nominated religion is not represented
within the school’s religious instruction program, the
prospective student will receive other instruction in a separate
location during the period arranged for religious instruction.
Parents/carers may change these arrangements at any time
by notifying the principal in writing.
Do you want the prospective student to participate in religious
instruction?
Yes No
If ‘Yes’, please nominate the religion:
PROSPECTIVE STUDENT LANGUAGE DETAILS
Does the prospective
student speak a
language other than
English at home?
No, English only
Yes, other – please specify __________________ Percentage English spoken at home________
EVIDENCE OF PROSPECTIVE STUDENT’S IMMIGRATION STATUS (to be completed if student is NOT an Australian
citizen)*
Permanent resident
Complete passport and visa details section below
Student Visa holder
Date of arrival:
____/____/____
Date enrolment approved to:
____/____/____
EQI receipt number:
Temporary Visa holder
Complete passport and visa details section below
Other, please specify
Temporary visa holders must obtain an ‘Approval to enrol in a state school’ from EQI
Passport and visa details (to be completed for a prospective student who is NOT an Australian citizen
NOTE: A permanent resident will have a passport with a permanent residency visa inside worded ‘Holder(s) permitted to remain in Australia indefinitely’.
For prospective students arriving in Australia as refugee or humanitarian entrants, either PLO 56 Immigration issued card or ‘Document to travel to Australia’ with ‘stay
indefinite’ recorded must be sighted by the school.
Passport number
Passport expiry date
____/____/____
Visa number
Visa expiry date (if applicable)
____/____/____
Visa sub class
COUNTRY OF BIRTH*
In which country was the
prospective student
born?
Australia Other (please specify country) ________________________
Lived in another country ______________ Length of residency_______________
Date of arrival in Australia: ____/____/____
Is the prospective student
an Australian citizen?
Yes No (If no, evidence of prospective student’s immigration status to be completed)
Education (General Provisions) Act 2006 Section 155(1) Approved from SEF – 1 V7. Page 5 of 13
EMERGENCY CONTACT DETAILS
(Other emergency contact details if parents/carers listed previously are not emergency contacts or cannot be contacted)*
Emergency contact
Emergency contact
Name
Address Line 1
Address Line 2
Relationship (e.g. aunt)
1
st
phone contact number
Work Home Mobile:
Work Home Mobile:
2
nd
phone contact number
Work Home Mobile:
Work Home Mobile:
3
rd
phone contact number
Work Home Mobile:
Work Home Mobile:
PROSPECTIVE STUDENT MEDICAL INFORMATION (including allergies)*
Privacy Statement
The Department of Education and Training (DET) is collecting this medical information in order to address the medical needs of students during
school hours as well as during school excursions, school camps, sports and other school activities. DET will not use this information to make a
decision about a prospective student’s eligibility for enrolment. The information will only be used by authorised employees of the department and
DET will only record, use and disclose the medical information in accordance with the confidentiality provisions at Section 426 of the Education
(General Provisions) Act 2006.
It is essential that you advise the school before the prospective student’s first day of attendance if the prospective student has any medical
conditions. You must also inform the school administration staff as soon as you are aware of any new medical conditions or a change to medical
conditions.
Should the prospective student need to take medication during school hours, an individual Health Plan, including Emergency Health Plan if relevant,
or Authority to Administer Medication Form will need to be completed each year and retained at the school office.
No known medical conditions
Medical condition (including allergies/
sensitivities), symptoms and
management (please refer to the list of
Medical Condition categories provided)
Medical condition (including allergies/
sensitivities), symptoms and
management (please refer to the list of
Medical Condition categories provided)
Medical condition (including allergies/
sensitivities), symptoms and
management (please refer to the list of
Medical Condition categories provided)
Does the prospective student require
any medical aids or devices (such as
glasses, contact lenses, prosthetics
or orthotics)? (This is for the purpose of
informing planning for school activities such as
sport and school excursions)
No
Yes – please specify ______________________________________________________
Name of prospective student’s
medical practitioner (optional)
Contact number of
medical practitioner
I authorise school staff to contact the prospective student’s medical practitioner for the purposes of seeking
advice in cases where an immediate but non-life threatening response is required (for instance, when the
prospective student may be on an excursion or sporting event)? (answer only if medical practitioner details have been
provided above)
Yes No
Medicare card number (optional)
Position number
Cardholder name (if not in name of
prospective student)
Private health insurance company
name (if covered)
(optional)
Private health
insurance membership
number (leave blank if
company name is not
provided)
Education (General Provisions) Act 2006 Section 155(1) Approved from SEF – 1 V7. Page 6 of 13
COURT ORDERS*
Out-of-Home Care Arrangements
Under the Child Protection Act 1999 when a Child Protection Order is approved by the Children’s Court, the child is placed in out-of-
home care (OOHCC).Out-of-home care includes short or long term placement with an approved kinship or foster carer; in a
supported independent living arrangement; in a safe house; and in residential care.
Is the prospective student identified as residing in out-of-home care?
Yes No
If yes, what are the dates of the court order? Please provide a copy of the current court
order and/or the Authority to Care.
Commencement date
___/___/_____
End date
___/___/_____
Contact details of the Child Safety Officer (if known)
Name
Phone number
Family Court Orders*
Are there any current Family Court orders made pursuant to the Family Law Act 1975
concerning the welfare, safety or parenting arrangements of the prospective student?
Yes No
If yes, what are the dates of the court order? Please provide a copy of the current court
order.
Commencement date
___/___/_____
End date
___/___/_____
Other Court Orders*
Are there any other current court orders, such as domestic violence order, concerning
the welfare, safety or parenting arrangements of the prospective student?
Yes No
If yes, what are the dates of the court order? Please provide a copy of the current court
order.
Commencement date
___/___/_____
End date
___/___/_____
TRAVEL DETAILS
Mode of transport to school
Walk Car Bus Bicycle Train
Other ________________
APPLICATION TO ENROL*
I hereby apply to enrol my child or myself at Brisbane State High School.
I understand that supplying false or incorrect information on this form may lead to the reversal of a decision to approve enrolment. I
believe that the information I have supplied on this form is true and correct in every particular, to the best of my knowledge.
Parent/Carer 1
Parent/Carer 2
Prospective Student
Signature
Date
____/____/____
____/____/____
____/____/____
Education (General Provisions) Act 2006 Section 155(1) Approved from SEF – 1 V7. Page 7 of 13
ORIGINAL DOCUMENTS PLUS ONE (1) PHOTOCOPY REQUIRED FOR ALL APPLICATIONS
We must sight the following ORIGINAL documents (where applicable) PLUS ONE (1) PHOTOCOPY OF EACH
DOCUMENT (certified copies will not be accepted). Please note the school does not provide a photocopy service.
CHILD’S ORIGINAL BIRTH CERTIFICATE (An official translation is necessary if not in English)
The school will require proof of at least one parent’s Australian citizenship if both parents were born overseas. If one parent was born in
Australia, proof of Australian citizenship is not required.
AND/OR IF REQUIRED
AUSTRALIAN CITIZENSHIP CERTIFICATE (of student OR parent), or
AUSTRALIAN OR NEW ZEALAND PASSPORT (of student NOT parent), or
APPROPRIATE VISA OF BOTH PARENT AND STUDENT (e.g. TR, PR) and ARRIVAL STAMP.
AND
CHILD’S SCHOOL REPORTS FOR PREVIOUS THREE (3) SEMESTERS (These do not form part of the selection process for the
Local Catchment Area applicants, but will be used by our Teaching and Learning staff to support students).
Copy of most recent NAPLAN results (Original to be sighted).
ADDITIONAL ORIGINAL DOCUMENTS
LOCAL CATCHMENT AREA:
ADDITIONAL ORIGINAL DOCUMENTS
SELECTIVE CATEGORIES:
We must see the following ORIGINAL documents
(applications must include the original to be sighted by the
school and a photocopy of each document).
We must see the following ORIGINAL documents (applications must
include the original to be sighted by the school and a photocopy of
each document). Please refer to the school website for the relevant
closing dates.
(A) HOME OWNERS:
Signed, unconditional sale agreement/or Land Title
Search; and
Current Brisbane City Council Rates Notice;
(B) LEASE HOLDERS:
Commercially drawn rental agreement stamped and
signed by real estate agency (as per the Enrolment
Management Plan); and
Original receipt from the Residential Tenancies
Authority (RTA) for lodgement of the rental bond;
ALL LOCAL CATCHMENT APPLICANTS:
Completed Statutory Declaration (witnessed, signed
and stamped by a Justice of the Peace or
Commissioner for Declarations – form included in the
application package).
Minimum of 3 current accounts and evidence of
payment
Home & Contents Insurance and Motor Vehicle
Insurance
Other evidence as requested by the Executive
Principal
Further details of documentation required is available on the
Brisbane State High School EMP.
SPORTING:
Documentation of Sporting Achievement:
Refer to the school website.
CULTURAL (VISUAL ART):
Art Folio (original folio must be submitted; copy not required)
CULTURAL (INSTRUMENTAL MUSIC):
Documentation of level of Music Achievement
(AMEB certification, NOT school reports)
*All Music applicants will audition
(Please see BSHS website for registration/information details)
ACADEMIC:
Child’s original school reports for the previous 3 semesters.
Photo identification verified by the child’s primary school principal or a
Justice of the Peace (JP) must be shown on entry to the academic
test.
Applicants will be unable to sit the academic test without their
Photo Identification Form, available on the school website.
SELECTIVE ENTRY APPLICATIONS - PROCESSING FEE PAYMENT OF $420 IS REQUIRED (Non-Refundable/Non-Transferable)
PROCESSING FEE – PAYMENT BY CREDIT CARD (Fee is subject to change without notice)
Please note: Applications must be fully completed and include all documents (photocopies and originals where applicable).
Incomplete applications will not be accepted for processing. Original documents (if sent by post) may be collected from the
school by a parent/carer (identification required) or they can be returned by post if a stamped self-addressed envelope is provided.
(BSHS cannot accept any responsibility for documents sent in the post).
Following written notification of an offer of enrolment, a non-refundable confirmation fee is required for all Selective Entry applications.
Education (General Provisions) Act 2006 Section 155(1) Approved from SEF – 1 V7. Page 8 of 13
PARENTAL OCCUPATION GROUPS FOR USE WITH PARENT / GUARDIAN DETAILS
Group 1: Senior management in large business organisation, government administration and defence, and
qualified professionals
Senior executive/manager/department head in industry, commerce, media or other large organisation.
Public service manager (Section head or above), regional director, health/education/police/fire services administrator
Other administrator [school principal, faculty head/dean, library/museum/gallery director, research facility director]
Defence Forces Commissioned Officer
Professionals generally have degree or higher qualifications and experience in applying this knowledge to design,
develop or operate complex systems; identify, treat and advise on problems; and teach others.
Health, Education, Law, Social Welfare, Engineering, Science, Computing professional
Business [management consultant, business analyst, accountant, auditor, policy analyst, actuary, valuer]
Air/sea transport [aircraft/ship’s captain/officer/pilot, flight officer, flying instructor, air traffic controller]
Group 2: Other business managers, arts/media/sportspersons and associate professionals
Owner/manager of farm, construction, import/export, wholesale, manufacturing, transport, real estate business
Specialist manager [finance/engineering/production/personnel/industrial relations/sales/marketing]
Financial services manager [bank branch manager, finance/investment/insurance broker, credit/loans officer] Retail
sales/services manager [shop, petrol station, restaurant, club, hotel/motel, cinema, theatre, agency]
Arts/media/sports [musician, actor, dancer, painter, potter, sculptor, journalist, author, media presenter, photographer,
designer, illustrator, proof reader, sportsman/woman, coach, trainer, sports official]
Associate professionals generally have diploma/technical qualifications and support managers and professionals.
Health, Education, Law, Social Welfare, Engineering, Science, Computing technician/associate professional
Business/administration [recruitment/employment/industrial relations/training officer, marketing/advertising
specialist, market research analyst, technical sales representative, retail buyer, office/project manager]
Defence Forces senior Non-Commissioned Officer
Group 3: Tradespeople, clerks and skilled office, sales and service staff
Tradespeople generally have completed a 4 year Trade Certificate, usually by apprenticeship. All tradespeople are
included in this group.
Clerks [bookkeeper, bank/PO clerk, statistical/actuarial clerk, accounting/claims/audit clerk, payroll clerk,
recording/registry/filing clerk, betting clerk, stores/inventory clerk, purchasing/order clerk, freight/transport/shipping clerk,
bond clerk, customs agent, customer services clerk, admissions clerk]
Skilled office, sales and service staff.
Office [secretary, personal assistant, desktop publishing operator, switchboard operator]
Sales [company sales representative, auctioneer, insurance agent/assessor/loss adjuster, market researcher] Service
[aged/disabled/refuge/child care worker, nanny, meter reader, parking inspector, postal worker, courier, travel agent, tour
guide, flight attendant, fitness instructor, casino dealer/supervisor]
Group 4: Machine operators, hospitality staff, assistants, labourers and related workers
Drivers, mobile plant, production/processing machinery and other machinery operators.
Hospitality staff [hotel service supervisor, receptionist, waiter, bar attendant, kitchenhand, porter, housekeeper]
Office assistants, sales assistants and other assistants.
Office [typist, word processing/data entry/business machine operator, receptionist, office assistant]
Sales [sales assistant, motor vehicle/caravan/parts salesperson, checkout operator, cashier, bus/train conductor, ticket
seller, service station attendant, car rental desk staff, street vendor, telemarketer, shelf stacker] Assistant/aide [trades’
assistant, school/teacher's aide, dental assistant, veterinary nurse, nursing assistant, museum/gallery attendant, usher,
home helper, salon assistant, animal attendant]
Labourers and related workers
Defence Forces ranks below senior NCO not included above
Agriculture, horticulture, forestry, fishing, mining worker [farm overseer, shearer, wool/hide classer, farm hand,
horse trainer, nurseryman, greenkeeper, gardener, tree surgeon, forestry/logging worker, miner, seafarer/fishing hand]
Other worker [labourer, factory hand, storeman, guard, cleaner, caretaker, laundry worker, trolley collector, car park
attendant, crossing supervisor]
Group 8: Have not been in paid work in the last 12 months
Education (General Provisions) Act 2006 Section 155(1) Approved from SEF – 1 V7. Page 9 of 13
Education Queensland Standardised Medical Condition Category List
Acquired brain injury
Allergies /Sensitivities
Anaphylaxis
Airway/lung/breathing - Oxygen required (continuously/periodically)
Airway/lung/breathing - Suctioning
Airway/lung/breathing -Tracheostomy
Airway/lung/breathing -Other
Artificial feeding - Gastrostomy device (tube or button)
Artificial feeding - Nasogastric tube
Artificial feeding - Jejunostomy tube
Artificial feeding - Other
Asthma
Attention-deficit /Hyperactivity disorder (ADHD)
Autism Spectrum Disorder (ASD)
Bladder and bowel - Urinary wetting, incontinence
Bladder and bowel - Faecal soiling, constipation, incontinence
Bladder and bowel - Catheterisation (continuous, clean intermittent)
Bladder and bowel - Stoma site, urostomy, Mitrofanoff, MACE, Chair
Bladder and bowel - Other
Blood disorders - Haemophilia
Blood disorders - Thalassaemia
Blood disorders - Other
Cancer / oncology
Coeliac disease
Cystic Fibrosis
Diabetes - type one
Diabetes - type two
Ear/hearing disorders - Otitis Media (middle ear infection)
Ear/hearing disorders - Hearing loss
Ear/hearing disorders - Other
Epilepsy - Seizure
Eye/vision disorders
Endocrine disorder - Adrenal hypoplasia, pituitary, thyroid
Heart/cardiac conditions - Heart valve disorders
Heart/cardiac conditions - Heart genetic malformations
Heart/cardiac conditions - other
Mental Health - Depression
Mental Health - Anxiety
Mental Health - Oppositional defiant disorder
Mental Health - Other
Muscle/bone / musculoskeletal disorders - spasticity (Baclofen Pump)
Muscle/bone / musculoskeletal disorders - Other
Skin Disorders - eczema
Skin Disorders - psoriasis
Swallowing/dysphagia - requiring modified foods
Swallowing/dysphagia - requiring artificial feeding
Transfer & positioning difficulties
Travel / motion sickness
Other
Education (General Provisions) Act 2006 Section 155(1) Approved from SEF – 1 V7. Page 10 of 13
Medical Details Form
Prospective Student’s Name: _____________________________________________________
Prospective student does not have any known medical conditions.
Prospective student has the following known medical conditions:
Medical Condition 1:
Medical Condition
Category:
(Please use list of Medical
Condition Categories
provided)
Symptoms:
(Include specific medical
condition name if known and
any symptoms school should
look for)
Management:
(Include any special
instructions the school
should follow with regard to
this condition)
Medical Condition 2:
Medical Condition
Category:
(Please use list of Medical
Condition Categories
provided)
Symptoms:
(Include specific medical
condition name if known and
any symptoms school should
look for)
Management:
(Include any special
instructions the school
should follow with regard to
this condition)
Medical Condition 3:
Medical Condition
Category:
(Please use list of Medical
Condition Categories
provided)
Symptoms:
(Include specific medical
condition name if known and
any symptoms school should
look for)
Management:
(Include any special
instructions the school
should follow with regard to
this condition)
If the prospective student has additional medical conditions please attach details of all medical conditions.
______________________________
Parent/Carer’s Signature
Education (General Provisions) Act 2006 Section 155(1) Approved from SEF – 1 V7. Page 11 of 13
Application to enrol in a Queensland State School
This sheet contains information on how to complete the Application for Student Enrolment
Form (SEF-1 Version 6).
Entitlement to enrolment
Under the Education (General Provisions) Act
2006 (Qld) a state school must enrol an applicant if
they are entitled to enrolment. While not exhaustive, a
list of matters which may affect an applicant’s
entitlement to enrolment are included
on the front cover of the enrolment form.
Questions which must be answered*
The Application for Student Enrolment Form
contains a number of questions marked with
an (*) which must be answered. These
include – Prospective student demographic
details, Prospective student address details,
Family details, Religion – Religious Instruction,
Country of birth, Emergency contact details,
Prospective student medical information and the
Application to enrol. These questions and
consent are considered necessary to ensure the
school can undertake its administrative and care
responsibilities.
Sections of the form not marked (*) are optional.
However, failure to complete these sections
may result in the school not being eligible for
important Federal and State funding.
Parent’s occupation and education
All parents across Australia, no matter which
school their child attends, are being asked to
provide information about family background
(answering this question is optional). The
main purpose of collecting this information is to
promote an education system which is fair for all
Australian students regardless of their
background.
Sighting of birth certificate
Schools are required to sight a prospective
student’s birth certificate. An alternative to a
birth certificate will be considered where it is not
possible to obtain a birth certificate (e.g. child
born in a country without a birth registration
system – passport or visa documents will
suffice).
Prospective mature age students that provide
appropriate photographic proof of identity do not
need to present a birth certificate.
Name on enrolment form
A prospective student should be enrolled under
their legal name as per their birth certificate.
There is provision to also record a preferred
family and/or given name. The preferred name
will be used on internal school documents such
as class rolls. The legal name will appear on
semester reports, however, at the parent’s
request, the preferred name can be used. The
preferred name only will be used on internal
school documents such class rolls.
Evidence of Prospective Student’s
Immigration Status
This section is required to be completed when a
prospective student is not an Australian citizen
and information is required to be recorded about
their passport and visa.
Medical information and emergency contacts
A prospective student’s medical condition,
symptoms, management and medication/s must be
documented. Medical conditions may include (but
are not limited to) seizures/ epilepsy, fainting,
diabetes, asthma, heart problems, anaphylaxis and
allergies (such as food or insect stings). Parents
must indicate if they are an emergency contact.
Three additional emergency contacts are also
required.
Religion – Religious Instruction
Applicants are asked if they would like the
prospective student to participate in religious
instruction. From Year 1, the prospective student
may participate in religious instruction if it is
available.
If you tick ‘No’ or if the nominated religion is not
represented within the school’s religious instruction
program, the prospective student will receive other
instruction in a separate location during the period
arranged for religious instruction.
Parents may change these arrangements at any
time by notifying the principal in writing.
Court Orders
Any court orders concerning the prospective
student’s welfare, safety or parenting
arrangements should be provided to the school,
and the school should also be provided with any
new or updated orders.
Office use
This section is to be completed by the school and
will assist in documenting specific details in
relation to a student’s enrolment, including
confirmation of the sighting of documentary
evidence such as a prospective student’s birth
certificate, passport or visa and prospective
student’s mature age status.
Education (General Provisions) Act 2006 Section 155(1) Approved from SEF – 1 V7. Page 12 of 13
QUEENSLAND
OATHS ACT 1867
STATUTORY DECLARATION
LOCAL CATCHMENT AREA CATEGORY
I, ______________________________________________________, do solemnly and sincerely declare that:
(Parent/Carer’s Name)
1. I am applying for entry to Brisbane State High School (BSHS) under the Local Catchment category on behalf of
my child ___________________________________ (child’s name).
2. This application is made in accordance with the Brisbane State High School Enrolment Management Plan.
Additionally, I acknowledge that I must notify the school of any change of address within 14 days of any change.
3. All documents enclosed with my application are true and correct.
4. The address cited in the application, namely,
______________________________________________________
______________________________________________________ ,
falls within the Local Catchment Area as defined in the Brisbane State High School Enrolment Management Plan.
5. This address is where we are residing and is the Principal Place of Residence of myself and my family, including
my child _______________________ (the applicant for entry) and that this is our permanent family home. We
will maintain a residence in the Local Catchment Area of BSHS for the remainder of _______________________
(child’s name) schooling at Brisbane State High School.
I make this solemn declaration conscientiously believing the same to be true, and by virtue of the provisions of the
Oaths Act 1867.
Signed: __________________________________________
Declared at _______________________________________ in the state of Queensland
this ___________________________ day of ____________________ 20 ___.
Before me _______________________________________
(Qualified Justice of the Peace or Commissioner for Declarations)
Stamp of Qualified Justice
of the Peace of
Commissioner for
Declarations
Cred
False or misleading statements or assertions about the student’s principal place of
residence amount to an offence and will be reported to Queensland Police Service.
The school’s Executive Principal may repeal a decision to enrol a student in such circumstances.
Education (General Provisions) Act 2006 Section 155(1) Approved from SEF – 1 V7.
Credit Card Payment –
Selective Entry Enrolment
Office Use Only
Name of Staff Member recording details: ___________________________________
Signature of Staff Member recording details: ____________________ Date: ___/___/___
Date Processed in OneSchool: ____/ ____/ ____
Student Name:
Current Year Level:
Enrolment Fee:
$420.00
Address of Cardholder: ______________________________________________________________
Information taken over phone or Signature of Cardholder: __________________________
Name of Cardholder: ________________________________________________________________
----------------------------------------------------------------------------------------------------------------------------------------
This section will be shredded after receipt is processed.
Mastercard Visa
CARD NO.
Expiry date on Credit Card: ____ / ____
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APPLICATION FOR PROSPECTIVE STUDENT ENROLMENT (Australian Correspondence Schools)

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Completed 30 August 2021

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