Enrolment in Prep through Class 6

Fields marked with an * are required.
Completion of this form does not guarantee a place for your child. Please see the Admissions Policy & Procedure document for details.

Child's Name *

First

Last

Date Of Birth *

Gender

Mother/Guardian Name *

First

Last

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Address

Address Line 1

Address Line 2

City

State / Province / Region

Country

Phone Number

Mobile Number

Email *

Postal code

Father/Guardian Name

First

Last

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Address

Address Line 1

Address Line 2

City

State / Province / Region

Country

Phone Number

Mobile Number

Email

Postal code

_________________________________________________________________________________________

Where/How did you hear about us?

Which School, Kinder or other program and level (if any) is your child currently attending?

Has your child attended a funded kindergarten program in Victoria before? (Kinder applicants only)

Yes
No

Are you applying for a place in our Prep Program? (Kinder applicants only)

Yes
No

Why have you chosen Steiner Education for your child?

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How many hours of screen time is your child exposed to per week?

Please tick all that apply

Television
Movies
Games

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Does your child have any difficulties with their learning?

Yes
No

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Does your child have any disabilities?

Yes
No

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Have any assessments been completed for your child?

Yes
No

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Does your child have any additional needs (dietary, behavioural, etc.)?

Yes
No

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Are there any court orders, parenting orders or parenting plans in place relating to powers, duties and responsibilities of the parents applicable to this child or access to this child?

Yes
No

Families have an obligation to disclose all information regarding the child’s physical, learning or behavioural needs at the time of application as outlined in the Admissions Policy & Procedure.

_________________________________________________________________________________________

I/We wish to apply for the enrolment of my/our child commencing

Term

Year

Year Level *

You are required to provide a copy of your child's Birth Certificate and Immunisation History Statement from the Australian Immunisation Register.

Please attach a copy of your Child's Birth Certificate

I/We have provided a copy of my/our Child's Birth Certificate

Yes
No

Please attach a copy of your Child's Immunisation History

I/We have provided a copy of my/our child's Immunisation History Statement

Yes
No

Non-Australian citizens are required to provide a copy of your child’s passport and any relevant visas

Please attach a copy of your Child's Passport/Visa

I/We have provided a copy of my/our child’s passport/visa

Yes
No
NA

_________________________________________________________________________________________

A non-refundable $100 Application Fee must accompany this application. Payments may be made in one of the following methods,
(Note : Please Use Reference [your child's surname]
If you experience any difficulties with an online payment, please contact the office)

Direct Deposit at a bank
Electronic transfer: BSB 063503; Account Number 1019 7443;
Pay Online below

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Do you want to make the Application Fee payment Online?

Online Debit/Credit Card Payment *

Card

Name on Card

I/We have read and accept the contents of the Admissions Policy & Procedure as well as the Fee Policy, and understand that the completion of this form does not guarantee enrolment for my/our child, but will place my/our child on a waiting list.

In a two-parent family both parents are required to sign.

Signature of the Mother/Gaurdian *

Date *

Signature of the Father *

Date *