Ballajura Community College Pre-Enrolment Form

Child's surname *This question is required.

Given names *This question is required.

Date of birth *This question is required.

Sex *This question is required.

Male
Female

Mr/Mrs/Ms *This question is required.

Mr
Mrs
Ms

Surname of parent/responsible person *This question is required.

Given names *This question is required.

Residential Address *This question is required.

Postcode *This question is required.

Postal Address (if different from residential address)

Postcode

Telephone - Home *This question is required.

Mobile Phone Number

Work Number (if convenient)

Email

Are there any Family Court Orders regarding the day to day or long term care, welfare and development of the child? *This question is required.

Yes
No

Year level child currently enrolled in (e.g. Year 7) and the name of the school the child is currently attending or was last enrolled. *This question is required.

Are you applying to enrol in the Advanced Curriculum Enrichment Program at Ballajura Community College? *This question is required.

Yes
No

Are you applying for an Academic Scholarship at Ballajura Community College? *This question is required.

Yes
No

Is your child learning a musical instrument? *This question is required.

Yes
No

Type of instrument:

Do you want your child enrolled in the SIMS instrumental music programme at the College.

Yes
No

Will there be any brothers or sisters attending this school? *This question is required.

Yes
No

Names and year levels:

Is your child currently under suspension from a school? *This question is required.

Yes
No
N/A

If yes, name of school:

Has your child ever been excluded from a school? *This question is required.

Yes
No
N/A

If yes, name of school:

Are you a permanent resident of Australia? *This question is required.

Yes
No

If no, please indicate date entered Australia:

VISA SUB CLASS No:

Does your child have a disability or medical condition?
This information will assist the school Principal with considering whether any specific or additional resources are required and available to assist the school with providing the best educational program for your child. *This question is required.

Space Cell	Yes	No
Physical *This question is required	Yes	No
Intellectual *This question is required	Yes	No
Other *This question is required	Yes	No
Medical *This question is required	Yes	No

Please outline nature of disability/medical condition:

By clicking the signature button, you are declaring the information on this form is true. *This question is required.