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BYOD

Expression of Interest Please be aware. This form is an expression of interest in enroling at our school.

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Student Enrolment

Student Name *

First

Last

Date Of Birth *

What year level will your child be going into? *

Contact Details

Parent / Guardian Name *

First

Last

Parent / Guardian Name

First

Last

Email *

Email

Confirm Email

Mobile Phone Number *

Home Phone Number

Current Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Are you planning on moving? *

Yes
No

Is the student living with parents/guardians? *

Yes
No

Proposed Address (if moving)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Proposed living arrangements (if not living with parents/guardians)

Medical Information

Does your child have any medical conditions? *

Yes
No

Please select from the following list *

Asthma
Allergy (including Anaphylaxis)
Other medical condition

Allergy (including Anaphylaxis) - Please provide information below *

Other Medical Condition - Please provide information below *

Please provide any Medical Action Plans for your child

Click or drag files to this area to upload. You can upload up to 5 files.

Commencement at Kyabram P-12 College

When are you hoping to commence at Kyabram P-12 College? *

Have you previously attended Kyabram P-12 College *

Yes
No

Reason(s) for wishing to enrol/return to Kyabram P-12 College? *

100 words or more

Language and Cultural Diversity

In which Country were you born? *

Australia
Other - Please specify below

If 'Other' above, please provide a copy of your current VISA and Passport below

Other - Please Specify *

Please provide a copy of your current VISA and Passport

Click or drag files to this area to upload. You can upload up to 2 files.

Do you speak a language other than English at home? *

No, English Only
Yes, other - please specify below

If YES, please provide a copy of your current Visa and Passport

Other - Please Specify *

Are you of Aboriginal or Torres Strait Islander Origin? *

No
Yes, Aboriginal
Yes, Torres Strait Islander

Any agencies involved? *

Yes
No

E.g. Dept. Human Services (HDS), Berry St. The Bridge, Child and adolescent Mental Health Services (CAMHS), Juvenile Justice, St Luke's or any similar agency, CASA

Agencies involved

if YES, please supply a contact name and number:

Is your child funded under the program for students with disabilities (PSD)? *

Yes
No

PSD Number:

If YES above please provide the PSD number

Does your child have an aide in class?

Yes
No

This college has a culture of supporting students as soon as they enrol. Are there any Teaching and Learning issues that need to be mentioned.

e.g. Needs Literacy assistance, Needs to sit at front of class.

Previous Education Provider

Have you previously attended another school? *

Yes
No

Previous School *

Previous School Phone Number *

Date exited this school *

Has your child had access or seen a:

Speech Therapist
Psychologist
Other Occupational Therapist
School-Based Counsellor

At their previous school? (Please tick)

If not attending school in the last 12 months, what have you been doing?

School Bus

Are you Seeking to travel on a School Bus? *

Yes
No

Travel to commence on what date?

Required Documents

Thank you for your enquiry. We will contact you to arrange a pre-enrolment meeting once you have provided the required documents;

Birth Certificate
Immunisation Certificate
School Report (If Applicable)
Visa (if applicable)

To provide the required documents, please upload them below or submit via the following;

Mail: PO Box 384, Kyabram, Victoria, 3619
Email: kyabram.p12@education.vic.gov.au
In person: Kyabram P-12 College Office,
57 Fischer street Kyabram, Victoria, 3620

Required Documents

Click or drag files to this area to upload. You can upload up to 4 files.

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