MBCFI School Apply Online – Melbourne Bangladeshi Community Foundation Inc

Student’s mainstream school name:

Student’s mainstream year level:

Student Australian Residency Status

Australian citizen/Permanent resident Fee paying international student Other If Other, please specify:

Parent/Guardian Details

Name of Parent/Guardian:

Relationship to student:

Emergency Contact Details (only complete if different from parent/guardian details)

Emergency contact name:

Relation to student:

Emergency contact phone:

Does your child suffer from any medical condition? (e.g. asthma, epilepsy, allergies etc.)?

Yes No

If Yes, please specify and provide a medical plan (e.g. asthma, anaphylaxis etc.)

Is your child currently on any medication?

Yes No

If Yes, please specify:

Privacy Collection Notice - Protecting your privacy and sharing information

The information about your child and family collected through this enrolment form will only be shared with school staff who need to know to enable the community language school and Department of Education and Training (Department) to educate or support your child, or to fulfil legal obligations including duty of care, anti-discrimination law and occupational health and safety law. The information collected will not be disclosed beyond the Department without your consent, unless such disclosure is lawful. For more about information- sharing and privacy, see the Department’s privacy policy at: http://www.education.vic.gov.au/Pages/privacy.aspx

Parent/Guardian Privacy Consent and Declaration

I confirm that the information provided on this enrolment form is true and correct and I acknowledge and agree to the terms and conditions of enrolment accompanying this enrolment form. I consent to:

he collection of my child’s health and personal information by the community language school;
the community language school disclosing my child’s personal information contained in this enrolment form to the Department of Education and Training for data verification and funding purposes;
the Principal or teacher (where the Principal or teacher in charge is unable to contact me) to administer such first aid to my child as the Principal or staff member may consider to be reasonably necessary including disclosing personal and health information to professional third parties in the event of a medical emergency.

Name of Parent/Guardian:

Signature of Parent/Guardian:

Address

Glenroy College, 120 Glenroy Road, Glenroy, VIC 3060

Contact

Dr Molla Huq

ABN: 66 311 201 176

Reg: A00099196N

Apply Now

Enrolment Form

Student Details

Emergency Contact Details (only complete if different from parent/guardian details)

Medical Information

Privacy Collection Notice - Protecting your privacy and sharing information

Parent/Guardian Privacy Consent and Declaration

Address

Contact

Privacy & Term