Mirani State High School Strive to excel

ENROLMENT AT MIRANI STATE HIGH SCHOOL

Dear Parents and Guardians

Thank you for your application to enrol your child at Mirani State High School.

To assist us to process your child’s application as quickly as possible, please note the following:

Applications which have attached to them the complete documentation requested, filled in accurately, will receive the highest priority for processing.

Applications will not be accepted where there are incomplete or inaccurate documents provided. As these applications cannot be processed, parents will be given their applications back and they can be submitted when all supporting documents are in order.

All applications must include a photocopy of all required documents to be kept by the school.

Applications will be processed in the order in which they were signed off by the school as having complete and correct documentation attached. The time taken after this to verify documentation before finalising the enrolment will vary from application to application.

Thank you for your understanding and assistance.

Yours sincerely

Scott CagePrincipal

Enrolment No:Category App:

APPLICANT FAMILY NAME:

APPLICANT GIVEN NAMES:

APPLICATION FOR ENTRY INTO GRADE

7 8 9 10 11 12 Year 20_____

ENROLMENT CATEGORY YOU WISH TO APPLY UNDER:

Local Catchment Academic Merit (STEM) Cultural Merit (Visual Art) Cultural Merit ( Instrumental Music) Cultural Merit (Drama)

Please refer to the Application to enrol in Queensland State School Information sheet at the end of this form when completing this application.

Failure or refusal to complete those sections of the form marked with an (*) or to provide required documentation may result in a refusal to process your application.

Sections of the form not marked (*) are optional. However, failure to complete these sections may result in the school not being eligible for important Federal and State Government funding reliant on such information. Parents of all student in Australia have been asked to provide information on their family background as part of national initial towards providing an education system that is fair to all students, regardless of their background. The required information includes the Indigenous status and language background of the student, and the education, occupation and language background of the parents.

If you have any questions about the enrolment form or process, or require assistance completing this form, including translation services, please contact the school in the first instance.

PRIVACY STATEMENTThe Department of Education, Training and Employment (DETE) is collecting the information on this form for the purposes outlined in the Education (General Provisions) Act 2006 (EGPA), and in particular for:

I. Assessing whether your application for enrolment should be approvedII. Meeting reporting obligations required by law or under Federal-State funding arrangements

III. Administering and planning for providing appropriate education, training and support services to studentsIV. Assisting departmental staff to maintain the good order and management of schools, and to fulfil their duty of care to all students and staffV. Communicating with students and parents.

This collection is authorised by ss. 155 and 428 of the EGPA 2006. DETE will disclose personal information from this form to the Queensland Curriculum and Assessment Authority when opening students’ accounts, in compliance with Part 3 of the Education (Queensland Curriculum and Assessment Authority) Act 2014 (Qld). 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 concerning parents’ school and non-school education, occupation group and main language other than English and students’ country of birth, main language other than English, sex and Indigenous status, is supplied to the Australian Government Department of Education in compliance with Federal – State funding agreements.

Personal information collected on this form may also be disclosed to third parties where authorised or required by law. 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 your child’s school in the first instance. If you have a concern or complaint about the way your personal information has been collected, used, stored or disclosed, please also contact your child’s school in the first instance.

ENTITLEMENT TO ENROLMENTUnder the EGPA 2006, an applicant for enrolment at a state school must be enrolled if they are entitled to enrolment. While not exhaustive, the following matters may affect an applicant’s entitlement to enrolment at a state school: Failure to adequately complete this enrolment form If the school has an Enrolment Management Plan or an Enrolment Eligibility Plan (enrolment is subject to eligibility under the plan) The applicant is a mature aged student (the applicant can only apply for enrolment at a mature age state school and will be subject to a satisfactory

criminal history check, or as a student in a program of distance education. All mature age students must have a remaining allocation of state education The applicant is not of correct age for enrolment (relates to Preparatory Year and Years 1 to 6) The applicant has been excluded or cancelled from enrolment or is subject to suspension from a state school at the time of the application The school is a state special school and the applicant does not meet the criteria for enrolment in a special school. The school principal reasonably believes that the applicant presents an unacceptable risk to the safety or wellbeing or members of the school

community (application is referred to Director-General) The proposed enrolment requires approval as part of a flexible arrangement under s.183 of the EGPA 2006, and the arrangement has not yet been

approved

MIRANI STATE HIGH SCHOOLAPPLICATION FOR STUDENT ENROLMENT

(Please use BLOCK letters and a blue or black pen to complete this form)

Received: / /

The student is not an Australian resident or citizen or the child or the child of an Australian permanent resident or citizen (visa restrictions may apply, fees may be charged, in some cases legislation requires that the applicant must obtain approval from the Chief Executive via Education Queensland International (EQI) to enrol).

OFFICE USE ONLYDate Enrolled __/____/____ Year Level EQ IDIndependent Student Yes No Roll Class

Birth Certificate/passport sighted, copied and DOB confirmed Yes NoIs the student over 18 years at time of enrolment Yes NoIf yes, is the student exempt from the mature age student process? Yes NoIf no, has the mature age applicant consented to a criminal history check? Yes NoSchool House EAL/D Support Yes No To be determined

FTE Associated Unit Visa and Associated documents sighted Yes No

EQI category SV – Student Visa / TV – Temporary Visa / DS – Dependent – Parent on Student Visa / EX – Exchange Student /DE – Distance Education

Approved: Yes No SIGNATURE_________________________________________________ DATE: / /

Oaths Act 1867

Statutory Declaration

LOCAL CATCHMENT AREA CATEGORY

QUEENSLANDTO WIT

I _____________________________________________________________________ Parent/Carer Name)

Of ___________________________________________________________________________, in the State of Queensland do solemnly and sincerely declare that:

I am applying for entry to Mirani State High School under the Local Catchment category on behalf of my child

__________________________________________(child’s name).

This application is made in accordance with the Mirani State High School Enrolment Management Plan. All documents enclosed with my application are true and correct copies of the originals. The address cited in the application, namely falls within the Local Catchment Area as defined in the Mirani State High

School Enrolment Plan. This address is where we are residing and is the Principal Place of Residence of myself and my family, including my child

______________________________________(the applicant for entry) and that this is our permanent family home.

And I make this solemn declaration conscientiously believing the same to be true, and by virtue of the provisions of the Oaths Act 1867.

Declarer _________________________________ (Signature of person making the declaration)

Taken and declared before me at ______________________________________ (insert name of town or city and suburb where affidavit signed)

this ______________________ day of ___________________ 20____, before me.

______________________________________Justice of the Peace/Commissioner for Declarations

Applicants should note that a false statement/assertion about the student’s principal place of residence may amount to an offence and may

be reported to police.

Stamp of Qualified Justice of the Peace of Commissioner for Declarations

BRING ORIGINAL DOCUMENTS TO INTERVIEW, DO NOT INCLUDE ORIGINAL DOCUMENTS WITH THIS APPLICATION

We must sight the following ORIGINAL documents at the interview, but please also include copies of items below.

CHILD’S ORIGINAL BIRTH CERTIFICATE – only if not currently enrolled in a Queensland State School (An official translation is necessary if not in English)The school will require proof of at least one parent’s Australian citizenship if both parents were born overseas. If one parent was born in Australia, proof of Australian citizenship is not required.

AND/OR IF REQUIRED

AUSTRALIAN CITIZENSHIP CERTIFICATE (of student OR parent), or AUSTRALIAN OR NEW ZEALAND PASSPORT (of student NOT parent), or APPROPRIATE VISA (eg. TR, PR)

AND

COPIES OF YOUR CHILD’S SCHOOL REPORTS FOR PREVIOUS THREE SEMESTERS (These do not form part of the selection process for the Local Catchment Area applicants, but may be used by our teachers in assisting students.

Most recent NAPLAN results.

ADDITIONAL ORIGINAL DOCUMENTSLOCAL CATCHMENT AREA:

ADDITIONAL ORIGINAL DOCUMENTSMERIT CATEGORIES

We must see the following ORIGINAL documents (applications must include copies to be kept by the school).

We must see the following ORIGINAL documents (applications must include copies to be kept by the school).

(A) HOME OWNERS:

Signed, unconditional sale agreement/or Land Title Search; and

Current Mackay Council Rates Notice;

And

Current account for supply of Domestic Electricity (showing usage); and

Completed Statutory Declaration (witnessed, signed and stamped by a Justice of the Peace or Commissioner for Declarations – form included in the application package).

OR

(B) LEASE HOLDERS:

Rental Agreement stamped and signed by real estate agency; and

Original receipt from the Residential Tenancies Authority (RTA) for lodgement of the rental bond; and

Current account for supply of Domestic Electricity (showing usage); and

Completed Statutory Declaration (witnessed, signed and stamped by a Justice of the Peace or Commissioner for Declarations – form included in the application package).

CULTURAL MERIT (DRAMA):

Documentation of Drama Achievement

CULTURAL MEDIT (VISUAL ART):

Art Folio

CULTURAL MERIT (INSTRUMENTAL MUSIC);

Documentation of level of Music Achievement

ACADEMIC MERIT (STEM):

Copies of Child’s school reports for the previous three semesters.

Please note: Applications must be fully completed and include copies of all documents. Applications which are incomplete will not be accepted for processing. Original documents (if sent by post) may be collected from the school by a parent (identification required) or they can be returned by post if a stamped self-addressed envelope is provided. Mirani State High School cannot accept any responsibility for documents sent or given to the school.

MEDICAL DETAILS FORM

Student’s Name: ___________________________________________________

My child does not have any known medical conditions.

My child has the following known medical conditions:

Medical Condition 1Medical Condition Category(Please use list of Medical Categories provided)Symptoms:(Include specific medical condition name if known and any symptoms school should look for)Management:(Include any special instructions the school should follow with regard to this condition)Medical Condition 2:Medical Condition Category:(Please use list of Medical Condition Categories provided)Symptoms:(Include specific medical condition name if known and any symptoms school should look for)Management:(Include any special instructions the school should look for)

Medical Condition 3:Medical Condition Category:(Please use list of Medical Condition Categories provided)Symptoms:(Include specific medical condition name if known and any symptoms school should look for)Management:(Include any special instructions the school should follow with regard to this condition)

If your child has additional medical conditions please attach details of all medical conditions.

______________________________ Parent’s Signature