enrolment form 2010

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					                                                               Education (General Provisions) Act 2006 Section 155(1) Approved form SEF – 1 V1

                                                           Application for Student Enrolment Form
PROSPECTIVE
STUDENT’S NAME:
Has the Student attended this School                           If Yes, provide details of this enrolment (ie. dates/previous names etc):
previously?                               Yes     No

Has the student ever attended a                                If Yes, provide name of school and approximate date of enrolment:
Queensland State School?                  Yes     No

Does the Student have a sibling at this                        If Yes, provide name and year level:
School?                                   Yes     No


PRIVACY STATEMENT
The Department of Education, Training and the Arts (DETA) is collecting the information on this form for the purposes outlined in the
Education (General Provisions) Act 2006 (EGPA 2006) and in particular for:
    i.          assessing whether your application for enrolment should be approved;
    ii.         administering and planning for providing appropriate education, training and support services to students;
    iii.        assisting departmental staff to maintain the good order and management of schools, and to fulfil their duty of care to all
                students and staff; and
    iv.         communicating with student and parents.
This collection is authorised by ss 155, 428 and 433 of the EGPA 2006. DETA will disclose personal information from this form to the
Queensland Studies Authority (QSA) when opening student accounts, in compliance with ss. 253 and 254 of the EGPA 2006. Personal
Information from this form will also be supplied to Centrelink in compliance with ss.194 and 195 of the Social Security (Administration ) Act
1999 (Cth). De-identified information from optional questions is supplied to the Commonwealth Department of Education, Science and
Training in compliance with Commonwealth/State funding agreements.
Personal information collected on this form may also be disclosed to third parties where authorised or required by law and otherwise in
accordance with Information Standard 42 – Information Privacy (http://www.governmentict.qld.gov.au/02_infostand/standards/is42.pdf).
Your information will be stored securely. If you wish to access or correct any of the personal information on this form or discuss how it has
been dealt with, please contact the enrolling school in the first instance.

FAMILY DETAILS
Names of adults with
                                                    Parent/Caregiver 1                                                   Parent/Caregiver 2
whom this student lives
Family Name

Given Names

Title
Sex                                                      Male          Female                                                   Male         Female
Relationship To Student

Occupation
This question is optional
What is the occupation                          (refer to provided sheet for the list of                              (refer to provided sheet for the list
group of the parent/                            Parental Occupation Groups)                                           of Parental Occupation Groups)
caregiver?
Please select the appropriate Parental Occupation Group from the provided list. If the person is not currently in paid work but has
held a job in the last 2 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, enter ‘8’ in the box above.

Office Use Only
                                                                                                    Learning Difficulty/Special Ed.
Date Enrolled                                   Year Level
                                                                                                    Support
Student ID                                      Roll Class                                          Birth Certificate Sighted                  Yes    No

EQ ID                                           House                                               Transfer Note Sighted                      Yes    No
                                                Semesters                                           Is the student 18 years of age at time
MIS ID                                                                                                                                         Yes    No
                                                Completed                                           of enrolment?
Learner Unique                                  Distance to                                         If Yes, has Mature Age Check been
                                                                                                                                               Positive Notice Exempt
ID                                              School                                              completed?
                                                Associated                                          Visa and Associated Documents
FTE                                                                                                                                            Yes    No
                                                Unit                                                sighted
Campus                                          ESL                   Yes    No                     EQI Category
STUDENT DESTINATION DETAILS FROM EXIT INTERVIEW
Destination                                         Queensland / Interstate / Overseas                                 Date Left
Destination School / Other
Location
                                                                                                                          Full Time
Sector                                      Prep / Primary / Secondary / VET / University / Other
                                                                                                                          Part Time
Reason for leaving




Uncontrolled copy: Refer to SMS-PR-027: Enrolment in State Primary, Secondary and Special Schools at
http://education.qld.gov.au/strategic/eppr/students/smspr027/ for master. Version 2.0 30 October 2006                                            Page 1 of 13
                                                                                               Application for Student Enrolment Form

FAMILY DETAILS (cont’d)
                                                         Parent/Caregiver 1                                               Parent/Caregiver 2
Work Location

Work Phone

Work Mobile

Home Phone

Home Mobile

E-Mail

Cultural Background

Country Of Birth
Needs Interpreter                                                Yes        No                                                    Yes        No

This question is optional
What is the highest year of primary or secondary school the parents/caregivers have completed?
(for persons who have never attended school, mark ‘Year 9 or equivalent or below’)
                    Parent/Caregiver 1                                        Parent/Caregiver 2
    Year 12 or equivalent                                     Year 12 or equivalent
    Year 11 or equivalent                                     Year 11 or equivalent
    Year 10 or equivalent                                     Year 10 or equivalent
    Year 9 or equivalent or below                             Year 9 or equivalent or below

This question is optional
What is the highest qualification the parents/caregivers have completed?
                      Parent/Caregiver 1                                          Parent/Caregiver 2
   Bachelor degree or above                                    Bachelor degree or above
   Advanced Diploma/Diploma                                    Advanced Diploma/Diploma
   Certificate I to IV (including trade certificate)           Certificate I to IV (including trade certificate)
   No non-school qualification                                 No non-school qualification

OTHER FAMILY INFORMATION (not including Access – complete the Student Access section if applicable)

....................................................................................................................................................................

....................................................................................................................................................................

....................................................................................................................................................................

....................................................................................................................................................................

....................................................................................................................................................................
STUDENT & PARENT/CAREGIVER LANGUAGE DETAILS
This question is optional
Does the student or their parent/caregiver 1 or their parent/caregiver 2 speak a language other than English at
home?
               Student                            Parent/Caregiver 1                      Parent/Caregiver 2
   No, English Only                        No, English Only                         No, English Only
   Yes, Other – Please specify             Yes, Other – Please specify              Yes, Other – Please specify

If the student speaks more than one
language other than English at home,                                                                                                                             %
indicate the additional languages that
are spoken and the percentage spoken                                                                                                                             %
in this section only




Uncontrolled copy: Refer to SMS-PR-027: Enrolment in State Primary, Secondary and Special Schools at
http://education.qld.gov.au/strategic/eppr/students/smspr027/ for master. Version 2.0 1 October 2006                                              Page 2 of 13
                                                                              Application for Student Enrolment Form

STUDENT DEMOGRAPHIC DETAILS
Family Name

Given Names

Preferred Name

Sex                                 Male      Female           Date of Birth


Is the student of Aboriginal or Torres Strait Islander origin?

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

In which country was the student born?

      Australia                       Other (please specify)

Cultural Background

Religion (Response optional)


Is the student an Australian Citizen, Permanent Resident or holding an International Visa?

      Australian Citizen/Permanent Resident                International Student – Date Of Arrival          /    /


STUDENT ORIGIN DETAILS

Origin                                                     Queensland / Interstate / Overseas
                                                                                                                      Full Time
Sector                       Prep / Primary / Secondary / VET / University / Other
                                                                                                                      Part Time
Previous School/
Other Location
                                                                                                                      Full Time
Previously Employed                                             Yes           No
                                                                                                                      Part Time

ADDRESS DETAILS
Home Address

Mailing Title

Address Line 1

Address Line 2

Suburb/Town                                                           State                  Postcode

Mailing address (if it is the same as home address, write ‘AS ABOVE’)

Mailing Title

Address Line 1

Address Line 2

Suburb/Town                                                           State                  Postcode




Uncontrolled copy: Refer to SMS-PR-027: Enrolment in State Primary, Secondary and Special Schools at
http://education.qld.gov.au/strategic/eppr/students/smspr027/ for master. Version 2.0 1 October 2006                 Page 3 of 13
                                                                                               Application for Student Enrolment Form

EMERGENCY CONTACT DETAILS (Parent/Caregivers are automatically the 1st and 2nd emergency contact unless otherwise stated)
                                                    Emergency Contact 3                                              Emergency Contact 4
Name

Relationship (eg Aunt)

Home Phone

Work Phone

Home Mobile

Work Mobile


MEDICAL INFORMATION (including allergies)
Medicare Number

Doctor’s Name

Doctor’s Address

Doctor’s Phone Number
Medical Condition
Symptoms/Treatment
Medical Condition
Symptoms/Treatment
Medical Condition
Symptoms/Treatment
Should your child need to take medication during school hours an Authority to Administer Medication to Students Form will need
to be completed each year and retained at the office.


TRAVEL DETAILS
Mode of Transport to
                                           Walk           Car          Bus           Bicycle           Other
School

VISA DETAILS (if applicable) Receipt of Payment or Exemption Letter is required to be provided for enrolment to proceed
Passport Number                                                                 Passport Expiry Date

Visa Number                                                                     Visa Expiry Date

Visa Sub Class                                                                  Visa Fees Paid                                    Yes        No      Exempt

STUDENT ACCESS
Is there any limitation(s) on contact between the student and a parent or another
person? If yes, attach a copy of current Court Order or registered parenting plan that                                                    Yes        No
contains the limitation(s).

OTHER INFORMATION

................................................................................................................................................................

................................................................................................................................................................
SIGNATURES
                                        Parent/Caregiver 1/Independent Student                                          Parent/Caregiver 2

Signature


Date




Uncontrolled copy: Refer to SMS-PR-027: Enrolment in State Primary, Secondary and Special Schools at
http://education.qld.gov.au/strategic/eppr/students/smspr027/ for master. Version 2.0 1 October 2006                                              Page 4 of 13
                                                                        Application for Student Enrolment Form
                      Parental Occupation Groups for use with Parent / Caregiver details
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]




Uncontrolled copy: Refer to SMS-PR-027: Enrolment in State Primary, Secondary and Special Schools at
http://education.qld.gov.au/strategic/eppr/students/smspr027/ for master. Version 2.0 1 October 2006           Page 5 of 13
                                                                   Application for Student Enrolment Form
                             PARK LAKE STATE SCHOOL ASTHMA POLICY

We ask that if your child suffers from Asthma that you complete the table below to indicate which category will
best suit your child and their medication needs.

School Management
Management of school health conditions, including the administering of medication, is a courtesy provided by
the school consistent with their duty of care to:
     Maximise the participation in school activities of students who require medication or special procedures
        for managing a health condition: and
     Optimise the health, safety and wellbeing of staff and students at a school site.
School staff can assist a student with medication under the carer provisions of the Health [Drugs and Poisons]
Regulation [1996] provided that a written request is received from a Doctor, the student’s parent or legal
guardian. Staff must follow the directions on the original pharmacy label attached to the medication
container.
Self – Administering of Medication
Some students may be approved to self-administer their medication. Students approved to carry, store their own
medication should demonstrate practices of secure storage of medication.
Recommended procedure for self-administering is as follows:
    The parent/caregiver provides a written request, with guidelines and procedures from the medical
      practitioner, for the student to be responsible for administrating their own medication
    The principal determines if the student is capable of assuming this responsibility
    The student and the school agree on where the medication is stored and where and how it is
      administered.
All other medications require secure storage and are administered only under the supervision of a staff member.
School staff must not administer over-the-counter medication or prescribed medication unless they have
     completed school medication form
     written request from a parent/caregiver accompanied by
     written advice from a medical practitioner with
     medication in the original labelled container.
     The exception is the reliever puffer, such as Ventolin, that is included for the emergency treatment of
        asthma.
Medication Categories:
The following categories apply in relation to children with Asthma

A.      Child is authorised by parent/guardian to self-administer Asthma medication as needed and is also
        authorised to be responsible for caring for the medication.
B.      Child is authorised by parent/guardian to self-administer Asthma medication as needed but with adult
        supervision. Medication is to be held at office.
C.      Parent/guardian requires that the child’s Asthma medication be held at the office and administered by an
        adult.
D.      The child suffers from mild Asthma only. In the event of an attack the child’s parent/guardian
        authorises their child to be administered medication by an adult and understands that a parent or other
        emergency contact will be notified.

Please complete the following table to indicate the category that best suits your child.

ASTHMATICS CATEGORY
Student Name:                                             Student Name:
                             Category: A B C D                                         Category: A B C D




Uncontrolled copy: Refer to SMS-PR-027: Enrolment in State Primary, Secondary and Special Schools at
http://education.qld.gov.au/strategic/eppr/students/smspr027/ for master. Version 2.0 1 October 2006   Page 6 of 13
                                                                            Application for Student Enrolment Form

                                                                                                        Consent Form
                                                    to use copyright material, image, recording or name
                               Uncontrolled copy. Refer to LGS-PR-001: Consent to use Copyright Material, Image, Recording Or Name
                                                                             http://education.qld.gov.au/strategic/eppr/legal/lgspr001




1       I GIVE CONSENT
        On behalf of the individual identified overleaf (the Individual), the person signing this Consent
        Form (the Signatory)* grants consent to the Department of Education and the Arts and to any
        Department or Agency of the State of Queensland (the Department and the State) to use and
        retain the Individual’s:
         name, image and sound or other recording; and
         copyright material (Individual work).

        *Note: If the Individual is under 18 years of age, the Signatory must be a parent or guardian of the
        Individual. If the Individual is 18 or older, the Signatory and the Individual will be the same person.
    2    FOR THE PURPOSE OF
         This consent applies to any use of the Individual’s name, recording or image, and Individual work,
         in connection with the Department or State, including for the following purposes:
          assessment of students and other purposes associated with the provision of education;
          public relations, promotion, advertising, media and commercial activities;
          use by the media in relation to activities that show the Individual in a positive light, eg. drama
             and musical performances, sports and prize giving; and
          any other activities, if any, identified in further schedules attached to this Consent Form.

    3    FOR THE DURATION OF
         This consent will continue until:
          where the Individual is under 18 years of age, when the Individual turns 18; and
          in any other case, when the Individual revokes consent (by writing to the Principal of the school,
             and in the case of employees, writing to the District Office),
         and where more than one of these events may apply, whichever occurs first.
         Despite the above, if, at the time such an event occurs, the Department or the State is using the
         Individual’s name, recordings or images or any Individual work, or the State has entered into
         contractual obligations in relation to that material, the consent will continue in relation to that
         material until the Department or the State’s use is complete or after the contractual obligations
         come to an end.

    4    I UNDERSTAND THAT
          ‘Use’ includes:
            - to create, make copies of or reproduce or retain in any form, including by camera, video, or
                digital recorder, webcam, closed circuit television, mobile phone or any other device; and
            - distribute, publish or communicate in any form, including via newsletters and other print
                media, television and the Internet,
            in whole or in part, and to permit other persons to do so.
          The Department or the State will not pay the Signatory, or the Individual, for my giving this
            consent or for the use of the Individual’s name, recording or image, or Individual work.
          This Consent Form revokes and replaces all previous consent forms.
          Nothing in this Consent Form limits the rights that the Department or the State have in relation
            to the use of my name, recording or image, copyright or other intellectual property under any
            other law.



Uncontrolled copy: Refer to SMS-PR-027: Enrolment in State Primary, Secondary and Special Schools at
http://education.qld.gov.au/strategic/eppr/students/smspr027/ for master. Version 2.0 1 October 2006                 Page 7 of 13
                                                                     Application for Student Enrolment Form


 5   LIMITATIONS ON CONSENT
     The Individual or Signatory wishes to limit the consent in the following way:




 6   DETAILS
     Name of Individual                                   Address of Individual




     Name of school (at which the Individual is           PARK LAKE STATE SCHOOL
     enrolled, employed, or works as a volunteer)         SHOALHAVEN AVE
                                                          PACIFIC PINES QLD 4212


     Signature of the Individual                          Date
                                                                 /       /




     Signature of the parent or guardian (if the          Date
     Individual is under 18 years)                               /       /




     Name of signing parent or guardian                   Address of signing parent or guardian




 7   NOTE
     The Department will use its best endeavours to ensure the person signing this Consent Form is
     authorised to do so, but takes no responsibility for circumstances in which it is misled as to the
     identity or authority of a person to provide consent.
     If you require a copy of this signed Consent Form, or if you wish to revoke this consent, please
     contact the Principal of the school at which the Individual is enrolled or works.




Uncontrolled copy: Refer to SMS-PR-027: Enrolment in State Primary, Secondary and Special Schools at
http://education.qld.gov.au/strategic/eppr/students/smspr027/ for master. Version 2.0 1 October 2006   Page 8 of 13
                                                                   Application for Student Enrolment Form

      PARK LAKE STATE SCHOOL - PERMISSIONS FORM

                     PARK LAKE STATE SCHOOL HEAD LICE POLICY
Head lice are a problem in all schools from time to time. In order to control outbreaks when they occur we
contact parents directly to inform them if a student is identified as having head lice and ask for the student to be
picked up and treated.

It must be noted that head lice can infest any student, they are not confined to clean or dirty hair, however they
do unfortunately seem to infest some students more than others.

We also put articles in our newsletter on a regular basis advising parents to check their children and treat as
required.

I agree to my child having their hair checked if it is suspected they have head lice and to be contacted to pick
them up and treat their hair prior to returning them to school.

                                                                            Yes                       No 


                         STUDENT INTERNET ACCESS AGREEMENT
I have read and understand my responsibilities as a student of Park Lake State School as they relate
to my access to computers and the Internet. I understand that breaches of this policy may result in
disciplinary action.
                                                                             Yes                      No 

                                   PARENT OR CARER CONSENT
I have read and understand the responsibilities of my child in regards to the use of computers and access to the
Internet. I accept that my child listed above understands these responsibilities and I hereby give my permission
for him / her to access the Internet under the school rules.

                                                                            Yes                       No 


                       PRIVACY STATEMENT ACKNOWLEDGEMENT
I have received a copy of Education Queensland Privacy Statement.

                                                                            Yes                       No 


                                     ELECTRONIC NEWSLETTER
I have received a copy of Park Lake State School Electronic Newsletter Information and agree to receive the
School Newsletter by email.

                                                                            Yes                       No 

The email address I would like our family newsletter sent to is: _______________________________


                         HOMEWORK POLICY ACKNOWLEDGEMENT
I have received a copy of the Park Lake State School Homework Policy and I agree to follow the guidelines.

                                                                            Yes                       No 


                               DRESS CODE ACKNOWLEDGEMENT
I have received a copy of the Park Lake State School Dress Code and I agree to follow the guidelines.

                                                                            Yes                       No 




Uncontrolled copy: Refer to SMS-PR-027: Enrolment in State Primary, Secondary and Special Schools at
http://education.qld.gov.au/strategic/eppr/students/smspr027/ for master. Version 2.0 1 October 2006   Page 9 of 13
                                                                    Application for Student Enrolment Form

                    RESPONSIBLE BEHAVIOUR PLAN FOR STUDENTS
I have received a copy of the Park Lake State School abridged Student Code of Behaviour and I agree to abide
by this policy. I acknowledge that a complete copy of the Student Code of Behaviour is available on request
from the School Office.

                                                                            Yes                        No 


                                    SUSPENSIONS/EXCLUSIONS
Has your child had any previous suspensions/exclusions from any other Educational Institution.

                                                                            Yes                        No 


                                RELIGIOUS EDUCATION CONSENT
Each year our students are offered 30 minute lessons in Religious Education one day a week through the
Cooperative Ecumenical Religious Instruction Program. These are conducted by volunteers approved by local
churches and endorsed by Education Queensland. All groups are taught in a non-denominational group within
the student’s classroom.

To comply with Education Queensland regulations please indicate your consent or otherwise:

I DO  / DO NOT  authorise my child                                                 to   participate   in   Religious
Education classes.



                                 CHANGE OF PERSONAL DETAILS
I will notify the School of any changes in personal details (i.e. address, contact phone numbers, etc)
immediately so that accurate records can be maintained particularly in case of emergency.

                                                                            Yes                        No 


                                ENROLMENT MANAGEMENT PLAN
I declare that I have been informed of the Park Lake State School Enrolment Management Plan and have read
and agree to the terms and conditions contained within said plan.
                                                                          Yes                  No 

I hereby declare that the information given in this enrolment form is true and correct at the date of enrolment.

Signed:__________________________________________ Date:_______/_______/_______
      (Student)

Signed:__________________________________________ Date:_______/_______/_______
      (Parent/Caregiver)

Signed:__________________________________________ Date:_______/_______/_______
        (Park Lake State School Administration)




Uncontrolled copy: Refer to SMS-PR-027: Enrolment in State Primary, Secondary and Special Schools at
http://education.qld.gov.au/strategic/eppr/students/smspr027/ for master. Version 2.0 1 October 2006    Page 10 of 13
                                                                   Application for Student Enrolment Form
                                   PARK LAKE STATE SCHOOL


                           Enrolment Agreement – Park lake State School
This enrolment agreement sets out the responsibilities of the student, parents or carers and the school staff
about the education of students enrolled at Park lake State School.

Responsibility of student to:
 attend school regularly, on time, ready to learn and take part in school activities
 act at all times with respect and show tolerance towards other students and staff
 work hard and comply with requests or directions from the teacher and principal
 abide by school rules, meet homework requirements and wear school’s uniform
 respect the school environment.

Responsibility of parents to:
 attend open evenings for parents
 let the school know if there are any problems that may affect my child’s ability to learn
 inform school of reason for any absence
 treat school staff with respect and tolerance
 support the authority and discipline of the school enabling my child to achieve maturity, self discipline and
   self control
 abide by school’s policy regarding access to school grounds before, during and after school hours
 have read the Enrolment Management Plan and sought clarification of any conditions prior to signing this
   Enrolment Agreement.

Responsibility of school to:
    develop each individual student’s talent as fully as possible
    inform parents and carers regularly about how their children are progressing
    inform students, parents and carers about what the teachers aim to teach the students each term
    teach effectively and to set the highest standards in work and behaviour
    take reasonable steps to ensure the safety, happiness and self-confidence of all students
    be open and welcoming at all reasonable times and offer opportunities for parents and carers to
      become involved in the school community
    clearly articulate the school’s expectations regarding the responsible behaviour plan for students and
      the school’s dress code policy
    ensure that the parent is aware of the school’s record-keeping policy including the creation of a transfer
      note should the student enrol at another school
    set, mark and monitor homework regularly in keeping with the school’s homework policy
    contact parents and carers as soon as is possible if the school is concerned about the child’s school
      work, behaviour, attendance or punctuality
    deal with complaints in an open, fair and transparent manner
    consult parents on any major issues affecting students
    treat students and parents with respect and tolerance.




Uncontrolled copy: Refer to SMS-PR-027: Enrolment in State Primary, Secondary and Special Schools at
http://education.qld.gov.au/strategic/eppr/students/smspr027/ for master. Version 2.0 1 October 2006   Page 11 of 13
                                                                   Application for Student Enrolment Form
I accept the rules and regulations of the Park Lake State School as stated in the school policies that have been
provided to me as follows:

        □ Asthma Policy (Application for Enrolment)
        □ Head Lice Policy (Application for Enrolment)
        □ Parent Notice for Religious Instruction in School Hours (Application for Enrolment)
        □ Consent to use Copyright Material, Image, Recording or Name
        □ Student usage of internet, intranet and extranet
        □ Responsible Behaviour Plan for Students
        □ Student Dress Code
        □ Homework Policy
        □ Privacy Statement
        □ Absences (Information Booklet)
        □ School Excursions (Information Booklet)
        □ Sun Safety Policy
        □ Resolving Concerns
        □ Appropriate Use of Mobile Telephones and other Electronic Equipment by Students
        □ School Charges and voluntary contributions

     I understand that if I disregard this agreement consequences are applicable and will be put into place.

    An interview with the Principal Education Officer, Student Services was offered and accepted/declined for
my student with a disability.


I acknowledge that information about the school’s current programs and services have been explained to me
and that I have read and understood the school’s enrolment management plan.



Student Signature:       Parent/Carer Signature:           On behalf of Park lake State School:

………………………                ……………………………                       ……………………………………………




Uncontrolled copy: Refer to SMS-PR-027: Enrolment in State Primary, Secondary and Special Schools at
http://education.qld.gov.au/strategic/eppr/students/smspr027/ for master. Version 2.0 1 October 2006   Page 12 of 13
                                                                          Application for Student Enrolment Form


                                              Contribution Scheme
I have read and understand the conditions of the Contribution Scheme at Park Lake State School in
2010. I agree to be involved in contributing to this scheme. I understand that the contribution is
$50.00 per child per year to a maximum of $125.00 for three or more children.


PARENT / CAREGIVER DETAILS

                                             Family Name                               Year Level
Student Given Name




Name of parent/caregiver (please print) ______________________ __________________________
                                       (first name)                    (last name)

Address: ___________________________________________________ Postcode: _______________

 (Home) ______________________________ (Work): _________________________________

_________________________________________ Date: _______/__________/__________
Signature

Preferred Method of Payment

        NOW:               I wish to make payment in full now (Preferred option by P&C)

OR

        INSTALMENTS: I wish to make four equal payments, due on the first day of each term.

        I do not wish to participate in the Contribution Scheme.

                                             Payments may be made by cash or cheque:
**       Cheques should be crossed “Not Negotiable – Account Payee Only” and made out to Park Lake State School P&C
Association.


                                                School Contribution 2010.


School Use Only
Receipt No: ________________________ Date: ___________/__________/_______Initial: ________

Retain and file with daily banking records




Uncontrolled copy: Refer to SMS-PR-027: Enrolment in State Primary, Secondary and Special Schools at
http://education.qld.gov.au/strategic/eppr/students/smspr027/ for master. Version 2.0 1 October 2006         Page 13 of 13

				
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