Registration Form www.aia.vic.edu.au PLEASE USE BLOCKED LETTERING Full Name Residential Address Post Code Postal Address Occupation Country of Birth Home Phone Mobile Work Phone Email Signature Date FATHER/MALE GUARDIAN DETAILS PARENT / GUARDIAN Family Name Given Name To enter year level in the year Gender Male Female Date of birth Country of birth Religion Nationality Present school / Kinder Student lives with Both parents or Father only or Mother only Grandparents Other please specify Australian Citizen Yes No Permanent Resident Yes No Visa Number STUDENT DETAILS (INCLUDING OVERSEAS COUNTRIES) (EG. YEAR 4) Full Name Residential Address Post Code Postal Address Occupation Country of Birth Home Phone Mobile Work Phone Email Signature Date MOTHER/FEMALE GUARDIAN DETAILS PARENT / GUARDIAN OFFICE USE ONLY RECEIPT NO. DATE RECEIPT STUDENT ID DEBTOR ID
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DATE RECEIPT Registration Form STUDENT ID DEBTOR ID
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Registration Form
www.aia.vic.edu.au
PLEASE USE BLOCKED LETTERING
Full Name
Residential Address
Post Code
Postal Address
Occupation Country of Birth
Home Phone Mobile
Work Phone Email
Signature Date
FATHER/MALE GUARDIAN DETAILS
PARENT / GUARDIAN
Family Name
Given Name
To enter year level in the year Gender Male Female
Date of birth Country of birth
Religion Nationality
Present school / Kinder
Student lives with Both parents or Father only or Mother only Grandparents
Other please specify
Australian Citizen Yes No Permanent Resident Yes No Visa Number
STUDENT DETAILS
(INCLUDING OVERSEAS COUNTRIES)
(EG. YEAR 4)
Full Name
Residential Address
Post Code
Postal Address
Occupation Country of Birth
Home Phone Mobile
Work Phone Email
Signature Date
MOTHER/FEMALE GUARDIAN DETAILS
PARENT / GUARDIAN
OFFICE USE ONLY
RECEIPT NO.
DATE RECEIPT
STUDENT ID
DEBTOR ID
*Completed form and attached Birth Certificate must be returned to the School Registrar.
Registration Form
Names of other children at this Academy Year Level
(PLEASE, FILL IN IF APPLICABLE. EVEN IF CURRENTLY AWAITING ADMISSION)SIBLINGS AT AUSTRALIAN INTERNATIONAL ACADEMY
CURRENT SCHOOL CONTACT (AS PART OF THE ENROLMENT PROCESS THE STUDENTS CURRENT SCHOOL WILL BE CONTACTED)
School Name Contact
Position Phone
Postal Address
Contact Name Mobile
Relationship to Student
EMERGENCY CONTACT (OTHER THAN PARENTS)
A one-off Registration Fee of $110 is payable with the Registration form. This fee is non-refundable.Methods of payment: Cash (in person) By Phone Cheque (Payable to Australian International Academy) Credit Card (in person, surcharge apply)
PAYMENT DETAILS ENROLMENT GUARANTEE (EG)The EG is an interest free deposit of $1,000 per student that is paid prior to commencing at the Academy.The EG will be refunded on written request if /when; Student leaves the Academy. Student completes final school year. Student was asked to leave, the Academy.
DECLARATIONWe declare that all the information provided in this Registration form is true and correct as of the date of registration. We request that the above child be registered for enrolment at the Australian International Academy. We understand that we will be informed if and when a place becomes available. We are aware that the Registration fee is non-refundable. We will also advise the Australian International Academy of any change of address or contact details we may have.