TRIAL DAY APPLICATION FORM

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Trial Day Enrolment Process

Please fill out the form below to register your child/children for a free trial day/days.

This form will take approximately 5 minutes to complete. Please complete all relevant fields and hit the "Submit" button at the end.

TRIAL DAY APPLICATION FORM

Comments

This field is for validation purposes and should be left unchanged.

Today's Date(Required)

Student's Full Name(Required)

Date Of Birth(Required)

Gender(Required)

Languages Spoken At Home (other than English)

Is The Student An Australian Citizen?(Required)

If Not An Australian Citizen, Please Insert Visa number

Do You Identify As Aboriginal Or Torres Strait Islander?(Required)

DOES YOUR CHILD HAVE ANY ALLERGIES, DIETARY REQUIREMENTS, BEHAVIOURAL OR SPECIAL NEEDS?(Required)

Allergies(Required)

Required Medications(Required)

Physical / Sensory(Required)

Sight / Hearing(Required)

Psychological(Required)

Speech(Required)

Behavioural / Safety(Required)

Medic Alert Bracelet(Required)

Does your child have a diagnosis?(Required)

If Yes, diagnostic reports must be provided

Upload Diagnosis Report (if relevant)

Max. file size: 1 GB.

If Yes, please include further details below.

Relevant details relating to or involving the student (e.g. family structure, ill health, physical disability, allergies, other learning requirements), must accompany this application. In cases of special learning requirements, the School needs to be fully informed in order to provide adequate support for your child should a place be offered. The School reserves the right to consider termination of the enrolment if relevant material is not disclosed.

PRESENT OR PREVIOUS SCHOOL NAME(Required)

CURRENT CLASS(Required)

Reason For Change Of School(Required)

WHY HAVE YOU CHOSEN TO APPLY FOR ENROLMENT AT HRSS?(Required)

HOW DID YOU HEAR ABOUT OUR SCHOOL?(Required)

WHAT CLASS DO YOU WANT TO TRIAL?(Required)

PREFERRED STARTING YEAR(Required)

PREFERRED STARTING TERM?(Required)

PARENT/GUARDIAN 1: FULL NAME(Required)

PARENT/GUARDIAN 1: ADDRESS(Required)

PARENT/GUARDIAN 1: HOME/MOBILE(Required)

PARENT/GUARDIAN 1: WORK/MOBILE(Required)

PARENT/GUARDIAN 1: EMAIL(Required)

PARENT/GUARDIAN 1: RELATIONSHIP TO CHILD(Required)

PARENT/GUARDIAN 1: NATIONALITY(Required)

PARENT/GUARDIAN 1: INDIGENOUS STATUS

PARENT/GUARDIAN 2: FULL NAME

PARENT/GUARDIAN 2: ADDRESS

PARENT/GUARDIAN 2: HOME/MOBILE

PARENT/GUARDIAN 2: WORK/MOBILE

PARENT/GUARDIAN 2: EMAIL

PARENT/GUARDIAN 2: RELATIONSHIP TO CHILD

PARENT/GUARDIAN 2: NATIONALITY

PARENT/GUARDIAN 2: INDIGENOUS STATUS

ANY FAMILY/CUSTODY/COURT/ RESTRAINING ORDERS? (IF YES, PLEASE PROVIDE SCHOOL WITH A COPY)

WHO DOES THE CHILD PRIMARILY RESIDE WITH?

EMERGENCY/AUTHORITY TO COLLECT PERSON 1: FULL NAME

EMERGENCY/AUTHORITY TO COLLECT PERSON 1: RELATIONSHIP TO CHILD

EMERGENCY/AUTHORITY TO COLLECT PERSON 1: PHONE

EMERGENCY/AUTHORITY TO COLLECT PERSON 2: FULL NAME

EMERGENCY/AUTHORITY TO COLLECT PERSON 2: RELATIONSHIP TO CHILD

EMERGENCY/AUTHORITY TO COLLECT PERSON 2: PHONE

CHILD'S MEDICARE NUMBER AND EXPIRY DATE(Required)

FAMILY DOCTOR AND CLINIC NAME(Required)

CLINIC ADDRESS

CLINIC PHONE NUMBER

HAS YOUR CHILD RECEIVED ALL SCHEDULED IMMUNISATIONS?(Required)