Junior School enrolment questionnaire – Ballarat Clarendon College

Student surname*

Student given names*

Student date of birth

Parent /Guardian 1 full name*

Parent/Guardian 2 full name

Enrolment year*

Enrolment Year level*

Which term will you begin your enrolment with us?*

If you are wish to start mid-term, please indicate the commencement date

Background Information

Who is in your child's family?*

Who else is important to them? (friends, pets, etc)*

Do you have any concerns with your child's hearing or vision?*

Yes
No

If yes, please provide further details.

Has your child had a hearing test?*

Yes
No

Has your child had an eye test?*

Yes
No

Does your child have any ongoing illness or allergies?*

Yes
No

If yes, please provide further details.

Community

Where does your child currently attend School?*

Name of current classroom teacher:*

Do you give permission for us to contact the current/previous school?*

Yes
No

Communication

What is your child's first language?:*

Does your child speak or understand any other languages?*

Yes
No

If yes, please list the language/s.

Is your child involved with a speech pathologist?*

Yes
No

If yes, please provide further detail below and provide any reports directly to the Admissions Office.

Identity

What interests does your child have?*

Do you have any concerns with how your child behaves?*

Yes
No

If yes, please provide further detail.

Do you have any concerns about how your child gets along with others?*

Yes
No

If yes, please provide further detail.

Learning

What subjects would you describe as your child's strongest?*

In what areas are you looking for improvement?*

Has your child been assessed for a learning disorder, such as ADHD, ASD, Dyspraxia?*

Yes
No

If yes, please provide further detail and reports if applicable.

Do you have any concerns about your child's concentration skills?*

Yes
No

If yes, please provide further detail.

Do you have any concerns about your child following requests or instructions?*

Yes
No

If yes, please provide further detail.

Why did you choose Ballarat Clarendon College for your child's future education?*

Please include any other information that will help support your child in their transition to school.

Phone

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