2019 Newman Selective  Gifted Education  

Application Form 

General Instructions:  

❏ Please complete all sections of the application form. 

❏ If available, please attach copies of up to 3 pieces of evidence to support your child’s application into the Newman Selective class (see examples listed on page 3) 

❏ Return this form to the Newman Selective Secondary school your child is enrolled in by the 31st October, 2017. 

 YEAR/GRADE APPLIED FOR 

STUDENT DETAILS 

Student’s family name   

Student’s given/first name   

Date of birth  Day  Month  Year 

Gender  ❏ Female  ❏ Male  ❏ Other 

The student’s current academic year   Year/Grade: 

Student’s current school   

Parent/Caregiver 1 name   

Parent/Caregiver 2 name   

Postal Address   

Suburb    Postcode

Home Phone    Mobile (1)    

Work Phone    Mobile (2)   

Email address Parent /Caregiver 1   

Email address Parent /Caregiver 2   

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STUDENT BACKGROUND 

Is your child an Aboriginal and/or Torres Strait Islander student?  ❏ Yes  ❏ No 

Has your child used the English language in school for less than 4 years? 

❏ Yes  ❏ No 

If ‘yes’ to the question above, what month and year did your child start using English in school work? 

Month  Year 

DIVERSE LEARNING NEEDS 

Does your child have any known or suspected exceptionalities, disabilities, complex social and emotional needs or other needs?  

❏ Yes  ❏ No 

If Yes, please specify:     

If your child requires adjustments, please indicate the most relevant adjustments that will be required for your child when sitting the Newman Selective School Test. 

❏ Large print ❏ FM transmission ❏ Coloured paper ❏ Separate seating / front of the room ❏ Other 

If you selected ‘Other’, please specify;     

OFFICE USE ONLY:   Documentation verified by school delegate 

NAME: 

❏ Yes 

❏ No 

Date  

PARENT’S / CAREGIVER’S DECLARATION 

❏ I/We declare that, to the best of my/our knowledge, the information I/we have provided in this application form is accurate. 

❏ I/We understand that, while our child is enrolled in a Newman Selective Gifted Education Secondary school, it does not guarantee our child a placement in the Newman Selective class. 

❏ (If applicable) I/We have attached to this form copies of up to 3 piece of evidence to support our child’s application into the Newman Selective class. 

Signature Parent/Caregiver 1   

  Date 

Signature Parent/Caregiver 2  

  Date 

   

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PORTFOLIO EVIDENCE:  

Examples of SUITABLE evidence  Examples of what NOT to submit as evidence 

Copy of: 

➢ Ê School Report showing Grade or  

Subject Acceleration  Eg: Year 4 student who is enrolled in Year 6 or  

Year 4 student completing Yr5-6 work 

 

➢ Ê IQ Assessment Report  Eg: WISC IV, WISC V, Stanford-Binet  

 

➢ Ê University competition achievement  Eg: UNSW International Competitions and  

Assessments for Schools (ICAS)  

  

➢ Ê Other educational institution   achievement  

Eg: Maths Olympiad, Young Scientist of the Year 

  

➢ Ê Participation in external extension   programs  

Eg: UNSW Scientia Program, UOW Early 

Learning  

Labs, Tournament of Minds 

  

➢ Ê Government Challenges achievement  Eg: Premier’s Reading Challenge, Debating   

Challenge, National History Challenge 

  

➢ Ê Student work sample evidencing high   ability in any key learning area. This work   sample must be marked/annotated by the   class teacher   Eg: Piece of writing, problem-solving task 

  

➢ Ê Diagnostic test results  (If child has come from a school outside  

of Sydney Catholic Schools )    Eg: Raven’s Progressive Matrices, PAT Reading,   PAT Math   

 

➢ Ü Any original documentation    

➢ Ü Audio-visual material    

➢ Ü Thumbdrives / external hard drives    

➢ Ü 3D structures / models / frames    

➢ Ü Trophies / medals    

➢ Ü Original photos    

➢ Ü Work samples not marked or annotated   by a teacher    

● Please note, copies of evidence must be included with the application on submission. ● All copies of evidence will be placed in the student’s school file after the application process.

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