EXPRESSION OF INTEREST FOR STUDENT ENROLMENT

This form is an expression of interest to enrol at Ripley Valley State Secondary College. Completion of this form does not constitute enrolment into the school. An Enrolment Management Plan is in place, with a corresponding boundary catchment map. This information is available on the Queensland Government website:

http://qgso.qld.gov.au/maps/edmap/

Please attach the following supporting documents:-

Proof of residency – rates notice, current signed lease agreement or unconditional sale agreement

Current utility bill (gas, electricity)

Student Australian Birth certificate or Student Current overseas Passport & Visa

Out of Catchment Applications must be accompanied by a letter including the following information:

• Date of application and student's current residential address• Student's name, age and intended year level in 2021• Reason(s) for wanting to enrol at Ripley Valley SSC• Name and ages of any other siblings• Signed and dated by both parent and student

I understand that supplying false or incorrect information on this form may lead to the reversal of a decision to approve

enrolment. I believe that the information I have supplied on this form is true and correct, to the best of my knowledge.

Preferred Name:

Current School:

Gender:

Student Family Name:

Legal Given Name:

Date of Birth:

Year level applying for

Indicate if applicable:

Sibling Enrolment - Name of enrolled sibling/s:

Out of Catchment Application (Application letter attached)

Parent / Carer 1

Name:

Address:

Phone:

Email:

Signature:

Date:

Parent / Carer 2

Name:

Address:

Phone:

Email:

Signature:

Date:

Please email to: administration@ripleyvalleyssc.eq.edu.au

Students transferring from Interstate/Non-State School Enrolments must also be accompanied by a Student Profile/Interstate Transfer Note including most recent School Report and NAPLAN results.

Enrolment Details

PRELIMINARY STUDENT PROFILE

Is the student in the care of Department of Child Safety - DOCS?

Details:

Does the student have English as a second language or EALD

Details:

Have they received EALD support in the past?

Details:

Has the student been identified as gifted & talented?

Details:

Has the student been verified with a disability or learning difficulty?

Details:

Has the student received learning support in the

past? If so, which year levels?

1 2 3 4 5 6 7 8 9 10 11 12

Has the student received support from a Special Education Program?

Details:

Any other relevant information in relation to the welfare and support of the student?

Details:

Is the student currently included in any legal/custody papers? Does the student have a family member currently serving with the Australian Defence Forces? Do you wish for your child to have the opportunity to study a Language other than English (LOTE)? If yes, what is your preferred LOTE?

MEDICAL HISTORY – Has your student seen any of the following? (tick as appropriate and provide details/reports)

Guidance Officer Contact Name: Phone:

Speech Language Pathologist Contact Name: Phone:

Optometrist Contact Name: Phone:

Audiologist Contact Name: Phone:

Paediatrican Contact Name: Phone:

Psychologist Contact Name: Phone:

Occupational Therapist Contact Name: Phone:

Other (please specify):