60 Barretts Road, Clapham SA 5062

(08) 8276 5633

dl.0952.info@schools.sa.edu.au

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Expression Of Interest For Future Enrolment

(Please note this is not an acceptance of enrolment. Your details will be kept on record for future enrolment and contact will be made from a member of the leadership team)

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Student Personal Details

Family Name

Given Names

Date Of Birth

Sex

Male Female Other

Is the student of Aboriginal Origin?

Yes No

Is the student of Torres Strait Islander Origin?

Yes No

Language spoken at home

Is this student an international student? If yes, please specify Visa Sub Class Code

Yes No

Commencement Year Level

Reception Year 1 Year 2 Year 3 Year 4 Year 5 Year 6

Previous Kindy / School

Date to commence school

Student Residential Address Details (Address of parent/Guardian with whom student lives)

Mailing Title

Address

Suburb / Town

Postcode

Phone Number

Mobile Number

Country (If not Australia)

Have you attended a Principal's Tour?

Yes No

Medical Information

Special Learning Requirements

Further Information

Biological Parent or Legal Guardian #1

Family Name

Given Names

Relationship to student

Email Address

Biological Parent or Legal Guardian #2 (Optional)

Family Name

Given Names

Relationship to student

Email Address

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