Enrolment Information

Prep Application Update

Step 1 of 7

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Student Details

Student Surname(Required)

Surname (Legal Surname)

Student First Name(Required)

Given Name

Academic Grade & Year of Entry(Required)

Kindergarten Details

Does this child attend a Kindergarten? If 'Yes' please provide details below.(Required)

Yes

Current Kindergarten

Kindergarten Teacher/s

First Name & Surname

Kindergarten Email address

Kindergarten Phone Number

Christian Faith Commitment

Does the student attend church, Sunday school or Christian youth/play group

Yes

Attendance

Regular (weekly/fortnightly)

Occasional (monthly)

On special occasions (Christmas/Easter)

Religion / Faith

Church Denomination

Current Church

Christian Leader's Reference

There is no need to update your Christian Leader's Reference if you have previously provided one. However, if you are able to provide a reference at this time, please upload below.

I have previously provided a Christian Leader's Reference and there are no updates required

I have a Christian Leader's Reference to upload. (Please upload below)

Is this child from a non-Christian background or other religion?

Yes

If the family does not have a Christian faith background, what religious experience does this child have?

Upload Christian Leaders Reference here

Drop files here or

Max. file size: 200 MB.

Medical Needs

Does this student have any of the following medical needs? If yes to any medical needs, please provide detailed information (including reports from Specialist/s if available).

Vision

Yes

Allergies

Yes

Hearing

Yes

Serious illnesses, operations or accidents

Yes

Asthma/Respiratory Problems

Yes

Blood Disorder

Yes

Diabetes

Yes

Epilepsy

Yes

Heart Condition

Yes

Migraine

Yes

If 'Yes' selected above, please include detailed information here.

Upload files here

Drop files here or

Max. file size: 200 MB.

Specialist Services

Has this student attended or is scheduled to attend any of the following Specialist services? If yes to any specialist services, please provide detailed information (including reports from Specialist/s if available).

State/Child Guidance/Counsellor

Yes

Specialist Clinic (Hospital/Private)

Yes

Speech Pathologist

Yes

Audiologist

Yes

Occupational Therapist

Yes

Educational Psychologist/Consultant

Yes

Physiotherapist

Yes

Paediatrician

Yes

Psychiatrist/Psychologist

Yes

Other (e.g. Optometrist)

Yes

Other

If 'Yes' selected above, please include detailed information here.

Upload files here

Drop files here or

Max. file size: 200 MB.

Educational Needs / Disability / Impairment

Has your child ever been diagnosed/verified or suspected as having any of the following? If yes to any Educational Needs, please provide detailed information (including reports Specialist/s if available).

Autism/Asperger's

Yes

Vision Impairment

Yes

Hearing Impairment

Yes

Learning Difficulty/Disability

Yes

Intellectual Impairment

Yes

Dyslexia

Yes

Development Delay

Yes

Attention Deficit Disorder ADD

Yes

Physical Impairment

Yes

Attention Deficit Hyperactivity Disorder ADHD

Yes

Speech Language Impairment

Yes

Obsessive Compulsive Disorder OCD

Yes

Other

Yes

Other

If 'Yes' selected above, please include detailed information here.

Upload files here

Drop files here or

Max. file size: 200 MB.

Psychological / Emotional / Pastoral Care Needs

Does the student have any social difficulties with other children?

Yes

Has the student been victimised or bullied in a previous educational setting?

Yes

Does the student require support in regards to specific emotional needs? e.g. loss of parent, trauma, social stresses, family breakdown?

Yes

Are any of the listed conditions above likely to affect the student’s ability to participate fully in school activities? (e.g. classroom learning, socialisation, sport, camps, excursions etc.)

Yes

Unsure

Does the student suffer from any psychological conditions? e.g. OCD, Phobias, Depression, Anxiety

Yes

If 'Yes' selected above please include detailed information here

Disclosure and Release of Information

Please note the following conditions of enrolment at Genesis Christian College as specified in the Student Enrolment Contract; full and frank disclosure of all information must be provided by the parent/s, in writing, to the College regarding the student's medical, educational, physical,
emotional, or psychological conditions, during the enrolment process, leading up to the commencement of enrolment, and ongoing throughout the student’s enrolment at the College. Failure to provide full and frank disclosure in writing may be in breach of the subsequent contractual agreement thus rendering it void and the enrolment offer or ensuing enrolment, may be withdrawn.

Privacy Information: Genesis Christian College collects information about students to enable the College to provide appropriate education and support for each student and to discharge duty of care. Permission for release of information is obtained upon application for enrolment for this purpose. A request may be made by the College on behalf of parents to obtain school records or make contact with teachers and other professionals to assist in the education and support of students.

Release Information(Required)

I/we give permission for Genesis Christian College to collect an Early Childhood Development Statement from my/our child's Kindergarten as listed for the purpose of enrolment information.

Parent/Carer

Name and Surname Relationship to student:

Date