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Parent / Guardian Contact Details

• First name
• Last name
• Email address **
• Address Line 1 **
• Address Line 2
• Suburb
• State
  VictoriaNew South WalesSouth AustraliaWestern AustraliaQueenslandNorthern TerritoryTasmania
• Postcode
• Contact number **
• Relationship to student

• Student Details

• First name **
• Last name **
• Date of birth DD/MM/YYYY **
• Campus **
  Brighton SeniorSandringham co-ed Junior campus (Prep - Year 6)Sandringham co-ed ELC (Early Learning)Brighton girls ELC (Early Learning)Brighton girls Junior campus (Prep - Year 6)
• Current School*