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Page 1 of 20 St Vincent’s Primary School PO Box 6574 GCMC QLD 9726 APPLICATION OF ENROLMENT STUDENT NAME ___________ YEAR LEVEL START DATE ___________ ! " OFFICE USE ONLY APPLICATION INFORMATION INTERVIEW INFORMATION ENROLMENT CONFIRMATION Lodgement Date Date Time Date Received Application Fee Paid Yes No Interviewer Signature Start Date Receipt No. Outcome Confirmation Fee Paid Yes No Special Circumstances Yes No Date Receipt No. BCE ID No.

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Page 1: APPLICATION OF ENROLMENT Parents/Documents/current... · 2017-12-05 · GCMC QLD 9726 APPLICATION OF ENROLMENT STUDENT ... Certificate I to IV (including trade certificate) No non-school

Page 1 of 20

St Vincent’s Primary School PO Box 6574

GCMC QLD 9726

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APPLICATION OF ENROLMENT

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STUDENT NAME ___________ YEAR LEVEL START DATE ___________ �

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OFFICE USE ONLY APPLICATION INFORMATION INTERVIEW INFORMATION ENROLMENT CONFIRMATION

Lodgement Date Date Time Date Received

Application Fee Paid Yes No

Interviewer Signature Start Date

Receipt No. Outcome Confirmation Fee Paid

Yes No

Special Circumstances Yes No

Date Receipt No.

BCE ID No.

Page 2: APPLICATION OF ENROLMENT Parents/Documents/current... · 2017-12-05 · GCMC QLD 9726 APPLICATION OF ENROLMENT STUDENT ... Certificate I to IV (including trade certificate) No non-school

APPLICATION FOR ENROLMENTThis form is to be completed in

When completing this form, please

Name of School:

STUDENT

Section 1: Student Personal DetailsA legible copy of the student’s Birth Certificate Legal Surname: Legal First Name: Other Given Name(s): BCE Student Id: (If known): Section 2: Student Cultural Background Country of Birth*: In which country was the student born?

Australia Other (Please specify) ___________________ Indigenous Status*: Is the student of Aboriginal or Torres Strait Islander origin?

No Yes, Aboriginal Yes, Torres Strait Islander Yes, Both Aboriginal and Torres Strait Islander

S __ __ __ __ __ __

Please circle the Year Level and indicate the Year for which the enrolment is required.

Prep Yr 1 Yr 2 Yr 3 Start Date:

St Vincent’s School

D D / M M / Y Y Y Y

Page 2 of 20

PPLICATION FOR ENROLMENTThis form is to be completed in conjunction with the Notes Booklet.

When completing this form, please PRINT CLEARLY in blue or black pen.

School Suburb:

TUDENT INFORMATION

Section 1: Student Personal Details

Birth Certificate (and Change of Name Certificate, if applicable)

Preferred Surname: (to be used only with Principal’s approval

Preferred First Name: (If different from Legal

Date of Birth: Gender*: Male Female

Cultural Background

___________________

Torres Strait Islander origin?

Both Aboriginal and Torres Strait Islander

First Language Spoken: What is the language that the student identifies, or remembers, as being the first language, which heextent of being able to conduct a conversation?

English Other (Please specify) ___________________ Main Language Spoken at HomeDoes the student speak a language other than English at home? If more than one language, indicate the one that is often.

No, English Only Yes, Other (Please specify)

Other Language Spoken at HomeDoes the student speak another language other than English at home and other than the Main Language Spoken at Home as indicated above?

No Yes, Other (Please specify

D D / M M / Y Y Y Y

circle the Year Level and indicate the Year for which the enrolment is required.

Yr 4 Yr 5 Yr 6 Yr 7 Yr 8 Yr 9

Student’s current Year Level is: Yr _____

Cleatr Island Waters

D D / M M / Y Y Y Y

PPLICATION FOR ENROLMENT conjunction with the Notes Booklet. PRINT CLEARLY in blue or black pen.

School Suburb:

must be attached.

to be used only with Principal’s approval)

f different from Legal First Name)

What is the language that the student identifies, or remembers, as

he/she could understand to the extent of being able to conduct a conversation?

___________________

Main Language Spoken at Home*: Does the student speak a language other than English at home? If more than one language, indicate the one that is spoken most

specify) _______________

Other Language Spoken at Home: Does the student speak another language other than English at home and other than the Main Language Spoken at Home as

specify) ______________

D D / M M / Y Y Y Y

circle the Year Level and indicate the Year for which the enrolment is required.

Yr 10 Yr 11 Yr 12

_____ or Not Applicable

Page 3: APPLICATION OF ENROLMENT Parents/Documents/current... · 2017-12-05 · GCMC QLD 9726 APPLICATION OF ENROLMENT STUDENT ... Certificate I to IV (including trade certificate) No non-school

Section 3: Student Citizenship Country of Citizenship: In which country does the student currently hold citizenship? Australia (If the student was not born in Australia or

were not Australian Citizens, proof of Australian

Proceed to Section 5: Current/Previous Schooling

Other Country (Please specify) ______________________________Proceed to Section 4: International Details

Section 4: Student International DetailsComplete this section for students who are NOT Australian Citizen A legible copy of the student’s Visa, Passport must be attached. Country of Passport Issue: Visa Sub-Class Number: Visa Expiry Date: Section 5: Student Current/Previous SchoolingProvide details of any educational environment which the Legible copies of any Transfer Documentation

School Name Suburb/Town

If more space is required, please attach a separate page

Section 6: Student Religious Background Has the student been baptised in the Catholic f Yes. A legible copy of the student

Received should be provided below No. Other Religion (Please specify)

Sacraments Received:

Baptism Date Received DD / MM / YY

Reconciliation Date Received DD / MM / YY

Eucharist Date Received DD / MM / YY

Confirmation Date Received DD / MM / YY

____ ____ ____

D D / M M / Y Y Y Y

Page 3 of 20

Citizenship

hold citizenship?

Australia or, the student was born in Australia and the parents proof of Australian Citizenship documentation must be provided

urrent/Previous Schooling

______________________________ nternational Details

International Details NOT Australian Citizens.

Visa, Passport (including passport number) and Health Care

Date of Entry to Australia Health Care Number: Health Care Expiry Date:

Student Current/Previous Schooling Provide details of any educational environment which the student currently attends or has previously attended

Documentation should be attached (if applicable).

Suburb/Town State Contact Number (if known)

Year Level(s)

Attended From

DD / MM /

DD / MM / YY

DD / MM / YY

space is required, please attach a separate page.

Religious Background

been baptised in the Catholic faith?

legible copy of the student’s Baptismal Certificate must be attached and details of any should be provided below

)

DD / MM / YY Parish ___________________ Suburb

DD / MM / YY Parish ___________________ Suburb

DD / MM / YY Parish ___________________ Suburb

DD / MM / YY Parish ___________________ Suburb

D D / M M / Y Y Y Y

D D / M M / Y Y Y Y

Australia and the parents were not born in Australia or Citizenship documentation must be provided)

and Health Care documentation

Date of Entry to Australia:

:

.

Attended From (Date)

Attended To (Date)

DD / MM / YY DD / MM / YY

DD / MM / YY DD / MM / YY

DD / MM / YY DD / MM / YY

must be attached and details of any Sacraments

Suburb __________________

Suburb __________________

Suburb __________________

Suburb __________________

Y Y Y Y

D D / M M / Y Y Y Y

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Page 4 of 20

RELATED PERSONS’ INFORMATION

Section 7: Related Persons’ Personal Details

Parent/Legal Guardian/Caregiver 1 Legal Surname: Legal First Name: Other Given Name(s): Preferred Surname: (If different from Legal Surname) Preferred First Name: (If different from Legal First Name) Title: Mr Mrs Miss Ms Dr Fr Sr Br Rev Prof Gender: Male Female Date of Birth:

Parent/Legal Guardian/Caregiver 2 Legal Surname: Legal First Name: Other Given Name(s): Preferred Surname: (If different from Legal Surname) Preferred First Name: (If different from Legal First Name) Title: Mr Mrs Miss Ms Dr Fr Sr Br Rev Prof Gender: Male Female Date of Birth:

Section 8: Related Persons’ Cultural Background

Parent/Legal Guardian/Caregiver 1 Country of Birth: Where was this person born?

Australia Other (Please specify) ___________________ Country of Passport Issue: If not eligible for an Australian passport.

Main Language Spoken at Home*: Does the parent/caregiver speak a language other than English at home? If more than one language, indicate the one that is spoken most often. No, English Only Yes, Other (Please specify) _______________ Other Language Spoken at Home: Does the parent/caregiver speak another language other than English at home and other than the Main Language Spoken at Home as indicated previously?

No Yes, Other (Please specify) _______________

Religion: Parish of Worship: (If applicable)

Parent/Legal Guardian/Caregiver 2 Country of Birth: Where was this person born?

Australia Other (Please specify) ___________________ Country of Passport Issue: If not eligible for an Australian passport.

Main Language Spoken at Home*: Does the parent/caregiver speak a language other than English at home? If more than one language, indicate the one that is spoken most often. No, English Only Yes, Other (Please specify) _______________ Other Language Spoken at Home: Does the parent/caregiver speak another language other than English at home and other than the Main Language Spoken at Home as indicated previously?

No Yes, Other (Please specify) _______________

Religion: Parish of Worship: (If applicable)

D D / M M / Y Y Y Y

D D / M M / Y Y Y Y

Page 5: APPLICATION OF ENROLMENT Parents/Documents/current... · 2017-12-05 · GCMC QLD 9726 APPLICATION OF ENROLMENT STUDENT ... Certificate I to IV (including trade certificate) No non-school

Page 5 of 20

Section 9: Related Persons’ General Information

Parent/Legal Guardian/Caregiver 1 Occupation Group*: What is the occupation group of the parent/caregiver? Select the appropriate parental occupation group number from the attached list in Appendix 1 in the Notes Booklet, and write the number in the box at right.

• 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, 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.

Highest School Level*: What is the highest year of primary or secondary school the parent/caregiver has completed? For persons who have never attended school, mark “Year 9 or equivalent or below”.

Year 12 or equivalent Year 11 or equivalent Year 10 or equivalent Year 9 or equivalent or below Highest Qualification Level*: What is the level of the highest qualification the parent/caregiver has completed?

Bachelor degree or above Advanced diploma/Diploma Certificate I to IV (including trade certificate) No non-school qualification Occupation: Describe the type of work, if any, which the parent/caregiver undertakes. (eg plumber, fire fighter, shop assistant, homemaker, nurse, pensioner, student) Workplace: Provide the name of the parent/caregiver‘s workplace. (eg Brisbane City Council, Mater Hospital, Coles)

Talents: Indicate any special talents the parent/caregiver possesses which may be of benefit to the school community.

Interests: Indicate any special interests the parent/caregiver possesses which may be of benefit to the school community.

Parent/Legal Guardian/Caregiver 2 Occupation Group*: What is the occupation group of the parent/caregiver? Select the appropriate parental occupation group number from the attached list in Appendix 1 in the Notes Booklet, and write the number in the box at right.

• 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, 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.

Highest School Level*: What is the highest year of primary or secondary school the parent/caregiver has completed? For persons who have never attended school, mark “Year 9 or equivalent or below”.

Year 12 or equivalent Year 11 or equivalent Year 10 or equivalent Year 9 or equivalent or below Highest Qualification Level*: What is the level of the highest qualification the parent/caregiver has completed?

Bachelor degree or above Advanced diploma/Diploma Certificate I to IV (including trade certificate) No non-school qualification Occupation: Describe the type of work, if any, which the parent/caregiver undertakes. (eg plumber, fire fighter, shop assistant, homemaker, nurse, pensioner, student) Workplace: Provide the name of the parent/caregiver’s workplace. (eg Brisbane City Council, Mater Hospital, Coles)

Talents: Indicate any special talents the parent/caregiver possesses which may be of benefit to the school community.

Interests: Indicate any special interests the parent/caregiver possesses which may be of benefit to the school community.

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Page 6 of 20

Section 10: Related Persons’ Address Information

Parent/Legal Guardian/Caregiver 1 Residential Address Details Street Address: Suburb/Town: State: Postcode: Country (if not Australia): Postal/Correspondence Address Details

Same as Residential address

Postal Address: Suburb/Town: State: Postcode: Country (If not Australia): Residential (Alternative) Address Details (If required) Street Address: Suburb/Town: State: Postcode: Country (if not Australia):

Parent/Legal Guardian/Caregiver 2 Residential Address Details

Same as Parent/Legal Guardian/Caregiver1

Street Address: Suburb/Town: State: Postcode: Country (if not Australia): Postal/Correspondence Address Details

Same as Residential address

Postal Address: Suburb/Town: State: Postcode: Country (If not Australia): Residential (Alternative) Address Details (If required) Street Address: Suburb/Town: State: Postcode: Country (if not Australia):

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Page 7 of 20

Section 11: Related Persons’ Contact Information

Parent/Legal Guardian/Caregiver 1

Order Silent Contact Method Type Home Telephone Number: Mobile Telephone Number: Email Address: Work Telephone Number: Work Mobile Telephone Number: Work Email Address: Comments:

Parent/Legal Guardian/Caregiver 2

Order Silent Contact Method Type Home Telephone Number: Mobile Telephone Number: Email Address: Work Telephone Number: Work Mobile Telephone Number: Work Email Address: Comments:

Section 12: Related Persons’ Relationship to the Student

Parent/Legal Guardian/Caregiver 1 What is the relationship of this person to the student? (Tick one (1) only) Mother Home Stay Sister Father Home Stay Brother Step Mother Aunt Step Father Uncle Foster Mother Niece Foster Father Nephew Grandmother Cousin Grandfather Friend Home Stay Parent Doctor Sister Dentist Brother Legal Guardian (for Dept. of

Communities only) Half Sister Care Provider Half Brother Counsellor/Social Worker Step Sister Agent Step Brother Reg. Exchange Org Foster Sister Foster Brother

Parent/Legal Guardian/Caregiver 2 What is the relationship of this person to the student? (Tick one (1) only) Mother Home Stay Sister Father Home Stay Brother Step Mother Aunt Step Father Uncle Foster Mother Niece Foster Father Nephew Grandmother Cousin Grandfather Friend Home Stay Parent Doctor Sister Dentist Brother Legal Guardian (for Dept. of

Communities only) Half Sister Care Provider Half Brother Counsellor/Social Worker Step Sister Agent Step Brother Reg. Exchange Org Foster Sister Foster Brother

( ) _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _

( ) _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _

Indicate best contact order

for this person.

Is this number silent?

( ) _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _

( ) _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _

Indicate best contact order

for this person.

Is this number silent?

Page 8: APPLICATION OF ENROLMENT Parents/Documents/current... · 2017-12-05 · GCMC QLD 9726 APPLICATION OF ENROLMENT STUDENT ... Certificate I to IV (including trade certificate) No non-school

Section 12: Related Persons’ Relationship to the Student

Parent/Legal Guardian/Caregiver 1 Does this person perform any of the following roles in regards to the student? Emergency Contact:

Yes. Circle the priority in which this person is to be contacted in relation to other persons who could be contacted in the case of an emergency.

1st 2nd No Legal Guardian: If this person is not a birth or adoptive parent, then legal documentation must be attached.

Yes

No

Caregiver: A person who has responsibility for the general wellbeing of a student on a day-to-day basis.

Yes

No

Main Contact: A student must have one (1) main contact.

Yes

No

Is this person to receive any of the following forms of Communication?

Report Cards/Progress Reports: Yes

Newsletters: Yes

Invitations: Yes

School Portal Access: Yes

Does this person reside with the student

Yes

No Does this person require the assistance of an interpreter?

Yes

No

Page 8 of 20

Relationship to the Student (continued...)

Parent/Legal Guardian/Caregiver 1

person perform any of the following

ircle the priority in which this person is to persons who

could be contacted in the case of an emergency.

this person is not a birth or adoptive parent, then legal

person who has responsibility for the general wellbeing of a

Is this person to receive any of the following

Yes No Yes No

Yes No

Yes No

student?

this person require the assistance of an

Parent/Legal Guardian/Caregiver 2 Does this person perform any of the following roles in regards to the st Emergency Contact:

Yes. Circle the priority in which this person is to be contacted in relation to other persons who could be contacted in the case of an emergency.

1st

No Legal Guardian: If this person is not a birth or adoptive parent, then legal documentation must be attached.

Yes

No

Caregiver: A person who has responsibility for the general wellbeing of a student on a day-to-day basis.

Yes

No

Main Contact: A student must have one (1) main contact.

Yes

No

Is this person to receive any of the following forms of Communication?

Report Cards/Progress Reports:

Newsletters:

Invitations:

School Portal Access:

Does this person reside with the student?

Yes

No

Does this person require the assistance of an interpreter?

Yes

No

Parent/Legal Guardian/Caregiver 2

Does this person perform any of the following roles in regards to the student?

ircle the priority in which this person is to be contacted in relation to other persons who could be contacted in the case of an emergency.

2nd

this person is not a birth or adoptive parent, then legal documentation must be attached.

person who has responsibility for the general wellbeing of a

A student must have one (1) main contact.

Is this person to receive any of the following forms of Communication?

Report Cards/Progress Reports: Yes No Yes No

Yes No Yes No

Does this person reside with the student?

this person require the assistance of an

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Page 9 of 20

ADDITIONAL STUDENT INFORMATION

Section 13: Student Address Information Residential Address Details

Same as Parent\Legal Guardian\Caregiver1

Same as Parent\Legal Guardian\Caregiver2 Street Address: Suburb/Town: State: Postcode: Country (If not Australia):

Residential (Alternative) Details (If required)

Same as Parent\Legal Guardian\Caregiver1

Same as Parent\Legal Guardian\Caregiver2 Street Address: Suburb/Town: State: Postcode: Country (If not Australia):

Section 14: Student Contact Information Order Silent Contact Method Type Home Telephone Number: Mobile Telephone Number: Email Address:

Order Silent Contact Method Type (If required)

Home (Alternative) Number:

( ) _ _ _ _ _ _ _ _ ( ) _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _

Indicate best contact order

for the student.

Is this number silent?

Indicate best contact order

for the student.

Is this number silent?

Page 10: APPLICATION OF ENROLMENT Parents/Documents/current... · 2017-12-05 · GCMC QLD 9726 APPLICATION OF ENROLMENT STUDENT ... Certificate I to IV (including trade certificate) No non-school

Section 15: Student Medical Information Does the student have a medical condition of which the school should be aware? Yes. Provide details below. No. Proceed to Section 16: Student

Condition Requires Medication

Allergy Yes

Anaphylaxis Yes

Asthma Yes

Diabetes Mellitus Type 1 Yes

Epilepsy Yes

Febrile Convulsions Yes

Other (Please specify)

Yes

# Note that if any medication is required to be administered to the student during school timeMedical Action Plan, additional information will neefile. Section 16: Student Specialist Assessments Has the student had any recent allied health or medical specialist be aware? (eg an assessment by a speech pathologist, behavioural psychologist, orthopaedic specialist

Yes. Provide details below and ensure report(s) is attached.

No. Proceed to Section 17: Education

Page 10 of 20

Student Medical Information

a medical condition of which the school should be aware?

Student Specialist Assessments

Requires Medication#

Has Medical Action Plan#

Brief Description of Condition and Treatment

No Yes No

No Yes No

No Yes No

No Yes No

No Yes No

No Yes No

No Yes No

if any medication is required to be administered to the student during school time, additional information will need to be provided upon enrolment and retained on the student’s

Student Specialist Assessments

Has the student had any recent allied health or medical specialist assessments of which the school should (eg an assessment by a speech pathologist, behavioural psychologist, orthopaedic specialist

Provide details below and ensure a legible copy of any relevant health or medical assessment

Educational Support Information

Brief Description of Condition and Treatment

if any medication is required to be administered to the student during school time or if the student has a d to be provided upon enrolment and retained on the student’s

assessments of which the school should (eg an assessment by a speech pathologist, behavioural psychologist, orthopaedic specialist, paediatrician etc.)

medical assessment

Page 11: APPLICATION OF ENROLMENT Parents/Documents/current... · 2017-12-05 · GCMC QLD 9726 APPLICATION OF ENROLMENT STUDENT ... Certificate I to IV (including trade certificate) No non-school

Section 17: Educational Support Information Does the student have any educational support requirements of which the

Yes. Respond to the questions below

No. Proceed to Section 18: Legal

Describe any physical, social/emotional, andand / or participation in school.

Has the student been diagnosed with a disability? If so, provide details.

Has the student been verified by an educational sector in Queensland Independent Schools Queensland or Catholic Education

If the student is from interstate or overseas, describe the

Section 18: Legal Information Is the student in Care of the State?

Yes

No Are there any legal issues concerning the student of which the school should be aware?

Yes. Provide details below and ensure a

No. Proceed to Section 19: Sibling

Type Legal First

of the pdocument is issued

Parenting Order

Parenting Agreement

Domestic Violence Order

Apprehended Violence Order

Child Protection Order

Other Caring Arrangement (Please specify)

Legal Guardianship Documentation

Page 11 of 20

Educational Support Information

the student have any educational support requirements of which the school should be aware?

below.

Legal Information

physical, social/emotional, and/or learning needs of the student which may impact on duty of care

Has the student been diagnosed with a disability? If so, provide details.

Has the student been verified by an educational sector in Queensland (eg Department of Independent Schools Queensland or Catholic Education)? If so, provide details.

If the student is from interstate or overseas, describe the educational support provided.

Are there any legal issues concerning the student of which the school should be aware?

Provide details below and ensure a legible copy of any relevant legal document(s) is attached.

Sibling Information

Legal First Name and Surname of the person for whom the

document is issued

Effective From (Date)

D D / M M / Y Y

D D / M M / Y Y

D D / M M / Y Y

D D / M M / Y Y

D D / M M / Y Y

D D / M M / Y Y

D D / M M / Y Y

school should be aware?

/or learning needs of the student which may impact on duty of care

Department of Education and Training,

Are there any legal issues concerning the student of which the school should be aware?

legal document(s) is attached.

Effective To (Date)

D D / M M / Y Y

D D / M M / Y Y

D D / M M / Y Y

D D / M M / Y Y

D D / M M / Y Y

D D / M M / Y Y

D D / M M / Y Y

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Page 12 of 20

Section 19: Sibling Information Does the student have any siblings attending an education environment or other younger non-school age siblings?

Yes. Provide details below.

No. Proceed to Section 20: Additional Information

Sibling 1 Sibling 2 Sibling 3 Sibling 4 Legal Surname

Preferred Surname

Legal First Name

Relationship to Student

Date of Birth D D / M M / Y Y Y Y D D / M M / Y Y Y Y D D / M M / Y Y Y Y D D / M M / Y Y Y Y School Name and Suburb (If applicable)

Class (If applicable)

House (If applicable)

Resides with Student? Yes No Yes No Yes No Yes No Section 20: Additional Information Is there any other information which you believe may assist with this application for enrolment?

Yes. Provide details below.

No. Proceed to Check List

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Page 13 of 20

CONSENT FORM ALL FORMS OF MEDIA AND COMMUNICATIONS

What is this consent form for? Schools collect photographic and multimedia images of students for a wide range of reasons – to show parents/legal guardians activities undertaken by students and to promote the school. These images may be used in school websites, newsletters, brochures, promotional materials and sometimes in the mass media or other publications. Photographs and multimedia images may also be taken of students for record and archival purposes, such as annual class and individual photographs and similar multimedia productions. On occasion, the media may visit the school and may take photographs, video, or audio of school activities or newsworthy events. This consent form gives permission for the student to take part in such activities and for the student’s school and Brisbane Catholic Education to publish the photographs, video or audio recordings in school or Brisbane Catholic Education or associated publications, productions, presentations or media. This includes digital media such as the school or Brisbane Catholic Education websites. Consent also authorises the use of the student’s image and details (if appropriate) in mass media, under the school’s supervision, and authorises supervised media access to the student in circumstances deemed appropriate by, and managed by, the school. If parents/legal guardians do not give consent, this means that the student’s image and other details will not appear in any school publications and productions, associated materials, or in the media. If consent is withheld, the school requests that parents and guardians inform the student of this. If parents/legal guardians wish to give consent for the use of the student’s image in certain, but not all, circumstances, details must be provided in writing to the school Principal by the parents/legal guardians. While the school and Brisbane Catholic Education will make all reasonable efforts to ensure that only appropriately authorised persons complete the consent form and sign the authorisation in section 4, Brisbane Catholic Education will not be responsible for circumstances in which it is misled as to the identity and authority of that person. Who should sign the consent form? The student’s parents/legal guardians should sign the form, along with the student themselves (if age appropriate). This ensures that the student is aware consent has been given, or withheld. What happens to the consent form once it is filled out and signed? The consent form will be placed on the student’s file or record and retained by Brisbane Catholic Education. If requested, a photocopy of the form will be made available to the student and/or the student’s parents/legal guardians. Should you require any further information, please contact the school’s Principal or Brisbane Catholic Education’s Communications and Marketing office:

John Phelan Manager Communications and Marketing Brisbane Catholic Education Phone 07 33033 7489 e-mail [email protected]

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Page 14 of 20

CONSENT FORM

ALL FORMS OF MEDIA AND COMMUNICATIONS

1. Student details (compulsory)

Student’s Legal Name:______________________________________________________________________ Date of Birth: ____________________________________________________________________

2. Photographic/video/audio/communication consent and release I authorise the school and Brisbane Catholic Education to take and use any photographs, video or sound recordings of the student/me and any other reproductions or adaptations of the student’s/my likeness (‘the material’), either in full or part, in conjunction with any wording or drawings, in any school, Brisbane Catholic Education or associated publication, production and presentation. I acknowledge that I have/the student has no rights in the material nor in any school, Brisbane Catholic Education or associated publication, production and presentation which includes the material.

3. Media access I authorise the school and Brisbane Catholic Education, in consultation with me/my parent or care provider, to grant media access via a media representative to my child/me and I acknowledge that: • The school and Brisbane Catholic Education have the right to refuse media access where it would, in the

opinion of the Principal, interfere with the student’s well-being, or interfere with the operation of the school; • Access to Brisbane Catholic Education staff and use of Brisbane Catholic Education facilities will be

entirely at the discretion of Brisbane Catholic Education; and • Media access will be managed, where possible, by representatives of the school or Brisbane Catholic

Education.

4. Authorisation I authorise the school and Brisbane Catholic Education to take the actions indicated above. Signature of student’s parents/guardians: Legal Name/s of student’s parents/legal guardians: Address: Telephone: (Home) (Work) (Mobile) Email: Date:

Signature of student: (where appropriate)

Legal name of student:

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Page 15 of 20

ACCEPTABLE USE OF COMPUTER AND

INTERNET RESOURCES

Computer and Internet resources have become of critical importance to schools in facilitating and supporting learning and teaching. Technology resources are provided to students for educational purposes only.

St Vincent’s Primary School have established significant computing and communication resources to support these activities. This includes technology provided on school grounds and school owned notebooks/computer that may be taken off the school grounds with permission from the school. St Vincent’s Primary School has specific guidelines relating to the use of notebooks/computers [see page 16].

This document has been developed to inform users of their rights, responsibilities and obligations when using Computer and Internet resources, consistent with Brisbane Catholic Education’s requirements that all such resources are used in an ethical, legal and responsible manner.

The requirements and rules set out below apply to all St Vincent’s Primary School technology resources whether they are accessed through computers owned by the school or through privately owned devices (for example, accessing school internet through a personal notebook or telephone).

Please read this document carefully. Each student and his/her Parent/Legal Guardian must sign the acknowledgment to confirm that they understand the requirements of acceptable use and the potential consequences of a breach of this policy.

Responsibilities of Users

1. Students must comply with the rules for accessing technology resources in this document. Permitted use of technology resources 2. Students must only access St Vincent’s Primary School technology resources for schoolwork. Students

must not:

a. buy or sell items or services over the internet; b. access or enter chat rooms; c. access, post or send inappropriate internet or email content, especially content that is illegal,

dangerous, obscene or offensive; d. amend documents created by another student without that student's consent; e. download, install or use unauthorised computer programs; f. deliberately install computer viruses or other malicious programs; g. gain unauthorised access to any system by any means; h. use technology resources to attack or compromise another system or network; i. access or intercept emails sent to other persons. j.

Confidentiality and cybersafety 3. Students should be aware that material they post on Internet sites (including Facebook and other social

media sites) is public. The content of public posts may have personal implications for students if, for example, potential employers access that material. The content of posts also reflects on our educational institution and community as a whole. Once information is on the internet it may not be possible to remove it.

4. Students should not display personal information about themselves or others in a way which is public. For

example, students should not post their own or anyone else's address, telephone number or other personal details on the Internet or communicate these details in emails. Students should not distribute someone else's personal information without their permission.

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Page 16 of 20

ACCEPTABLE USE OF COMPUTER AND INTERNET RESOURCES (cont)

5. Where disclosure of personal information is made through authorised avenues (e.g. by the use of email or

an official website), users should be aware that invasions of privacy may sometimes occur and it is outside St Vincent’s Primary School’s control to prevent such instances from occurring.

6. Students should be aware that persons on the Internet might not be who they say they are. Students must

not arrange to meet persons who they have met on the Internet. 7. The operation and maintenance of technology resources often requires the backup and caching of data,

the logging of activity and the monitoring of general usage patterns and as such, complete confidentiality and privacy cannot be guaranteed. St Vincent’s Primary School may also be required to inspect or provide copies of electronic communications where required to by law, or where the investigation of possible misuses of technology resources is required.

Cyberbullying and defamation 8. Students must not use email or the Internet to say mean, rude or unkind things about other people or send

threatening, harassing or offensive messages. Improper use of technology resources could amount to defamation.

Security 9. Students must perform a virus check on all attachments received by email and on all storage devices (e.g.

USB, Discs, music devices, etc.) before opening. Students must ask for assistance if they are unsure as to how to perform a virus check or the virus check identifies a problem with the attachment/disk.

10. Students must select a secure password and keep their username and password information private. The

password should be changed regularly and should be difficult for other people to guess. Students must log off at the end of their computer session.

11. Students must not use another person's name and password to access resources. 12. Students must report a suspected breach of security to a teacher. Copyright 13. Just because something is on the Internet it is not freely available - copying or downloading material from

the Internet may be a breach of copyright or other intellectual property rights. Students must not use St Vincent’s Primary School technology resources to copy, download, store or transmit any such material that may include music files, movies, videos or any other form of media.

Consequences following a breach of this policy

14. A breach of this policy will be taken seriously and may result in disciplinary action. 15. Examples of possible consequences range from loss or restriction of access to technology resources, to

formal disciplinary action for breach of the School Discipline policy. Students and Parents/Legal Guardians may be financially liable for damage caused to resources.

16. Cases of serious, deliberate, and/or criminal breach will be referred to external authorities and may result in

civil or criminal proceedings.

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Page 17 of 20

ACCEPTABLE USE OF COMPUTER

AND INTERNET RESOURCE

CONSENT FORM This Acceptable Use of Computer and Internet Resource Consent Form must be signed and returned prior to students being granted access to the Internet and other information and communication technology resources. Parents/Legal Guardians are encouraged to review and discuss the contents of the Acceptable Use of Computer and Internet Resources policy with the student and answer any questions that they may have. Any queries in relation to this material should be directed to the school on 55721688 or [email protected] By signing this Consent Form, both Parents/Guardians and students are agreeing to the terms of access as set out in the Acceptable Use of Computer and Internet Resources policy and acknowledge they will be responsible in the event of any breach and that appropriate disciplinary steps may result. Student Acceptance I agree to comply with all requirements as set out in the Acceptable Use of Computer and Internet Resources policy and all other relevant laws and restrictions in my access to the various information and communication technology resources through the BCE and school network. NAME: __________________________ HOME GROUP/PC CLASS: _____________ SIGNATURE: _____________________ DATE: _________________ Parent/Guardian Consent As the Parent or Legal Guardian of the student named above, I grant permission for them to access the various information and communication technology resources (including email and the internet). I understand that access is granted to student subject to the restrictions contained in the Acceptable Use of Computers and Internet Resources policy and that if breached, consequences may follow. I acknowledge that some material available on the Internet may be objectionable and that in addition to the Acceptable Use of Computer and Internet Resources statement, I have discussed appropriate restrictions for the student when accessing or sharing information or material over the Internet. NAME: __________________________ DATE: _________________ SIGNATURE: ______________________

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Page 18 of 20

Brisbane Catholic Education (BCE) Information Collection Notice

.

Information we collect: Brisbane Catholic Education collects and records personal information, including sensitive information about students and parents/ legal guardians, before and during the course of a student’s enrolment at our school. Laws governing or relating to the operation of schools require that certain information is collected. These may include Public Health and Child Protection laws. We may ask you to provide medical reports about students from time to time. Health information about students is sensitive information within the terms of the National Privacy Principles under the Privacy Act (1988). Purpose of collection: The primary purpose of collecting and recording this information is to enable the provision of quality Catholic education. In addition, some of the information we collect and record is to satisfy the school’s legal obligations, particularly to enable the school to discharge its duty of care to students and parents/legal guardians. This information may also be used for appropriate parish purposes.

Disclosure of information: This information may be disclosed by us for administrative and educational purposes to others including, but not limited to, personnel within Brisbane Catholic Education Office, other Brisbane Catholic Education schools, medical practitioners, people providing services to schools, such as specialist visiting teachers and consultants. Personal information collected from students is regularly disclosed to their parents/ legal guardians. On occasions, information such as academic and sporting achievements, student activities, and other news may be published in newsletters, magazines, and on our website. Parents may seek access to personal information collected about them and their son/daughter by contacting the school.

Students may also seek access to personal information about them. However, there will be occasions when access is denied. Such occasions would include where access would have an unreasonable impact on the privacy of others, where access may result in a breach of the school’s duty of care to the student, or where students have provided information in confidence.

The school from time to time engages in fundraising activities. Information received from you may be used to make an appeal to you. It may also be disclosed to organisations that assist in the school’s fundraising activities solely for that purpose. We will not disclose your personal information to third parties for their own marketing purposes without your consent. We may include your contact details in a class list and school directory.

If you provide the school with the personal information of others, such as doctors or emergency contacts, we encourage you to inform them that you are disclosing that information to all Brisbane Catholic Education schools and why. They should also be informed that they can access that information if they wish and that the school does not usually disclose the information to third parties.

Our privacy position: Brisbane Catholic Education is bound by the Privacy Act (1988), and has adopted the ten (10) National Privacy Principles. A privacy statement detailing Brisbane Catholic Education’s practices and procedures for the use and management of the personal, sensitive and health information it collects and records can be accessed on the school’s website or the Brisbane Catholic Education website http://www.bne.catholic.edu.au Alternatively a hard copy of the statement may be provided on request.

Information required: If we do not obtain the personal, sensitive or health information referred to above, we may not be able to enrol or continue to enrol your student.

SIGNATURE of Parent or Legal Guardian

PRINT NAME of Parent or Legal Guardian

RELATIONSHIP to Student

DATE SIGNED

D D / M M / Y Y Y Y

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Page 19 of 20

APPENDIX 1 – List of Parental Occupation Groups

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/fire services administrator Other administrator [school principal, faculty head/dean, library/museum/gallery director, research facility director] Defence Forces Commissioned Officer Professionals generally have degree or higher qualifications and experience in applying this knowledge to design, develop or

operate complex systems; identify, treat and advise on problems; and teach others. Health, Education, Law, Social Welfare, Engineering, Science, Computing professional Business [management consultant, business analyst, accountant, auditor, policy analyst, actuary, valuer] Air/sea transport [aircraft/ship’s captain/officer/pilot, flight officer, flying instructor, air traffic controller] Group 2: Other business managers, arts/media/sportspersons and associate professionals Owner/manager of farm, construction, import/export, wholesale, manufacturing, transport, real estate business Specialist manager [finance/engineering/production/personnel/industrial relations/sales/marketing] Financial services manager [bank branch manager, finance/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 have 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 representative, retail buyer, office/project manager] Defence Forces senior Non-Commissioned Officer Group 3: Tradesmen/women, clerks and skilled office, sales and service staff Tradesmen/women generally have completed a 4 year Trade Certificate, usually by apprenticeship. All tradesmen/women are

included in this group. Clerks [bookkeeper, bank/PO clerk, statistical/actuarial clerk, accounting/claims/audit clerk, payroll clerk, recording/registry/filing

clerk, betting clerk, stores/inventory clerk, purchasing/order clerk, freight/transport/shipping clerk, bond clerk, customs agent, customer services 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 adjuster, 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 service supervisor, receptionist, waiter, bar attendant, kitchenhand, porter, housekeeper] Office assistants, sales assistants and other assistants. Office [typist, word processing/data entry/business machine operator, receptionist, office assistant] Sales [sales assistant, motor vehicle/caravan/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 [farm overseer, shearer, wool/hide classer, farm hand,

horse trainer, nurseryman, greenkeeper, gardener, tree surgeon, forestry/logging worker, miner, seafarer/fishing hand]

Other worker [labourer, factory hand, storeman, guard, cleaner, caretaker, laundry worker, trolley collector, car park attendant, crossing supervisor]

If the person is not currently working 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, select ‘Not in paid work in last 12 months’.

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CHECK LIST Please complete before

Note that original documents will need to be sighted to finalise enrolment confirmation.

Documents provided:

• Birth Certificate

• Australian Citizenship Documentation

• Current Visa

• Current Passport

• Health Care Documentation

• Current/Previous School Transfer Form

• Baptism Certificate

• Health or Medical Assessment Report

• Legal Documentation

Signature(s) I declare that:

• I have completed this form in conjunctio

• The information provided in this form is complete and

to the student seeking enrolment

I understand that:

• I have an obligation to inform the school of any change to the information provided in this

affect this Application for Enrolment

• Should this Application for Enrolment be successful,

relevant, current information about the student for the period of enrolment at the school

SIGNATURE of Parent or Legal Guardian

PRINT NAME of Parent or Legal Guardian

RELATIONSHIP to Student

DATE SIGNED

D D / M M / Y Y Y Y

Page 20 of 20

before submitting the Application for Enrolment

original documents will need to be sighted to finalise enrolment confirmation.

Yes No

Documentation Yes No Not Applicable

Yes No Not Applicable

Yes No Not Applicable

Yes No Not Applicable

Previous School Transfer Form Yes No Not Applicable

Yes No Not Applicable

th or Medical Assessment Reports Yes No Not Applicable

Yes No Not Applicable

completed this form in conjunction with the Notes Booklet

information provided in this form is complete and is a full and frank disclosure of information pertinent

to the student seeking enrolment

I have an obligation to inform the school of any change to the information provided in this

ication for Enrolment

Should this Application for Enrolment be successful, I have an ongoing obligation to provide the school with

information about the student for the period of enrolment at the school

or Legal Guardian

or Legal Guardian

SIGNATURE of Parent or Legal Guardian

PRINT NAME of Parent or Legal Guardian

RELATIONSHIP to Student

DATE SIGNED

D D / M M / Y Y Y Y

Editable

nrolment form

original documents will need to be sighted to finalise enrolment confirmation.

t Applicable

t Applicable

t Applicable

t Applicable

t Applicable

t Applicable

Not Applicable

t Applicable

disclosure of information pertinent

I have an obligation to inform the school of any change to the information provided in this form that may

I have an ongoing obligation to provide the school with

information about the student for the period of enrolment at the school

or Legal Guardian

or Legal Guardian

to Student

D D / M M / Y Y Y Y

Editable Print Version - V2: 20110705