Student's Full Name (This name should match your child's birth certificate)
Date of Birth (Please format as DD/MM/YY)
Entry Year Level
- Choose -
Year of Entry
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Language Spoken (at home)
Language Spoken (other)
Country of Birth
Citizenship Visa Number if not Permanent Resident
Year Level at Present School
- Choose -
Birth Certificate Please attach: A copy of Birth Certificate. International Students to supply a copy of Passport and Visa details.
Recent photo of your daughter (A clear, passport sized individual photo)
Current School report Please attach a copy of current school report
Current NAPLAN Report Please attach a copy of current NAPLAN report
Learning Enhancement needs (Support or Enrichment)
Please give details (Please attach all relevant documentation)
Please note: Please advise us of the listed Special Considerations. Please note: If the Learning Enhancement needs section is not completed, the College will assume your daughter does not have specific learning needs which require support. Non-disclosure may lead to a review of this enrolment. Documentation provided will be forwarded to the Learning Enhancement Centre.
Resides with student
Parent 1 Residential Address
Postal Address (If different from residential)
Resides with student
Parent 2 Postal Address (If different from residential)
CUSTODY DETAILS: If applicable, please state below the full names of all persons who have lawful custody of the student.
Persons with lawful custody
Are court orders in place?
Documentation: Provision of any documentation in relation to any Family Court order or binding agreement regarding residency, contact, or any other parenting issues which apply to the student is a requirement of admission.
Please attach documentation
OTHER FAMILY MEMBERS Who have attended (Mothers who are Fairholme Old Girls should include their names again here), are attending, or will be attending Fairholme College:
Relationship to student
Year of leaving/Current Year level
Maiden Name (if applicable)
Additional family members (if there are multiple family members please list details in box below)
FAMILY REFEREE: Please state the name and address of parents’ referee to whom the Principal may refer.
Family Referee Full Name
Referee Home Phone
Referee Mobile Phone
Referee Work Phone
Referee Email Address
STUDENT MEDICAL DETAILS*: Please note any medical conditions and attach any documentation that outlines previous and/or existing physical, emotional or mental conditions that may affect your daughter’s progress. Note that the Fairholme College Medical Form will be sent for completion prior to final enrolment. Some students at Fairholme have an extreme and life threatening reaction to peanuts and, as such, we seek care and caution from all members of the College community.
EMERGENCY CONTACT: (Other than parents listed) If future mail from school does not reach you promptly or parents are not available (eg. grandparents, neighbours, close friend)
Emergency contact Full name
Emergency contact Relationship to student
Emergency Contact Home Phone
Emergency Contact Mobile Phone
Emergency Contact Work Phone
Emergency Contact Email Address
PAYMENT OPTIONS: Please indicate how you intend to make payment of the non-refundable application fee of $110 (Day Students/Boarders) and $132 (Overseas students) by checking one of the boxes below:
DECLARATION: I/We, the parent/s or guardian/s hereby apply to have the above named student enrolled at the College, and should she/he be accepted, I/we agree to be bound by the Conditions of Entry enclosed with this Application and to accept, comply with and support in all respects the aims of the College as detailed in the College Prospectus, a copy of which the parent/s or guardian/s acknowledge having already received prior to signing this Application. We understand and support the College’s preferred approach to conflict resolution through a model of restorative practices.
I/We undertake to abide by the College regulations, policies and social code in all respects and to pay all proper fees and charges in the amounts and the manner as prescribed by the College Board from time to time. For students entering Years Prep to 12, I/We also undertake to give 90 days’ notice of the above named student’s withdrawal from the College. I/We also acknowledge that if the above named student does not commence studies at the College, the Enrolment Confirmation Fee will not be refunded. For students entering Kindy, the College’s Kindy Enrolment Policies regarding the Enrolment Confirmation Fee applies and I acknowledge having received, understood and accept these policies. This Enrolment Confirmation Fee will be sought well before commencement of each student at the College, or at the time of commencement if a place is not offered in advance. Our obligations under this agreement are joint and several.
This section indicates your agreement to the conditions of entry to Fairholme College:
Conditions of Entry ›