Enrolment Form - Wanneroo Secondary College

"*" indicates required fields

1. Student Details

Enrolment Year Level*

Entry Year*

Enrolment Type*

Out of area applications will be assessed based on individual criteria. Priority is given to students applying for a SPECIALIST Program (Performing Arts or AFL). If your child is NOT applying for a Specialist Program, we strongly advise you to apply to your local intake area school. We will keep your application on file and review it at the end of term 3. We will contact you directly if we have the capacity to enrol your child.

Surname*

Legal Surname*

As on birth certificate/extract/passport

Name (Given)*

Middle Name: (if applicable)

Third Name: (if applicable)

Preferred Name

Date of Birth*

Gender*

Residential Address*

Number & Street Suburb/Town Postcode

Student Mobile

Siblings at Wanneroo Secondary College

Uset the + icon to add multiple

Name

Year Group

What school did the student previously attend?*

If previously enrolled in Home Education, please specify the Education Region

Reason for school movement

Finishing Primary School

Moving house

Change in family circumstance

Other

Has the student ever been excluded from another school?*

If yes, please specify below.

If Yes, please specify which school*

Is this student subject to any Access Restrictions?*

If yes, please specify and attach supporting documentation below.

If Yes, please specify*

Attach any supporting documentation

Max. file size: 128 MB.

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Is this student in the care of the Department of Children and Family Services? DCFS*

If yes, please provide details and attach supporting documentation below.

Case Manager*

Phone Number*

DCFS Address

Number & Street Suburb/Town Postcode

Attach any supporting documentation

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Is the student subject to any court orders in respect of their care, welfare and development?*

If yes please specify and attach supporting documentation below

If Yes, please specify*

Attach any supporting documentation

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Who does the student live with?

2. Specialist Programs & Educational Support Application

Is your child interested in applying for any of the following selective programs?

Specialist AFL Program

Specialist Performing Arts Program

Instrumental Music Program (IMMS)

Endorsed Education Support Program

Once you have completed this enrolment form, please ensure you complete the AFL, Performing Arts or Instrumental Music Application Forms (whichever is applicable) available on the enrolments page of our website.

Endorsed Education Support Program

Previous School Attended

Psychology Involvement

Previous School Psychology Involvement

Yes

To be determined

DIAGNOSES - this section MUST be completed for the child to be considered for the Education Support Program. (Eligibility for Education Support requires at least ONE of these diagnosis – previous school should have these documents and can assist with completing this section).

ID – DSM-5: (Intellectual Disability)

Mild

Moderate

Severe

Profound

ID - DSM-5 Documentation to be provided

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ID(IDD) - DSM-5 Documentation

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ASD – DSM-5: (Autism Spectrum Disorder)

Level 1

Level 2

Level 3

ASD – DSM-5 Documentation to be provided

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ASD – DSM-5 Documentation

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Co-Occurring Conditions

ADD

ADHD

Anxiety

Depression

Conduct Disorder

Expressing Language Disorder

Seizure Disorder

Hypermobility

Other (please specify below)

Other co-occurring conditions:

IDA Funding

IDA funding level (if unsure please contact your previous school)

Support Plans

These may be provided by medical practitioners, therapists, or previous schools; please submit all relevant plans.

Please select where applicable

Attach Documents*

Max. file size: 128 MB.

3. Family Details

Parent/Guardian/Caregiver 1

Name*

Title First Name Surname

Relationship to Student*

Residential Address*

Number & Street Suburb/Town Postcode

Mobile*

Work Phone

Email Address*

Lives with the student*

Parental responsibility*

Receive correspondence, reports etc*

Responsible for payment of Contributions & Charges*

Parent/Guardian/Caregiver 1 Background Information

Do you speak a language other than English at home*

If Yes, please specify*

What is the highest year of schooling you have completed?*

Year 12 or equivalent

Year 11 or equivalent

Year 10 or equivalent

Year 9 or equivalent

If you did not attend school, mark "Year 9 or equivalent or below".

What is the highest level of qualification you have completed*

Bachelor’s degree or above

Advanced Diploma/Diploma

Certificate I to IV (including trade certificates)

No non-school qualification

Please view the following occupation group information:

Occupation Group Information

What is your occupation group?

Parent/Guardian/Caregiver 2

Name*

Title First Name Surname

Relationship to student*

Address*

Number & Street Suburb/Town Postcode

Mobile*

Work Phone

Email Address*

Lives with the student*

Parental responsibility*

Receive correspondence, reports etc*

Responsible for payment of Contributions & Charges*

Parent/Guardian/Caregiver 2 Background Information

Do you speak a language other than English at home*

If Yes, please specify*

What is the highest year of schooling you have completed?

Year 12 or equivalent

Year 11 or equivalent

Year 10 or equivalent

Year 9 or equivalent

If you did not attend school, mark "Year 9 or equivalent or below".

What is the highest level of qualification you have completed?

Bachelor Degree or above

Advanced Diploma/Diploma

Certificate I to IV (including trade certificates)

No non-school qualification

Please view the following occupation group information:

Occupation Group Information

What is your occupation group?*

4. Emergency Contact Details

Additional Emergency Contacts

Other than Parent/Guardian/Caregiver - In an emergency, where the parent/guardian cannot be contacted, please provide alternative contact/s. For independent students, this is the first point of contact in an emergency.

Additional Contact 1

Name*

Title First Name Surname

Relationship to student*

Phone number 1*

Phone number 2*

Additional Contact 2

Name

Title First Name Surname

Relationship to student

Phone number 1

Phone number 2

Emergency Contact Order

Indicate by placing a number in the box (1, 2, 3, 4) the order in which the following people should be contacted in an emergency.

Parent/Guardian/Caregiver 1*

Please enter a number from 1 to 4.

Parent/Guardian/Caregiver 2*

Please enter a number from 1 to 4.

Additional Contact 1*

Please enter a number from 1 to 4.

Alternate Contact 2

Please enter a number from 1 to 4.

5. Student Details - Additional Information

Religion

First Language

Main Language Spoken

Is the student of Aboriginal or Torres Strait Islander origin

Yes, Aboriginal

Yes, Torres Strait Islander

Yes, both Aboriginal and Torres Strait Islander

What is the student's country of birth?*

Is the student an Australian Citizen?*

Yes

Date of arrival in Australia (if born in another country)

Visa Sub Class Number

Visa Grant Number

Visa Expiry Date

6. Permissions & Policies

Consent for publication of a student’s photo and/or work

We request permission for work and/or images of your child to be taken during school activities and published. Work/images would be used for the purposes of educating students, promoting our school and/or promoting public education.

I agree to the school capturing images of my child during school activities and the use of my child’s work for the purpose of educating students, promoting the school and promoting public education*

I agree to my student’s photo being included in the yearly class/specialist photos*

School Curriculum & Standards Authority (SCaSA) and Dept of Education (DoE) Release of Information

The School Curriculum & Standards Authority (SCaSA) & Dept of Education ((DoE) are now required by legislation to establish and maintain a record of all High School students. On some occasions it may need to release information to other organisations as follows:

1. Results of studies may warrant the granting of an award. If you DO NOT wish the SCaSA and/or DoE to publish or release your student’s name or address to an individual or organization, please enter ‘No’ in the dropdown box.*

2. Organisations may request your student’s name and address from the SCaSA and/or DoE so that they can send you career information. If you DO NOT give the SCaSA and DoE permission to release your student’s name and/or address to any such organization, please enter “NO” in the dropdown box.*

3. Relevant for students who will be sitting Schools Curriculum & Standards Authority examinations. The SCaSA and/or DoE organisations and/or committees may wish to use your student’s answers to examination questions in educational publications. If you DO NOT give permission for the SCaSA and/or DoE to use and/or release your student’s examination script for such publications, please enter “NO” in the dropdown box. (Any time your student’s work is used in a publication, he or she will be advised and sent a complimentary copy of the relevant publication).*

Smartrider

The Public Transport Authority (PTA) advised that all new secondary students are eligible to receive a Student SmartRider concession card, similar in size to a credit card. Students require a Student SmartRider to access student fare/concession travel on Transperth bus, rail, ferry services and Trans WA country road and rail services. To obtain a SmartRider, parent/guardian permission is required for the college to provide student details to the PTA for the purpose of registering the student for concession travel and to enable to SmartRider to be produced. The information that will be released is student name, date of birth, address and student number. The PTA must comply with the privacy act for the public sector and will only use the information provided by the college for the issuance of the Student SmartRider concession card. If you wish your child to be issued with Student SmartRider, please sign the slip below and return to Wanneroo Secondary College Administration with $2.00. Alternatively, SmartRiders may be purchased via the Qkr! app. (NB: Qkr! transactions do not require you to return this permission slip.) Replacement cards will cost $5.00 per card. You can apply directly to a Transperth Information Office for a SmartRider card, however you will need proof of current enrolment and a $5.00 fee applies. All bus information is available through Transperth on 13 62 13.

Parent/Guardian/Caregiver Name*

Student Name*

Date*

Smartrider cards can be purchased via the QKR app or from admin

ICT Acceptable Use Policy

Please read the attached information regarding the ICT Acceptable Use Policy

ICT Acceptable Use Policy

Date*

Dress Code

The Department of Education’s policy on school dress code allows schools and colleges to make the wearing of a school uniform a requirement. Wearing of the uniform brings with it many benefits such as: The promotion of the College’s public image, an enhanced college spirit, a reduction of rivalry between students, an increase in convenience, cost-saving for parents and preparation for work environments which have dress and safety codes.

Student Dress Code

7. Health

Student Health Care Summary

Doctor/Practice Name*

Phone*

Permission to call Doctor*

Yes

Permission to administer First Aid*

Yes

Do you have ambulance insurance*

Yes

Insurance Provider

Medicare Card*

Yes

Card Number

Expiry Date

List any essential information that could affect your child in an emergency

Administration of Medication

Written authorisation must be provided for staff to administer any form of medication. If your child requires medication to be administered, please contact the school office to request and complete an Administration of Medication Form. All medication must be supplied by parents/guardians/caregivers in original packaging

Informed Consent

Your child's health care information will be shared with staff on a "need to know" basis unless otherwise stated.

Do you give permission for the school to share your child's health care information?*

Yes

Does your child have one or more health condition(s) that will require support from school staff?*

Yes

Immunisation Status

Please select your child's immunisation status*

Immunisation complete

Immunisation incomplete

Not immunised

Medical Alert Information

Does your child have a Medical Alert bracelet or pendant?*

Yes

If yes, please provide details

Health Conditions

Please indicate any health conditions your child experiences

Severe allergy/anaphylaxis

Vision condition

Seizures

Minor/moderate allergies

Diabetes

Migraine/headaches

ADD/ADHD

Hearing condition (diagnosed)

Asthma

Other health conditions/needs

Diagnosed Learning Difficulty/Disability

Other diagnosed learning difficulty/disability

Please indicated any mental health condition your child experiences

8. Documentation

Please select which documents you will be providing & upload the documents to the fields provided.

The school requires ONE of the following as evidence of residence

A copy of your rental agreement showing a minimum of 12 months

A copy of your current rates bill if owner occupied

Please upload your selected file here*

Max. file size: 128 MB.

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PLUS at least TWO of the following showing your residential address

Power Account

Gas Account

Telephone Account (Not Mobile)

Water Corporation Account

Please upload your selected file here

Max. file size: 128 MB.

Please upload your selected file here

Max. file size: 128 MB.

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Please upload your selected files here

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Max. file size: 128 MB.

The school requires ALL of the following, please use this as a checklist to ensure you have included these in this application

Copy of Full Birth Certificate

Copy of Passport/Visa (if born overseas)

Copy of latest school report

Copy of Medicare Immunisation History

Copy of latest NAPLAN Report

Copy of any Family Court orders (if applicable)

Copy of Diagnosed Learning Difficulty/Disability information (if applicable)

Copy of Full Birth Certificate*

Max. file size: 128 MB.

Copy of Passport/Visa (if born overseas)

Max. file size: 128 MB.

Copy of latest school report

Max. file size: 128 MB.

Copy of Medicare Immunisation History*

Max. file size: 128 MB.

Copy of latest NAPLAN Report

Max. file size: 128 MB.

Copy of any Family Court orders (if applicable)

Max. file size: 128 MB.

Copy of Diagnosed Learning Difficulty/Disability information (if applicable)

Max. file size: 128 MB.

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Document Upload

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Max. file size: 128 MB.

9. Declaration

I delcare that the information provided on this form is ture. I understand that if false information is provided, the enrolment of my child at Wanneroo Secondary College will be terminated.
My child is not currently under suspension at, nor excluded from, another school.
I have read ad understood the Enrolment Overview. Please note that this application will NOT be processed unless
- All requested documentation is included
- The points above have been read and the application is signed below.

Name of person enrolling student: Title / Firstname / Surname

By clicking here, I state that I have read and understood the Declaration

I have read and understood the declaration

Date

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