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Student Details ParentGuardian Details (for invoicing purposes

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					Submit this form via:       Mail – Level 1 Unit 4/4 Hughes Street Cabramatta NSW 2166 or Fax (02) 9755 7779
For Assistance:             Email – info@paleducation.com or Phone: (02) 9755 7778 (Mon – Sun, 9am-6pm EST)



Student Details:
 First Name:                                                                                 M             F

 Last Name:

 Date of Birth:          DD/MM/YYYY                             Current Grade:

 Current School:



Parent/Guardian Details                          (for invoicing purposes):

    father              mother        guardian          other: __________
 First Name:

 Last Name:

 Postal Address:

                                                                Post Code:

 Tel:
 (home):                                                        (mobile):
 Email:

 Home Language:             English         Mandarin            Chieu Chow               Vietnamese
                            Khmer           Tamil/ Hindi        Others:__________________



Emergency Contact (other than the one stated above):
    father              mother        guardian          other: __________
 First Name:

 Last Name:

 Tel:
 (home):                                                        (mobile):
                                                                                          [ please turn over ]




                                                                                     PE Enrolment Form (v2007.9.1)
Centre of Enrolment
   Cabramatta Branch (Head Office)             Liverpool Branch (Subsidiary)
   Level 1 Unit 4/4 Hughes Street              251 Bigge Street
   Cabramatta NSW 2166                         Liverpool NSW 2170



  Subject/s Details
Grade Enrolled: _________      primary       secondary       senior

Subject/s Enrolled: (please tick)           Total Number of Subject/s: _______
                        Primary Literacy Reading
                     Primary Literacy Writing
 Year 3-6            Primary General Abilities
 (0.45 hour/subj)    Primary Fundamental Maths
                     Secondary English Reading
                     Secondary English Writing
 Year 7- 9
                     Secondary Mathematics
                     Secondary Sciences
                     Senior Advanced English
                     Senior Mathematics (2 Units)/ General Mathematics
                     Senior Mathematics (3 Units)/ Extension I
 Year 10-12
                     Senior Mathematics (4 units)/ Extension II
                     Senior Sciences (Physics)
                     Senior Sciences (Chemistry)
                     Senior Sciences (Biology)



Result of Placement Test (if any)
   1. Subject: _________________________ Marks: ___________%
   2. Subject: _________________________ Marks: ___________%
   3. Subject: _________________________ Marks: ___________%
                                                                       [ please turn over ]



                                                                  PE Enrolment Form (v2007.9.1)

				
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Description: Student Details ParentGuardian Details (for invoicing purposes