CHARLTON CHRISTIAN COLLEGE (Administered by Christian Education Foundation Limited) ABN

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1 CHARLTON CHRISTIAN COLLEGE (Administered by Christian Education Foundation Limited) ABN A Fassifern Road FASSIFERN NSW PO Box 605 TORONTO NSW 2283 Ph: Fax: Website: Application for Enrolment Please attach a recent photograph of your child (if possible) Completion of this form does not guarantee enrolment. An interview with the Executive will be arranged to discuss the application, after which you will be advised in writing as to the result. STUDENT INFORMATION Date: Name: Address: (Surname) (Christian Names) Age: Date of Birth: Current School/Preschool Attended: Present Class: In which year is entry desired? Class: OTHER CHILDREN IN THE FAMILY:- NAME: AGE APPLYING FOR ADMISSION (Please note a separate application must be completed for each child) YES/NO Class Year 20 YES/NO Class Year 20 YES/NO Class Year 20 RELIGIOUS INFORMATION Religion/Denomination: Church attended: Address: Rector/Minister/Pastor: Telephone Number: Father: Active Christian? Yes / No Mother: Active Christian? Yes / No Are Christian values the basis for relationships in your family? Yes / No Would you be willing to attend a Christianity Explained style of Seminar should one be available? Yes/No

2 Family s Christian Status, e.g. not Committed, Seeking, Church Goers, Active Christian FAMILY INFORMATION FATHER FULL NAME: (Title) ADDRESS: TELEPHONE NUMBER: MOTHER FULL NAME: (Title) ADDRESS: TELEPHONE NUMBER: WORK: EXT: WORK: EXT: MOBILE MOBILE I would like to receive the weekly I would like to receive the weekly College newsletter by College newsletter by Occupation: Employer: Parent s Marital Status Occupation: Employer: Language Spoken at Home Does any other adult have direct parental access to the child? Yes / No If Yes, give particulars: Name: Telephone: Person Responsible for Fees (other than parents) Address GENERAL INFORMATION How did you hear about this school? What are your expectations of the school? PUBLICATION CONSENT I consent to the publication of information and images featuring the achievements and activities undertaken by my child/ren. Examples of such publications include, but are not limited to, newsletters, magazines, concert videos, the school website, newspapers and school films for educational or publicity purposes. Yes No

3 I acknowledge that personal information will be maintained in accordance with the school s privacy Policy. Signature Date Signature Date TRANSPORT Please specify the mode it is anticipated your child would use when travelling to and from school. PRIVATE CAR PRIVATE BUS TRAIN OTHER (e.g. walk, cycle) SCHOLASTIC INFORMATION Please indicate academic level of pupil s previous work: Excellent Good Average Poor Please note any special achievements or strengths: Are there any areas of concern you may have with your child s progress, i.e. English / Maths / Emotional / Social / Behavioural / Speech / Other? Has your child undergone any asse ssments in relation to this area of concern? Yes/No Is your child currently receiving support from outside specialists or therapists? i.e. Speech Therapy / Occupational Therapy, etc. Please attach all supporting documentation in your possession. If you are changing schools, did your child receive any support from their previous school? Yes/No Please describe the support received Please attach any relevant paperwork including report(s).... BEHAVIOUR INFORMATION Please indicate your child s general level of past conduct: Excellent Good Average Poor Has the child ever been expelled, suspended, or refused admission to another school? If so, please explain: Has the child ever had any disciplinary difficulties? At home? At school? If so, please explain:

4 Has the child ever been in trouble with the law, arrested, etc.? Yes/No If so, please explain: Has the child ever used alcohol, tobacco, or illegal drugs of any kind? If so, please explain:... MEDICAL INFORMATION Family Physician: Telephone Number: Does the student have any physical ailments or allergies? Tick if immunised against: Diphtheria Tetanus Polio Has your child recently had their hearing checked? Yes/No When? Has your child recently had their sight checked? Yes/No When? Please indicate the level of your child s general health: Excellent Good Average Poor Please describe any health concern (physical, emotional, abuse etc) or past problem that the school should be aware of : It is essential that parents/carers disclose all relevant information and documentation pertaining to your child s special needs. Failure to do so may result in the cancellation of this application process. NB Parents must disclose full medical and psychological information regarding their child. In some instances, the school may not be able to offer the physical and financial support required to accommodate students with special needs The College may be able to access funding to provide individual / small group / or additional resources for your child if they fulfil the specific criteria outlined by the Association of Independent Schools. However, for students with severe disabilities or needs, our College resources may be inadequate to provide for all their needs. DECLARATION I/we declare, to the best of my/our knowledge, that all the information above is true and correct Father s Signature Mother s Signature Signatories must attend interview with their child.

5 NEW REQUIREMENTS FOR COLLECTING INFORMATION ON STUDENTS BACKGROUND CHARACTERIS TICS The State, Territory and Commonwealth Education Ministers have made decisions that now require all government and non-government schools to comply with new data collection and reporting arrangements. All schools must collect information on the sex, Indigenous status, geographic location, socioeconomic background and language background of school students to fulfil their functions and obligations under State, Territory and Australian Government legislation. For more information, please go to All information which could identify or would reasonably identify individual students to whom particular background characteristics belong is removed for national reporting so that no personal information is reported publicly. Information collected from this form will be covered by the School s Privacy Policy. A copy of this policy is available from the school office. If you have any questions regarding these matters, please do not hesitate to speak to Marnie Theodoulou at the school office. 1 Sex Male Female Data Collection Form 2 Is the student of Aboriginal or Torres Strait Islander origin? (For persons of both Aboriginal and Torres Strait Islander origin, mark both Yes boxes) No... Yes, Aboriginal... Yes, Torres Strait Islander... 3 In which country w as the student born? Australia... New Zealand... England... China... Philippines... South Africa... Hong Kong... India... United States of America... South Korea... Other please specify Does the student or their mother/guardian or their father/guardian speak a language other than English at home? (If more than one language, indicate the one that is spoken most often) student father/guardian2 mother/guardian1 No, English only Yes, Italian Yes, Cantonese Yes, Arabic (incl. Lebanese) Yes, Vietnamese Yes, Greek Yes, Mandarin Yes, Tagalog - (Filipino) Yes, Spanish Yes, Macedonian Yes, Other please specify 5(a) What is the highest year of primary or secondary school the parents/guardians have completed? (For persons who have never attended school, mark Year 9 or equivalent or below) Mark one box only in each column father/guardian2 mother/guardian1 Year 12 or equivalent Year 11 or equivalent Year 10 or equivalent Year 9 or equivalent or below......

6 5(b) What is the lev el of the highest qualification the parents/guardians have completed? Mark one box only in each column father/guardian2 mother/guardian1 Bachelor degree or above Advanced diploma/diploma Certificate I to IV (including trade certificate) No non-school qualification (a) What is the occupation group of the father/parent2/guardian2? 6(b) What is the occupation group of the mother/parent1/guardian1? Please select the appropriate parental occupation group from the following list. If the person is not currently in paid work but has had a job in the last 12 months or has retired in the last 12 months, please use the person s last occupation. If the person has not been in paid work in the last 12 months, enter 8 in the box above 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/f ire services administrator Other administrator [school principal, f aculty head/dean, library/museum/gallery director, research facility director] Defence Forces Commissioned Officer Professionals generally have degree or higher qualif ications and experience in applying this knowledge to design, dev elop or operate complex systems; identify, treat and advise on problems and teach others Health, Education, Law, Social Welfare, Engineering, Science, Computing prof essional Business [management consultant, business analyst, accountant, auditor, policy analyst, actuary, valuer] Air/sea transport [aircraft/ship s captain/officer/pilot, flight officer, fly ing instructor, air traffic controller] Group 2: Other business managers, arts/media/sportspersons and associate professionals Owner/manager of farm, construction, import/export, wholesale, manuf acturing, transport, real estate business Specialist manager [f inance/engineering/production/personnel/industrial relations/sales/marketing] Financial services manager [bank branch manager, f inance/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 hav e 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 representativ e, retail buyer, office/project manager] Defence Forces senior Non-Commissioned Officer Group 3: Tradesmen/w omen, clerks and skilled office, sales and service staff Tradesmen/women generally hav e completed a 4 y ear Trade Certif icate, usually by apprenticeship. All tradesmen/women are included in this group Clerks [bookkeeper, bank/po clerk, statistical/actuarial clerk, accounting/claims/audit clerk, pay roll clerk, recording/registry/filing clerk, betting clerk, stores/inv entory clerk, purchasing/order clerk, f reight/transport/shipping clerk, bond clerk, customs agent, customer serv ices 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 adjustor, 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 serv ice supervisor, receptionist, waiter, bar attendant, kitchenhand, porter, housekeeper] Office assistants, sales assistants and other assistants Office [ty pist, word processing/data entry/business machine operator, receptionist, office assistant] Sales [sales assistant, motor v ehicle/carav an/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 [f arm ov erseer, shearer, wool/hide classer, farm hand, horse trainer, nurseryman, greenkeeper, gardener, tree surgeon, f orestry/logging worker, miner, seafarer/f ishing hand] Other worker [labourer, f actory hand, storeman, guard, cleaner, caretaker, laundry worker, trolley collector, car park attendant, crossing superv isor]

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