Application For Enrolment

Student Details

• Given names(s) **
• Surname **
• Preferred Name
• Date of birth DD/MM/YYYY **
• Gender **
• Copy of Student's Birth Certificate **
• Nationality **
• Is your child an Australian citizen? **
  • Yes
  • No
• If not, please provide Passport and Visa details
• Copy of Passport and Visa
• Religion **
• Desired date of Entry **
• Year Level of Entry **
• Current School **
• Current Year Level **
• Sisters/brothers (and ages) **
• Campus
  Senior School BrightonBoarder Senior School BrightonCo-ed Junior School Sandringham (Prep-Year 6)Co-ed Early Learning Centre SandringhamCo-ed ELC 3 Part Time SandringhamJunior School Brighton (Prep-Year 6)Early Learning Centre BrightonELC 3 Part Time Brighton

• Contact Details Parent/Guardian 1

• Title
• Given name **
• Surname **
• Email **
• Address **
• Mobile **
• Occupation **
• Company **

• Contact Details Parent/Guardian 2

• Title
• Given name
• Surname
• Address
• Mobile
• Email
• Occupation
• Company
• Please list any special needs, learning issues or circumstances that the School needs to be aware of in order to assist your child:
• Special needs or learning issues
• If parent/grandparent/other relative is an Old Grammarian of Firbank, please state:
• Name at School
• Relationship to student
• House
• Year left Firbank