Section 1 - Student Detailsbradfield.nsw.edu.au/media/2970/bradfield-senior-college...Section 1 - Student Details Family Name First Name Middle Name Preferred Name Gender Mobile No

213 Pacific Highway, St Leonards NSW 2065 | Ph: 9942 0399 | www.bradfield.nsw.edu.au

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Please do not leave blank spaces. Write N/A if not applicable. Please print clearly.

You must submit the following with this application:

☐ Two most recent school reports

☐ A personal reference

☐ Year 9 NAPLAN

☐ ToSA/RoSA transcript (if applicable)

☐ TAFE results (if applicable)

☐ Medical or diagnostic reports (if applicable)

☐ Centrelink income statement (if applicable)

Country of Birth Please state your city & country of birth Year of arrival

Residency Status

What is your residency Status? ☐Australian Citizen ☐New Zealand Citizen

☐Permanent Resident - ☐ Please attach a copy of your e-visa.

☐Neither Australian/New Zealand resident or permanent visa holder

Temporary visa holders, please provide the following:

Current visa sub-class Visa expiry date / /

☐ Please attach a copy of your e-visa.

Aboriginality

☐Aboriginal ☐Torres Strait Islander ☐Both Aboriginal and Torres Strait Islander

Allowances

Are you claiming a Centrelink benefit? ☐Yes ☐No If yes, you will need to provide supporting documentation.

Section 2 – Residency Status

Section 1 - Student Details

Family Name First Name Middle Name Preferred Name Gender Mobile No. Date of Birth / / Home Phone No. Day Month Year

Home Address Suburb Post Code

Personal Email

NESA Student Number ☐ I have never been issued a NESA Student Number.

If you have been enrolled in Year 10 in NSW, you will have a NESA student number. It can be located on your ToSA/RoSA transcript. Alternatively, phone the school where you completed the NAPLAN test.

USI Number

A Unique Student Identifier number is required to access your results. Go to www.usi.gov.au and register to obtain your USI Number to submit with your application. You will need a form of ID to obtain your USI eg birth certificate

http://www.bradfield.nsw.edu.au/

http://www.usi.gov.au/


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Parent/Carer 1 Primary contact (is contacted first in case of an emergency) ☐resides with student

Do you wish to receive the following? ☐Emails ☐ Academic Reports ☐Attendance Notifications

Family Name First Name Relationship to Student Mobile No. Home Phone Home Address if different to your student Suburb Post Code Personal Email

Parent/Carer 2 ☐resides with student

Do you wish to receive the following? ☐Emails ☐Academic Reports ☐Attendance Notifications Family Name First Name Relationship to Student Mobile No. Home Phone Home Address if different to your student Suburb Post Code

Personal Email Postal Address if different to Home Address Suburb Post Code

If you have any other contacts that you feel should be added to this application, please attach them on a separate piece of paper entitled Section3 – Student/carer details

Emergency Contact Please nominate a person over the age of 18 who may be contacted in the event of an emergency if the school is unable to contact the parents/carers listed above. Ideally the contact should be someone who lives near the school. Please ensure that you have discussed with this person their willingness to be an emergency contact.

Family Name First Name Relationship to student Phone Number Mobile If there are any special circumstances or times it is not convenient to phone please comment in the section below

Section 3 – Family/Carer Details

Details



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Section 4 - Student Educational History

What year are you applying to start at Bradfield Senior College? ☐Preliminary (Year 11) ☐HSC (Year 12) ☐Pathways Starting Term 1 2018 Starting Term 4 2017

Previous/Current School

Please provide details of any school where you have previously been enrolled over the last 4 years

School Start Date / / School Year

End Date / /


End Date / /


End Date / /

Year in which you are currently or were last enrolled in school ☐Year 10 ☐Year 11 ☐Year 12

Why have your left or are leaving your previous/current school?

Have you completed Year 10? ☐Yes ☐Completing this year ☐No (if no please provide details eg TAFE Courses or equivalent)

Have you completed Year 11? ☐Yes ☐Completing this year ☐No

Please list the Year 11 subjects that you have completed or are completing this year

If you are not currently enrolled at a school, what date did you leave? / / What have you been doing since you left school?

Have you been involved in Gifted and Talented/extension programs? ☐Yes ☐No What extra-curricular activities have you been involved in at school? (bands, leadership, debating, sport etc.)

Name and telephone number of a referee we can contact who is a staff member at your current/former school:

Name Position

Phone Number ☐I give permission to contact this referee

1. 2.

3. 4.

5. 6.

7. 8.



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Section 5 – About You

Why do you want to enrol at Bradfield?

Tell us about yourself: your personal interests, strengths, challenges and passions:

What would you say is the most important thing at this point in your life?

Do you plan to seek further education after your HSC? ☐Yes, tick appropriate ☐TAFE ☐University ☐Other ☐No

Do you have career goals? ☐Yes ☐No ☐Unsure ☐Undecided Expand on your choice

Do you experience difficulty in learning? If yes, explain

Do you currently or have you had a job? ☐Yes ☐No Current job: Hours per week: Have you participated in voluntary work (list)? How did you hear about Bradfield?

☐Careers Advisor ☐Counsellor ☐Teacher/Principal (Current school) ☐Family

☐Google Search ☐Social Media ☐Website ☐ Word of Mouth

☐ Other (please specify) Connections with the College Please name any current/ex/future Bradfield students that you know including family or relatives



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Please indicate if you have any of the following

☐ Hearing impairment ☐ Dyslexia ☐ Intellectual disability

☐ Physical disability ☐ Vision disorder ☐ Other (please specify)

Has any previous education provider prepared a documented plan to support your additional learning needs?

☐ Yes if yes, please provide details ☐ No

Please provide the name, address and phone number of any doctor or medical specialist who may be currently treating

you for any medical condition other than allergies and mental health you have mentioned above. Attach an additional

page if necessary.

Medical Condition

Doctor’s Name Phone Number

Address

Section 7 – Student Health/Disability

Section 6 – Special Circumstances

Are there any special circumstances about you that the school should know prior to enrolment?

(eg living apart from parental supervision, out of home care arranged by the state, etc). ☐ Yes ☐ No

If yes, please provide a brief description of the circumstance. Write in the space below.

Do you consider yourself to have a disability, impairment or long term condition? ☐Yes ☐No

Do you require or are you receiving assistance for this disability, impairment or long term condition? ☐Yes ☐No

Section 7a – Physical Health



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If you do not have any serious health conditions please move on to section 8

Section 7b – Mental Health

Please indicate if you have any psychological or emotional difficulties that may affect your learning?

☐ADD/ADHD ☐Depression ☐Anxiety ☐Autism ☐OCD

☐Bipolar ☐ODD ☐Eating Disorder ☐PTSD ☐Behaviour Disorder

☐Sleep Disorder ☐Addiction (Gaming, substance abuse etc) ☐Other (please specify) If yes, please state below how this condition may affect you:

Are you currently on medication? ☐Yes ☐No If yes, what is the prescribed medication?

If yes, do you wish for your medication to be stored in the College sickbay? ☐Yes ☐No

Have you had outside help to deal with your condition in the last 12 months? (eg psychologist, psychiatrist, counsellor)

please state below:

How often does this occur? ☐ weekly ☐fortnightly ☐monthly ☐other

If you have responded yes to any of the above an interview with one of our counsellors may be scheduled.

Please provide the name, address and phone number of any specialist who may be currently treating you for the above mentioned. Attach an additional page if necessary. Condition


Address



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Allergies – These can include allergies to insect stings, drugs, latex, food (eg nuts, eggs, peanuts) or other If you have any allergies, please specify in the box below. For this allergy please answer the questions that follow (where applicable). If there is insufficient space below, please attach additional pages clearly marked Allergies. For any additional allergies you have, please answer the questions below (where applicable) on a separate page for each allergy, clearly marked Allergies.

Allergic to

Has a doctor diagnosed this allergy? ☐Yes ☐No

Is this a severe allergy (anaphylaxis)? ☐Yes ☐No Anaphylaxis is a severe, potentially life-threatening, allergic reaction

Have you been hospitalised with a severe allergic reaction (anaphylaxis) or any other allergy? ☐Yes ☐No

Do you have an ASCIA action plan for anaphylaxis/allergies? ☐Yes ☐No

If yes, is this action plan attached ☐Yes ☐No

Have you been prescribed an adrenaline autoinjector (ie EpiPen)? ☐Yes ☐No If you have been prescribed an adrenaline autoinjector, you will need to provide the school with one (and renew prior to

expiry date). You must carry your EpiPen with you at all times; Agree ☐Yes ☐No Each time you are prescribed a new adrenaline autoinjector the doctor should issue an updated ASCIA action plan for anaphylaxis. It is important that any updated plan is provided to the school. What is the expiry date of the adrenaline autoinjector that will be provided to the school? / / If not known at the time of completing this form, the school will require this information on enrolment. Please list any other medication prescribed for this allergy:

Please provide the name, address and phone number of any doctor or medical specialist who may be currently treating you for the allergies you have mentioned above. Attach an additional page if necessary


Address Medical conditions other than allergies (eg asthma, severe asthma, diabetes, epilepsy) Please identify and provide details below of any other medical condition for which you are being treated. (if more than one condition or insufficient space, please attach additional pages and include the answers to all the questions below clearly marked Medical Conditions).

Medical Condition

Has a doctor diagnosed this condition? ☐Yes ☐No

Have you been hospitalised with this condition? ☐Yes ☐No

Do you have a documented action plan from a doctor (eg asthma action plan)? ☐Yes ☐No

If yes, is this plan attached ☐Yes ☐No

Are you taking prescribed medication for this condition? ☐Yes ☐No

Do you need your medication to be stored in the College sickbay? ☐Yes ☐No If yes, what is the prescribed medication? The school will require further details in relation to prescribed medication on enrolment.

Section 7c – Medical Conditions



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Section 8 – Risk Assessment

Student’s history relevant to risk assessment TAFE NSW has a responsibility to assess and manage any risk of harm to its staff and students. This application gives you the opportunity to provide the school with information that will help facilitate your smooth transition into this specific school setting. This may include preparing a behaviour management plan or other appropriate strategies directed at meeting your particular needs. The action taken in response to the information you provide will help ensure your safety, and the safety of other students and staff.

To your knowledge, is there anything in your history or circumstances (including medical history not listed previously)

which might pose a risk of any type to yourself, other students or staff? ☐Yes ☐No If yes, please provide a brief description of medical or other history which might pose a risk of any type to yourself, other students or staff at this school. Please provide names and contact details of health professionals or other relevant bodies that have knowledge of these issues.

Have you been bullied? ☐Yes ☐No If yes, please provide details below:

Have you ever been suspended from school? ☐Yes ☐No

Have you ever been expelled from school? ☐Yes ☐No If yes, please provide details below:

Do you have any history of violent behaviour? ☐Yes ☐No If yes, please provide details Please note that non-disclosure is a breach of the TAFE discipline policy and will affect your enrolment at Bradfield.



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Section 9 - Selecting your HSC Subjects

Review the subject descriptions found in the application pack or on our website www.bradfield.nsw.edu.au. If you intend to apply for university placement, ensure you select sufficient units to qualify for an Australian Tertiary Admissions Rank (ATAR). Note: indicates Non-ATAR courses.

Please be aware that courses run subject to demand. During your interview you will have an opportunity to discuss and finalise your subject selection.Preliminary (Year 11) students need to choose at least 14 units (7 subjects) from the selection below.HSC (Year 12) students must study a minimum of 10 units (5 subjects) in the HSC year.

Indicate your interest in the following subjects

Select the courses you wish to study by placing a cross in the appropriate boxes ☒ Industry Experience Program (Work Studies) is compulsory for Preliminary students. English is compulsory in Preliminary and HSC. Select at least one course. Vocational courses: all Preliminary students must select one or more vocational course. Please outline why you want to do the selected Vocational course(s). General Preliminary and HSC courses

Do you want to achieve an ATAR? (This is used for direct University placement after the HSC) ☐Yes ☐No ☐Unsure

☐Industry Experience encompasses the HSC subject Work Studies, the TAFE Certificate III in Career Advancement and

TAFE Certificate I in Information, Digital Media and Technology.

☐English Studies ☐English Standard ☐English Advanced ☐English Extension 1 ☐English Extension 2 (Year 12)

Bradfield Vocational Courses

☐Assistant Dance Teaching ☐Information Digital Technology ☐Retail Services

☐Business Services ☐Media Communications ☐Screen & Media (Film & Radio)

☐Contemporary Visual Arts ☐Music Industry ☐Event Management

☐Design Fundamentals ☐Musical Theatre Performance ☐Entertainment Industry

☐Furniture Making ☐Fashion & Textiles (2 years) ☐Other TAFE Course

☐Ancient History ☐Industrial Technology – Multimedia ☐PD/Health/PE

☐Biology ☐Investigating Science ☐Photography, Video & Digital Imaging

☐Business Studies ☐Legal Studies ☐Senior Science (Year 12 only)

☐Community & Family Studies ☐Mathematics ☐Society & Culture

☐Dance ☐Mathematics General ☐Software Design & Development

☐Design & Technology ☐Mathematics Extension ☐Sports, Lifestyle & Recreational Studies

☐Drama ☐Modern History ☐Visual Arts

☐Food Technology ☐Music 1 ☐Specify other subjects not listed

☐History Extension (Year 12) ☐Music 2 …………………………………………………………………

………………………………………………………………….




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Additional application requirements and information

At the interview you many need to bring in additional documentation:

If you have previously studied a vocational course (ie Retail, Hospitality, Entertainment) and have selected to study this course in Year 12, you need to bring to interview your Log Book or other evidence showing the Units of Competency and Work Placement hours you have completed

Original copies of reports and transcripts.

All courses have particular requirements while others require an audition or portfolio to help determine if the course is suitable to your needs.

Contemporary Visual Arts

Please bring a portfolio or samples of your work to the interview, to support your application for this course. HSC Dance

You will be assessed on dance technique and performance quality at interview. We can then determine whether the course is suitable for you. Design Fundamentals

Students must enrol in Preliminary Design and Technology if they wish to receive the full Certificate III in Design Fundamentals. Please bring a portfolio or samples of your work to the interview, to support your application for this course. Entertainment

The course has a strong practical orientation and requires students to be involved in technical rehearsals outside of normal class time. Your suitability for this course will be assessed in your first lesson. Music Industry

If you apply for entry into this course, you must attend an audition and complete the following:

1. Perform two contrasting pieces of music. The pieces you choose should demonstrate your knowledge of different styles of music.

2. Answer a series of questions related to your previous music experience and your commitment to completing this course.

You can bring to the interview other resources that may support your performance or application. Musical Theatre

The course has a strong practical orientation and requires students to develop skills in singing, acting and dancing. Students will be involved in performances and rehearsals outside of normal class time. Your suitability for this course will be assessed in your first lesson.



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Section 10 - Personal information, consent and declaration of accuracy

To be considered for a position at Bradfield Senior College, I (student name) agree to abide by the NSW TAFE Student Discipline Policy and the following: Attendance

I understand that an attendance rate of 100% in each class is a desired attendance target

My parent/carer will notify the college of any non-attendance by calling 9942 0399

I will supply supporting medical certificates or notes for any absences if requested

I will catch up on any missed work before the next class. Behaviour

I will co-operate with my peers and staff.

I understand that requests by staff are designed to support all students’ learning and I will follow directions from staff

I will use technology and social media in a productive and appropriate manner

I will conduct myself in a way that will bring credit to myself, my family and Bradfield Senior College.

Participation in Learning

I will attempt all class work and learning requested of me to the best of my ability

I will contribute to class activities and not create interruptions during the lesson by displaying negative behaviour.

Industry Training

I understand the Industry Experience Program is a mandatory course for year 11 and requires a work placement.

Participation in Learning Support

I understand I can obtain support and help with course work in the Learning Centre

I agree to attend Learning Support classes if they appear on my timetable.

Personal Responsibilities

I will accept responsibility for my actions and will discuss any concerns with a staff member

I will not carry, consume or be under the influence of alcohol or non-prescribed drugs at college.

Parent/Carer involvement

☐I allow the college to communicate information about my

attendance and progress with my parents/carers throughout my studies at Bradfield

Centrelink (If applicable) If I am on Centrelink payments:

I understand that Centrelink monitors student attendance and I must make satisfactory progress

I must inform them if I change my study program within 2 weeks

I understand Bradfield Senior College will grant access of my student

records including attendance, marks and reports via the parent portal

of Edumate (student management system).

Signature Date

MEDICAL PLAN I will require a school individual health management or risk management plan Yes No If yes, please give details: A current plan is included with this signed form Requires one to be developed or supplied ................................................................................................................. ................................................................................................................. ................................................................................................................. AUTHORITY TO PUBLISH - PHOTO, ARTWORK & WORDS This is an agreement between you and Bradfield Senior College/TAFE NSW. Please read it carefully and sign it at the bottom. TAFE NSW would like to be able to quote you and/or use a photo of you and your work in some of its printed and/or electronic promotional material eg, College website, prospectus, marketing flyers and TAFE magazines. If you sign this release form it means that you agree to the following:

1. TAFE NSW is able to use your information, photo(s) and/or words as many times and in as many ways as it wants. This includes social networking sites such as: Facebook, Twitter and YouTube. A photo of work that you have created may also be published.

2. Your photo(s) may be reproduced in colour or black and white and may be altered, distorted or blurred for design purposes.

3. There is no requirement for the College to discuss with you the specific context in which your photo(s) and/or words appear.

TAFE NSW will not use or disclose your information, words and/or photo(s) for any purpose other than the general promotion of TAFE NSW. Should you agree to the use of your words and/or photo but wish to further restrict that use, please provide details in the box provided below.

Your agreement to permit the use of your photo(s) and/or words is greatly appreciated. Any inquiries you have may be directed to the College on 9942 0399.

☐ Yes, I agree for my ☐ Photo(s) ☐ Artwork ☐ Words

☐ No, I DO NOT want my photo(s), artwork or words to be used

under any circumstance. It is the student’s responsibility to inform

teachers/photographers that images/names/words/art work is not to

be used.

I have read this release and understand what it means. Agree If there are restrictions please give details:

Declaration

☐The information supplied in this application is correct and accurate. Signature (Student) Date Signature (Parent/Guardian/Caregiver) (If student is under 18) Date



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Application to enrol in Bradfield Senior College – Information Sheet

How to complete this application form

■ Applicants must complete all sections

■ Use a black or blue pen to fill in this form

■ When you are asked to mark a box, put a cross in the box like

this: ☒

■ Please print as neatly and legibly as possible like this:

■ Attach any additional information securely to the back of this form.

Clearly indicate which section this information refers to.

■ If you require another application form, you can download

additional copies from: www.bradfield.nsw.edu.au

In addition

If your student is the subject of family law matters you will need to provide:

Copies of any family law or other relevant court orders

In addition

If your child has health, disability or other support needs you will need to provide:

Copies of medical/healthcare or emergency action plans

Evidence of any disability or other support needs, including any learning and support plans

In addition

Non-Australian Citizens

If your child is a permanent resident but not an Australian citizen you will need to provide:

Passport or travel documents

Current visa and previous visas (if applicable)

In addition

Temporary visa holders

If your child is a temporary visa holder you will need to provide:

Passport or travel documents

Current visa and previous visas (if applicable)

Authority to Enrol issued by the Temporary Residents Program Unit. This is required for visitor and temporary visa holders (other than sub class 571P referred to below)

Authority to Enrol or evidence of permission to transfer issued by the International Student Centre (if holding an international full fee student visa, sub class 571P)

Evidence of the visa the student has applied for (if the student holds a bridging visa)

PLEASE TEAR OFF THIS BACK PAGE BEFORE RETURNING YOUR APPLICATION TO THE SCHOOL.

Having trouble with this form? If you have difficulty understanding this form or would like further information, please

call Bradfield on (02) 9942 0399.

Print as clearly as possible in the boxes

You must submit the following with this application:

☐Two most recent school reports

☐A personal reference

☐Year 9 NAPLAN

☐ToSA/RoSA transcript (if applicable)

☐TAFE results (if applicable)

☐Medical or diagnostic reports (if applicable)

☐Centrelink income statement (if applicable)

Mail, email, or deliver your completed application and supporting documents to:

Bradfield Senior College, Building A, 213 Pacific Highway, St Leonards NSW 2065

Postal Address: PO Box 1007, Crows Nest NSW 1585

Email: [email protected] We will contact you after reviewing your application to arrange an interview/audition if appropriate



mailto:[email protected]

Documents

Section 1 - Student Detailsbradfield.nsw.edu.au/media/2970/bradfield-senior-college...Section 1 - Student Details Family Name First Name Middle Name Preferred Name Gender Mobile No