Fillable Enrolment APPLICATION (Australian National University)

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Enrolment APPLICATION (Australian National University)

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suncoastlittlelearners.com.au
Enrolment
APPLICATION
APPLICATION FOR ENROLMENT SUNCOAST LITTLE LEARNERS2 Full and frank disclosure is required otherwise initial or ongoing enrolment will be aected.
LITTLE LEARNERS ENROLMENT APPLICATION
CHILD INFORMATION
Child’s full legal name:
Child’s CRN
(Customer Reference Number): (Issued by Family Assistance Office Ph: 136 150)
First name (to be known as): Male/Female:
Residential address:
Home phone: Health Care No: Expiry:
Date of birth: Country of birth:
Is the child of Indigenous descent? Yes No Torres Strait descent? Yes No
Languages spoken at home:
Are there any religious, cultural or personal beliefs for your child or family that require consideration from our centre? Yes No
Previous care arrangements (e.g. day care 1 day per week, no previous care): Duration:
FAMILY INFORMATION
Father or Legal Guardians Mother or Legal Guardians
CRN: CRN:
Married ( ) Separated ( ) Divorced ( ) Married ( ) Separated ( ) Divorced ( )
Single ( ) Widower ( ) Single ( ) Widower ( )
Title: Title:
Given and surname: Given and surname:
DOB: DOB:
Drivers licence: Drivers licence:
Medicare Number Medicare Number
Medicare Position on card (eg. 2, 3, 4) Medicare Position on card (eg. 2, 3, 4)
Medicare Expiry Medicare Expiry
Home address: Home address:
Postal address: Postal address:
Resides with child: Yes/No Resides with child: Yes/No
Phone - home: Phone - home:
work: work:
mobile: mobile:
Email for Centre contact: Email for Centre contact:
Country of birth: Country of birth:
Arrival date in Australia if born overseas: Arrival date in Australia if born overseas:
Ethnicity or cultural background: Ethnicity or cultural background:
First language: First language:
Occupation: Occupation:
Employer: Employer:
Is your family involved in a church? Is your family involved in a church?
Church name/denomination: Church name/denomination:
Parent/Guardian name registered for Child Care Benefits? Father ( ) Mother ( ) Guardian ( )
APPLICATION FOR ENROLMENT SUNCOAST LITTLE LEARNERS3 Full and frank disclosure is required otherwise initial or ongoing enrolment will be aected.
LONG DAY CARE OPTIONS
PRE-KINDERGARTEN
Commencing: ______/______/______
I would like to express interest in enrolling my child in:
Pre-Kindy (Children 2 ½ years – 5 Years) 6:45am – 5:45pm flexible program - 48 weeks
Monday Tuesday Wednesday Thursday Friday (please tick the required days)
KINDERGARTEN OPTIONS (Year before Prep)
Commencing: ______/______/______
I would like to express interest in enrolling my child in: (please place a ‘1’ in your most preferred option and a ‘2’ in your second
preference etc in the appropriate boxes)
Option 1:
Kindergarten | 7:45am – 3:15pm | 40 weeks
Monday Tuesday Wednesday Thursday Friday (please tick the required days)
Option 2 (Five day fortnight):
Kindergarten | 7:45am – 3:15pm | 40 weeks (Monday, Tuesday, alternate Wednesday program) - Five day fortnight
Option 3 (Five day fortnight):
Kindergarten | 7:45am – 3:15pm | 40 weeks (Thursday, Friday, alternate Wednesday program) - Five day fortnight
KINDY PLUS
I require additional after hours care (from 6:45am-7:45am, 3:15pm-5:45pm for my child at $5 per day.
Yes No (If yes, please nominate days required)
Monday Tuesday Wednesday Thursday Friday (please tick the required days)
OUTSIDE SCHOOL HOURS CARE OPTIONS
BEFORE SCHOOL CARE
Commencing: ______/______/______
I would like to express interest in enrolling my child in:
Before School Care (School Aged Children) 6:45am – 8:15am flexible program (Term Time Only)
Monday Tuesday Wednesday Thursday Friday (please tick the required days)
AFTER SCHOOL CARE
Commencing: ______/______/______
I would like to express interest in enrolling my child in:
After School Care (School Aged Children) 3:00pm – 5:45pm flexible program (Term Time Only)
Monday Tuesday Wednesday Thursday Friday (please tick the required days)
APPLICATION FOR ENROLMENT SUNCOAST LITTLE LEARNERS4 Full and frank disclosure is required otherwise initial or ongoing enrolment will be aected.
PERSONS AUTHORISED TO COLLECT CHILD & EMERGENCY CONTACTS
I/We give permission for a Little Learners staff member to deliver or collect my child from the centre in special circumstances. I will
notify the Director of the particulars of each situation.
I/We authorise a Little Learners staff member to escort my child to and from the bus.
I/We give permission for my child to be signed IN /OUT of the Centre by their siblings. Please note that siblings must be in Senior
School, Years 11&12, to be able to collect a child from the centre.
OTHER THAN PARENTS/GUARDIANS (MUST BE OVER 18 YEARS OF AGE)
Only the persons listed below will be authorised to collect a child and persons ticked YES below will be authorised to collect the child
from Suncoast Little Learners in the event of illness or emergency. Current identification will be required.
CONTACT 1
Contact name:
Relationship to child:
Home phone: Mobile: Work:
Address:
Do you authorise this person in the event of illness or emergency to collect your child from Suncoast Little Learners.
Yes No
CONTACT 2
Contact name:
Relationship to child:
Home phone: Mobile: Work:
Address:
Do you authorise this person in the event of illness or emergency to collect your child from Suncoast Little Learners.
Yes No
CONTACT 3
Contact name:
Relationship to child:
Home phone: Mobile: Work:
Address:
Do you authorise this person in the event of illness or emergency to collect your child from Suncoast Little Learners.
Yes No
CONTACT 4
Contact name:
Relationship to child:
Home phone: Mobile: Work:
Address:
Do you authorise this person in the event of illness or emergency to collect your child from Suncoast Little Learners.
Yes No
CONTACT 5
Contact name:
Relationship to child:
Home phone: Mobile: Work:
Address:
Do you authorise this person in the event of illness or emergency to collect your child from Suncoast Little Learners.
Yes No
CONTACT 6
Contact name:
Relationship to child:
Home phone: Mobile: Work:
Address:
Do you authorise this person in the event of illness or emergency to collect your child from Suncoast Little Learners.
Yes No
APPLICATION FOR ENROLMENT SUNCOAST LITTLE LEARNERS5 Full and frank disclosure is required otherwise initial or ongoing enrolment will be aected.
CUSTODY OR ACCESS NOTICES
Current copies of orders and/or agreements must be provided to Suncoast Little Learners with this enrolment form. Updates must
be provided throughout the duration of the child’s placement at the Centre. Failure to provide current orders may result in the
cancellation of the child’s placement.
Are there current Family Court Orders pertaining to this child?
Yes No
Is there a current Restraining Order which involves this child or a parent?
Yes No
Is there a current Parenting Plan or Statement of Agreement pertaining to this child? Must be signed by both parents.
Yes No
FAMILY DOCTOR
Doctor/Practice name:
Address: Phone:
HEALTH DETAILS
Was the birth of your child: Premature Full Term Normal Difficult
Birth history that may affect your child’s development Forceps Complications Other (Please specify:)
Has your child been hospitalised?
Yes No
Reason for hospitalisation:
Does your child have allergies?
Yes No
Specify allergies:
Has your child had any serious illnesses or accidents?
Yes No
Specify illness/accident:
Does your child have a physical disability?
Yes No
Specify disability:
Does your child have a learning delay?
Yes No
Specify learning delay:
Is your child under medical treatment at present?
Yes No
Specify medical treatment:
Do you have any concerns about your child’s development?
Yes No
Specify concerns:
* If you require further space, please attach additional page/s and sign
Please note: If your child has a long term illness eg epilepsy, asthma, anaphylactic reaction, severe allergies or disabilities, Suncoast Little Learners
requires a management plan from your Doctor detailing medication and its administration and procedures for emergencies.
KINDERGARTEN PROGRAM
Your child will be participating in the Queensland Kindergarten Program at our centre.
Does your child attend another Queensland Kindergarten Program?
Yes No
If yes, do you nominate your Kindergarten funding to Suncoast Little Learners?
Yes No
Do you have a Health Care Card?
Yes No
If yes, number & expiry
APPLICATION FOR ENROLMENT SUNCOAST LITTLE LEARNERS6 Full and frank disclosure is required otherwise initial or ongoing enrolment will be aected.
PERMISSIONS
SIGNATURES REQUIRED THIS SECTION
Child’s full legal name:
MEDICAL
I/We give permission for First Aid to be administered to my child by Suncoast Little Learners.
I/We require medication to be administered to my child as part of their Individual Health Care Plan.
I/We consent to Educators at Suncoast Little Learners administering Ventolin and/or Epi Pen injection to my child when
undiagnosed but considered reasonable and necessary in an emergency.
I/We give permission for my child to be administered children’s Panadol (or equivalent), if my child has a fever and is unable to be
collected from the Suncoast Little Learners. I understand that every effort will be made by staff to contact parents/guardians prior
to my child receiving the Panadol.
I/We give permission for my child to have insect repellent applied to them when deemed necessary.
Signed Mother/guardian Date:
Signed Father/guardian Date:
ONLY SIGN IF APPLICABLE: Administration of life saving medication (eg. Epipen or ventolin)
I give permission to Suncoast Little Learners Staff to administer ventolin/epipen to my child in an emergency situation. I also provided
Suncoast Little Learners with an action plan from my doctor including information about how this medication would be used
• Adrenaline (Epipen) for treatment of anaphylaxis; and
• Salbutamol inhaler (Ventolin) for the treatment of acute asthma.
Signed Mother/guardian Date:
Signed Father/guardian Date:
PHOTOGRAPHS
Periodically Suncoast Little Learners’ staff will take photographs as a pictorial record of the educational programs and the children’s
participation in them. These photographs are displayed for parents to view and may be published in the College newsletter,
magazine, year book, website, advertising and other promotional material.
I understand that my child’s photograph will be taken within the context of the Centre’s education programs
Signed Mother/guardian Date:
Signed Father/guardian Date:
SUNSCREEN
Suncoast Little Learners provides sunscreen. It is Suncoast Little Learners’ policy that parents apply sunscreen to their child upon
arrival at the classroom. Staff will re-apply sunscreen throughout the day.
I understand that staff will reapply sunscreen to my child throughout the day as necessary. I/We will supply specific sunscreen in
the event my child has an allergy to sunscreen supplied by Suncoast Little Learners.
Signed Mother/guardian Date:
Signed Father/guardian Date:
EXCURSIONS
I give permission for my child to attend regular excursions (such as to the College Library & Bush Kindy on a weekly basis) within
the Suncoast campus and also at other times as deemed appropriate by the Teacher.
Signed Mother/guardian Date:
Signed Father/guardian Date:
APPLICATION FOR ENROLMENT SUNCOAST LITTLE LEARNERS7 Full and frank disclosure is required otherwise initial or ongoing enrolment will be aected.
PARENT/GUARDIAN PARTICIPATION
The Centre has an open door policy and welcomes parents to visit at any time. Do you have any skills, interests or knowledge that you
would be willing to share with Suncoast Little Learners? Please include things that may enhance the children’s program.
1
2
3
ENROLMENT AGREEMENT
I/We the parent/guardian agree to the following terms and conditions regarding attendance of my/our child at Suncoast
Little Learners.
I/We understand and accept that fees must be paid fortnightly in advance at all times of attendance and that normal fees
are payable at all times including for any periods of absence of my/our child for illness, holiday, public holiday or for any
other reason whatsoever.
I/We understand that if fees are not paid, my/our child’s continued enrolment at Suncoast Little Learners cannot be
guaranteed.
I/We understand that a Priority of Access system is applied at Suncoast under conditions laid by the Federal Government
whereby the children of working parents must be given priority over those of non-working parents.
I/We agree to notify Suncoast Little Learners promptly of any absence on the enrolled day. I/We agree to give (2) weeks’
notice of intention to withdraw my/our child from the Centre, or pay two weeks’ fees in lieu of such notice period.
I/We agree to keep the child home while he/she is suffering from any infections or contagious illness, or when he/she is in
such poor health as to be unfit for normal day care conditions.
I/We agree that if, in the case of sudden illness or accident, if the parents cannot be contacted, the Director as agent for the
parents will have the discretionary power to seek immediate medical attention.
If, at any time, my/our child is in need of emergency medical, hospital or ambulance service and neither parent/guardian
can be located, I/we give my/our consent for their use at my/our expense.
I/We will ensure that the child is accompanied to and from the Suncoast Little Learners by a responsible person over the
age of 18 years, that the child will be signed in and out at the appropriate locations on each day of attendance, that any
absences will be signed for as required and that the staff member in charge is notified of arrivals and departures.
I understand that Kindergarten Enrolment is charged at 40 weeks per year including and up until the final day of Term 4 of
each year.
I/We understand that Little Learners is founded on the basis of Biblical Christian values and I will support the centre in
these faith endeavors and the teaching and programs offered.
SIGNATURES REQUIRED
Signed Mother/guardian Date:
Signed Father/guardian Date:
APPLICATION FOR ENROLMENT
___________________________________________________
Please complete all pages of this form and forward to:
Suncoast Little Learners, PO Box 5254, SUNSHINE COAST MC QLD 4560
Corner Schubert & Kiel Mountain Roads | WOOMBYE QLD 4559
Phone: (07) 5451 3600 Fax: (07) 5442 2212
Email: info@suncoastcc.qld.edu.au Web: www.suncoastcc.qld.edu.au
NB: Full and honest disclosure is required to ensure this enrolment proceeds.
It is the applicant’s responsibility to update information when changes occur.
APPLICATION FOR ENROLMENT SUNCOAST LITTLE LEARNERS8 Full and frank disclosure is required otherwise initial or ongoing enrolment will be aected.
PRIVACY NOTICE
Protecting the Privacy and confidentiality of personal information about you and the child is important. We want to ensure that you
are aware of various matters relating to our collection and use of that information.
1. The Suncoast Christian College collects personal information about the child and their Parents/Guardians from time to time
during the child’s enrolment at the College.
2. The primary purpose of collecting the information is to enable the College to plan for the education of the child.
3. If we do not collect the information we may not be able to enrol or continue the enrolment of the child.
4. From time to time the College is required to disclose the information for administrative and educational purposes.
5. Parents/Guardians may access the information collected about them. There may be occasions when access to the information is
denied.
6. Personal information collected about a child may be disclosed to their parent/guardian.
7. Information such as achievements, activities, news and photos may be published in the College newsletter, facebook, magazine,
year book, website, advertising and other promotional material.
8. From time to time the College engages in fundraising activities. The information may be used to make an appeal to you or
disclosed to organisations that assist the College in its fundraising activities.
9. The College will not disclose personal information to third parties for their marketing purposes.
By signing the Application for Enrolment you confirm your consent to the collection and use of the personal information. Unless you
withdraw your consent in writing, the College will act on the basis that it has your consent to each such collection and use.
ACKNOWLEDGEMENT
I/We acknowledge and accept the purposes of the Suncoast Little Learners and willingly endorse a Christ-centred education for my/
our child.I/We consent to the collection and use of personal information on the basis detailed in the Privacy Notice.
If this application results in the enrolment of the child, I/we agree to comply and ensure that the child complies with the conditions of
entry and Suncoast Little Learners’ Policies.
In accordance with the National Law and Regulations, our educators will support each child to manage their own behaviour, respond
appropriately to the behaviour of other children and communicate effectively to resolve conflicts. We will also work with each child’s
family to support any children with diagnosed behaviour and social difficulties. I/We understand that my/our child’s enrolment at
Suncoast Little Learners may be terminated if the Nominated Supervisor decides my/our child’s behaviour threatens the safety, health
or wellbeing of any other child at Suncoast Little Learners.
I/We hereby apply for the child named in this application to be enrolled at Suncoast Little Learners and request the College to exercise
its discretion to enrol the child, in our favour.
I/We have attached copies of the following documents:
Birth Certificate Immunisation Register Custody/Parenting Order (is applicable)
Child’s Health Care Card Medical Action Plan from Doctor
Signed Mother/guardian
Date:
Signed Father/guardian
Date:
Signature: Director Suncoast Little Learners
on behalf of Suncoast Little Learners
Date:
APPLICATION FOR ENROLMENT SUNCOAST LITTLE LEARNERS9 Full and frank disclosure is required otherwise initial or ongoing enrolment will be aected.
MORE ABOUT YOUR CHILD
These questions are applicable to your child’s stage of development
The name my child prefers to be called is:
My child’s interests/hobbies are:
My child’s strengths are:
My child might still need help with:
Our favourite family activities are:
Additional information to assist staff understanding your child better:
Sleeping Habits (children enrolled in OSHC please go to next question)
What time does your child go to bed? (pm) What time do they awake? (am)
Does your child have an afternoon sleep? Yes No If yes, approximately at what time/s?
How does your child like to go to sleep? (eg with a special toy, pacifier, comfort blanket, likes to be patted, likes to be read to, listens to
music, left alone?)
Note: Please note that it is a Government regulation that all children attending child care must have a designated physical rest period.
Toilet Habits (children enrolled in OSHC please go to next question)
Is your child toilet trained? Yes No
(Please note children who are not yet toilet trained are encouraged to wear nappies or pull-ups)
Dietary Requirements
Does your child have any special dietary requirements?
Does your child have any allergic reactions to any food/s?
Siblings
Does your child have any siblings? Yes No
Full name: Age: Which school/childcare:
Full name: Age: Which school/childcare:
Full name: Age: Which school/childcare:
Full name: Age: Which school/childcare:
APPLICATION FOR ENROLMENT SUNCOAST LITTLE LEARNERS10 Full and frank disclosure is required otherwise initial or ongoing enrolment will be aected.
APPLICATION FOR ENROLMENT SUNCOAST LITTLE LEARNERS11 Full and frank disclosure is required otherwise initial or ongoing enrolment will be aected.
APPLICATION FOR ENROLMENT SUNCOAST LITTLE LEARNERS12 Full and frank disclosure is required otherwise initial or ongoing enrolment will be aected.
Love. Learning. Adventure.
SUNCOAST LITTLE LEARNERS
A Suncoast Christian College,
Cnr Schubert & Kiel Mountain Roads, Woombye QLD 4559
P 5451 3600
E kcullen@suncoastcc.qld.edu.au
www.suncoastlittlelearners.com.au
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Enrolment APPLICATION (Australian National University)

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Completed 1 February 2022

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