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Initial Enquiry Form
Name of Parent/Responsible Person
*
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Middle
Last
Name of Partner
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Middle
Last
Number of Children to enrol
*
One
Two
Three
First Child Details
First Child's Name
*
First
Middle
Last
First Child Starting Year
*
Pre Kindy (3 Year Old Program)
Kindy
Pre-Primary
Yr One
Yr Two
Yr Three
Yr Four
Yr Five
Yr Six
First Child Sex (M/F)
*
Male
Female
First Child Date of Birth
*
DD slash MM slash YYYY
Second Child Details
Second Child's Name
First
Middle
Last
Second Child Starting Year
Pre Kindy (3 Year Old Program)
Kindy
Pre-Primary
Yr One
Yr Two
Yr Three
Yr Four
Yr Five
Yr Six
Second Child Date of Birth
DD slash MM slash YYYY
Second Child Sex (M/F)
Male
Female
Third Child Details
Third Child's Name
First
Middle
Last
Third Child Starting Year
Pre Kindy (3 Year Old Program)
Kindy
Pre-Primary
Yr One
Yr Two
Yr Three
Yr Four
Yr Five
Yr Six
Third Child Date of Birth
DD slash MM slash YYYY
Third Child Sex (M/F)
Male
Female
Family Details
Residential Address
*
Street Address
Address Line 2
Suburb
Post Code
Postal Address
Same as Residential
Different to Residential
Postal Address
*
Street Address
Address Line 2
Suburb
Post Code
Home/Primary Phone
*
Work Phone
Mobile Phone
Email
*
Requested Start Date
*
DD slash MM slash YYYY
Religious Denomination
*
Catholic
N/A
Other
Please specify other Religious Denomination
If applicable, name of school at which the child is currently or was last enrolled
Permanent Resident of Australia?
Yes
No
Please indicate date entered Australia
MM slash DD slash YYYY
VISA SUB CLASS No.
I/we have completed this initial application form to the best of my/our knowledge. I/we are aware that other forms and supporting documents may be required at a later stage:
Yes
How did you find out about us?
Word of mouth/recommendation
Parish
In the neighbourhood
Referring website
Google search
Advertising
Facebook
Newspaper
Twitter
Promotional Flyer
Other
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Western Australian Immunisation Requirements
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