Always Worthy

Cleveland District State High School

ENROLMENT PACK

Education Queensland International CRICOS Code 00608A

Preparing students to meet the future

WELCOME

We understand that the process of enrolling at a new school is an important one. As a result,

we have put all the forms in one booklet to assist you in completing this process.

The enrolment checklist is best filled out right at the end, as it helps us to be sure that you have

all the necessary documents and have completed the appropriate forms. The checklist

requires evidence of residential address for families within our Catchment Area, since our

school has reached its enrolment capacity and operates in accordance with an Enrolment

Management Plan. You will find a Catchment Area Map located on the enrolment page of our

website or direct via http://www.qgso.qld.gov.au/maps/edmap/.

Our list of Frequently Asked Questions and Answers attempts to help you with commonly

asked questions.

Next in the pack is the actual enrolment form. This is the standard Department of Education

form. It provides us with the necessary contact and personal details.

The class allocation summary attempts to collect some background information that helps us

tailor the education program for your student. Please answer the questions on our Pre-

Interview Summary sheet before you submit your enrolment paperwork. The additional forms are completed to verify your agreement to the conditions of enrolment,

use of school computers and your student’s media release forms.

CONTENTS 1. Frequently asked questions

2. Enrolment Checklist

3. Application for student enrolment form

4. Education Agreement

5. Technology Agreement

6. Copyright and Media Consent – State School Consent Form

7. Student Resource Scheme Participation Agreement Form

8. Catchment Exemption Application Form

9. Class Allocation Summary Sheet

10. Redland City Libraries Membership Form

11. Additional information and Application Forms - Specialist Programs

Frequently Asked Questions

Question Answer

How do I apply to enrol at Cleveland District SHS?

Submit the completed Enrolment Pack, including all supporting documents, as outlined on the enrolment checklist at the front of this pack. Once all documents are received, the application will be forwarded to the Executive Principal for consideration. In recent years Cleveland District State High School has experienced significant growth and we operate in accordance with an Enrolment Management Plan. This Plan ensures that students who live within the “catchment area” are guaranteed a place at their local high school and allows students from outside our catchment to apply for enrolment and be considered using a fair process.

Who can attend Cleveland District SHS? All students living in the catchment area in Years 7-12.

What if you live outside the boundary/catchment area?

You should fill out the catchment exemption form in this pack. This will be considered by the Enrolment Committee.

My child has a disability. How can I enrol

him/her?

Students with a disability have an adjustment process where applicable. These families meet with the Deputy Principal of Inclusion.

Where can I purchase the school uniform? Cleveland District State High School offers an on-site Uniform Shop that supplies our uniforms for students. Please also refer to our School Dress Code.

How do I get information about bus and train timetables and bus routes?

Transdev: Phone 13 12 30 or visit the Translink website www.translink.com.au

How do I know what subjects my student has been given?

Students receive a timetable on their first day of school. Senior students will be required to attend an interview to choose their subjects.

What do I need to bring on my first day of school?

A writing book and pens. Teachers will provide further details of what is required in class. Stationery lists are provided along with the Student Resource Scheme documentation.

Where do I go on my first day? At the beginning of the school year you will be met by a Student Dean in the Paul Bancroft Centre who will take you through an induction program before you go to class.

For mid-term enrolments, you report to the Administration Office on your first day, where you will be met by a school officer to assist and guide you to your first class.

Enrolment Checklist

Student Name:

Year Level of Enrolment: Requested Start Date:

Does the student have a sibling at this school? Yes No Name: _________________________________________ Year level: ___________

Parent

Checklist Please

Office Use Only

Application for student enrolment form - completed and signed

Birth Certificate - please provide a copy

If Born Overseas –

Provide a copy of Evidence of Residency / Citizenship (if applicable) □ Have you lived in Australia for FEWER THAN five years? Yes / No

Passport – please provide a copy of:

Photo page □ Arrival Stamp □ Visa □

If you reside within catchment, evidence of residential address for parent / legal

guardian is required. Current proof of residency at the address indicated can be supported by providing a copy of one of each of the following documents:

One primary source – a current lease agreement and RTA bond receipt or unconditional sale agreement and rates notice showing this same address and

parent’s/legal guardian’s name One secondary source – a utility bill (eg. electricity, gas) and One personal information document – drivers licence, passport or electoral roll

enrolment (www.aec.gov.au)

To determine if you reside inside our catchment area, please utilize the online tool from the enrol page of our website or direct via http://www.qgso.qld.gov.au/maps/edmap/

For families who reside outside our catchment:

Complete the Catchment Exemption Form and Provide a copy of one personal information document – drivers licence, passport,

electoral roll enrolment or birth certificate.

Most Recent School Reports – Year 7 – please provide copy of your Year 6, Semester 1 report Years 8 to 12 - please provide copies of the 3 most recent reports Most recent NAPLAN – Year 5 or Year 7 or Year 9

Signed Forms: Education Agreement Technology Agreement State School Consent and Agreement Form Student Resource Scheme (SRS) Participation Agreement Form Redland City Libraries Membership Form

Class Allocation Summary Sheet completed

Special Needs or Student Support Program documentation – please make note here and provide copies of documents.

Excellence Programs – Expression of interest:

□ Academic Extension Program (Years 7 and 8)

□ Creative Arts (Music Extension) (Years 7 and 8)

□ Language, including Chinese, Japanese and French (Years 7 and 8)

□ Sport Development – Football (Soccer), Touch Football and Volleyball (Year 7 only)

□ International Baccalaureate Diploma Programme (Years 10 – 12)

Please be aware that some of these specialist programs require separate documentation, for example, an audio visual recording for the Creative Arts Excellence Program.

Enquiries to: enrolments@clevelanddistrictshs.eq.edu.au

Education (General Provisions) Act 2006 Section 155(1) Approved form SEF – 1 V7

Application for student enrolment form INSTRUCTIONS Please refer to the Application to enrol in a Queensland State School information sheet at the end of this form when completing this application.

Failure or refusal to complete those sections of the form marked with an (*) or to provide required documentation may result in a refusal to process your application.

Sections of the form not marked (*) are optional. However, failure to complete these sections may result in the school not being eligible for important Federal and State

Government funding reliant on such information. Parents of all students in Australia have been asked to provide information on their family background as part of a

national initiative towards providing an education system that is fair to all students, regardless of their background. The required information includes the Indigenous

status and language background of the student, and the education, occupation and language background of the parents.

If you have any questions about the enrolment form or process, or require assistance completing this form, including translation services, please contact the school in

the first instance.

PRIVACY STATEMENT The Department of Education and Training (DET) is collecting the information on this form for the purposes outlined in the Education (General Provisions) Act 2006

(EGPA 2006), and in particular for:

i. assessing whether your application for enrolment should be approved

ii. meeting reporting obligations required by law or under Federal – State Government funding arrangements

iii. administering and planning for providing appropriate education, training and support services to students

iv. assisting departmental staff to maintain the good order and management of schools, and to fulfil their duty of care to all students and staff

v. communicating with students and parents.

This collection is authorised by ss. 155 and 428 of the EGPA 2006. DET will disclose personal information from this form to the Queensland Curriculum and

Assessment Authority when opening student accounts, in compliance with Part 3 of the Education (Queensland Curriculum and Assessment Authority) Act

2014 (Qld). Personal Information from this form will also be supplied to Centrelink in compliance with ss.194 and 195 of the Social Security (Administration) Act

1999 (Cth). De-identified information concerning parents’ school and non-school education, occupation group and main language other than English and

students’ country of birth, main language other than English, sex and Indigenous status, is supplied to the Australian Government Department of Education in

compliance with Federal – State Government funding agreements.

Personal information collected on this form may also be disclosed to third parties where authorised or required by law. Your information will be stored securely. If

you wish to access or correct any of the personal information on this form or discuss how it has been dealt with, please contact the school in the first instance.

If you have a concern or complaint about the way your personal information has been collected, used, stored or disclosed, please also contact the school in the

first instance.

ENTITLEMENT TO ENROLMENT Under the EGPA 2006, an applicant for enrolment at a state school must be enrolled if they are entitled to enrolment. While not exhaustive, the following matters may

affect an applicant’s entitlement to enrolment at a state school:

failure to adequately complete this enrolment form

if the school has an Enrolment Management Plan or an Enrolment Eligibility Plan (enrolment is subject to eligibility under the plan)

the applicant is a prospective mature age student (the applicant can only apply for enrolment at a mature age state school and will be subject to a satisfactory criminal history check, or as a student in a program of distance education. All prospective mature age students must have a remaining allocation of state education.)

the applicant is not of correct age for enrolment (relates to Preparatory Year and Years 1 to 6)

the applicant has been excluded or cancelled from enrolment or is subject to suspension from a state school at the time of the application

the school is a state special school and the applicant does not meet the criteria for enrolment in a special school

the school principal reasonably believes that the applicant presents an unacceptable risk to the safety or wellbeing of members of the school community (application is referred to Director-General)

the proposed enrolment requires approval as part of a flexible arrangement under s.183 of the EGPA 2006, and the arrangement has not yet been approved

the prospective student is not an Australian resident or citizen or the child of an Australian permanent resident or citizen (visa restrictions may apply, fees may be charged, in some cases legislation requires that the applicant must obtain approval from the Chief Executive via Education Queensland International (EQI) to enrol).

Uncontrolled copy. Refer to the Department of Education and Training Policy and Procedure Register at http://ppr.det.qld.gov.au to

ensure you have the most current version of this document.

EX – exchange student DE – distance education

SV – student visa TV – temporary visa DS – dependent – parent on student visa EQI category

No Yes

Is the prospective student over 18 years of age at the time of enrolment

If yes, is the prospective student exempt from the mature age student process?

If no, has the prospective mature age student consented to a criminal history

check?

Office use only

Independent

student Yes No Birth certificate/passport sighted, number recorded

and DOB confirmed Yes

Number:

No

Associated unit Yes No Visa and associated documents sighted FTE

To be determined

No Yes EAL/D support School house/

team

No Yes

No Yes

EQ ID Roll Class

Year level

/ / Date enrolled

PROSPECTIVE STUDENT DEMOGRAPHIC DETAILS

Legal family name* (as per birth certificate)

Legal given names* (as per birth certificate)

Preferred family name

Preferred given names

Sex* Male Female Date of birth*

/ /

Copy of birth certificate available to show school staff*

Yes No

Enrolment may not be approved without enrolling staff sighting the prospective student’s birth certificate. An alternative to birth certificate will be considered where it is not possible to obtain a birth certificate (e.g. prospective student born in country without birth registration system. Passport or visa documents will suffice). This does not include failure to register a birth or reluctance to order a birth certificate.

For international students approved for enrolment by EQI, a passport or visa will be acceptable.

For prospective mature age students, proof of identity supplied and copied*

Yes No

Prospective mature age students must provide photographic identification which proves their identity:

current driver’s licence; or

adult proof of age card; or

current passport.

APPLICATION DETAILS

Has the prospective student ever attended a Queensland state school?

Yes No

If yes, provide name of school and approximate date of enrolment.

What year level is the prospective student seeking to enrol in?

Please provide the appropriate year level.

Proposed start date

/ / Please provide the proposed starting date for the prospective student at this school.

Does the prospective student have a sibling attending this school or any other Queensland state school?

Yes No

If yes, provide name of sibling, year level, date of birth, and school

Name:

Year Level

Date of birth

/ /

School

PROSPECTIVE STUDENT ADDRESS DETAILS*

Principal place of residence address

Address line 1

Address line 2

Suburb/town

State

Postcode

Mailing address (if it is the same as principal place of residence, write 'AS ABOVE')

Address line 1

Address line 2

Suburb/town

State

Postcode

Email

FAMILY DETAILS

Parents/carers Parent/carer 1 Parent/carer 2

Family name*

Given names*

Title Mr Mrs Ms Miss Dr Mr Mrs Ms Miss Dr

Sex Male Female

Male Female

Relationship to prospective student*

Is the parent/carer an emergency contact?

Yes

No

Yes

No

FAMILY DETAILS (continued)

Parents/carers

Parent/carer 1

Parent/carer 2

1st Phone contact number*

Work/home/mobile

Work/home/mobile

2nd Phone contact number*

Work/home/mobile

Work/home/mobile

3rd Phone contact number*

Work/home/mobile

Work/home/mobile

Email

Employer name

Occupation

What is the occupation group of the parent/carer?

(Please select the parental occupation group from the list provided at the end of this form. If parent/carer 1 is not currently in paid work but has had a job in the last 12 months or has retired in the last 12 months, please use the last occupation. If

parent/carer 1 has not been in paid work in the last 12 months, enter ‘8’)

(Please select the parental occupation group from the list provided at the end of this form. If parent/carer 2 is not currently in paid work but has had a job in the last 12 months or has retired in the last 12 months, please use the last

occupation. If parent/carer 2 has not been in paid work in the last 12 months, enter ‘8’)

Country of birth

Country of residence

Does parent/carer 1 or parent/carer 2 speak a language other than English at home? (If more than one language, indicate the one that is spoken most often)

No, English only

Yes, other – please specify

Needs interpreter? Yes No

No, English only

Yes, other – please specify

Needs interpreter? Yes No

Is the parent/carer an Australian citizen?

Yes No

Yes No

Is the parent/carer a permanent resident of Australia?

Yes No

Yes No

Address line 1

Address line 2

Suburb/town

State

Postcode

Postcode

Mailing address (if it is the same as principal place of residence, write 'AS ABOVE')

Address line 1

Address line 2

Suburb/town

State

Postcode

Postcode

Parent/carer school education

What is the highest year of primary or secondary school parent/carer 1 has completed? (For people who have never

attended school, mark 'Year 9 or equivalent or below')

What is the highest year of primary or secondary school parent/carer 2 has completed? (For people who have never

attended school, mark 'Year 9 or equivalent or below')

Year 9 or equivalent or below

Year 10 or equivalent

Year 11 or equivalent

Year 12 or equivalent

Parent/carer non-school education

What is the level of the highest qualification parent/carer 1 has completed?

What is the level of the highest qualification parent/carer 2 has completed?

Certificate I to IV (including trade certificate)

Advanced Diploma/Diploma

Bachelor degree or above

No non-school qualification

_______________________

PROSPECTIVE STUDENT ORIGIN DETAILS

Origin Queensland/interstate/overseas

Origin type Childcare centre or kindergarten/Prep/primary/secondary/VET/other

Previous school/other location

Previously employed Yes No Full-time Part-time

INDIGENOUS STATUS

Is the prospective student of Aboriginal or Torres Strait Islander origin?

No

Aboriginal

Torres Strait Islander

Both Aboriginal and Torres Strait Islander

RELIGION – RELIGIOUS INSTRUCTION*

From Year 1, the prospective student may participate in religious instruction if it is available.

If you tick ‘No’ or if the nominated religion is not represented within the school’s religious instruction program, the prospective student will receive other instruction in a separate location during the period arranged for religious instruction.

Parents/carers may change these arrangements at any time by notifying the principal in writing.

Do you want the prospective student to participate in religious instruction?

Yes No

If ‘Yes’, please nominate the religion:

COUNTRY OF BIRTH*

In which country was the prospective student born?

Australia

Other (please specify country)

Date of arrival in Australia / _/

Is the prospective student an Australian citizen?

Yes No (if no, evidence of the prospective student's immigration status to be completed)

PROSPECTIVE STUDENT LANGUAGE DETAILS

Does the prospective student speak a language other than English at home?

No, English only

Yes, other – please specify

EVIDENCE OF PROSPECTIVE STUDENT'S IMMIGRATION STATUS (to be completed if this person is NOT an

Australian citizen)*

Permanent resident Complete passport and visa details section below

Student visa holder

Date of arrival in Australia _/ _/

Date enrolment approved to: _/ /

EQI receipt number:

Temporary visa holder Complete passport and visa details section below

Other, please specify

Temporary visa holders must obtain an 'Approval to enrol in a state school' from EQI

Passport and visa details (to be completed for a prospective student who is NOT an Australian citizen).

NOTE: A permanent resident will have a passport with a permanent residency visa inside worded ‘Holder(s) permitted to remain in Australia indefinitely’.

For prospective students arriving in Australia as refugee or humanitarian entrants, either PLO 56 Immigration issued card or ‘Document to travel to Australia’ with ‘stay indefinite’ recorded must be sighted by the school.

Passport number

Passport expiry date

/ /

Visa number

Visa expiry date (if applicable)

/ /

Visa sub class

EMERGENCY CONTACT DETAILS (Other emergency contact details if parents/carers listed previously are not emergency

contacts or cannot be contacted)*

Emergency contact Emergency contact

Name

Relationship (e.g. aunt)

1st phone contact number* Work/home/mobile Work/home/mobile

2nd phone contact number* Work/home/mobile Work/home/mobile

3rd phone contact number* Work/home/mobile Work/home/mobile

PROSPECTIVE STUDENT MEDICAL INFORMATION (including allergies)*

Privacy Statement

The Department of Education and Training (DET) is collecting this medical information in order to address the medical needs of students during school hours as well as during school excursions, school camps, sports and other school activities. DET will not use this information to make a decision about a prospective student’s eligibility for enrolment. The information will only be used by authorised employees of the department and DET will only record, use and disclose the medical information in accordance with the confidentiality provisions at Section 426 of the Education (General Provisions) Act 2006.

It is essential that the school is advised before the prospective student’s first day of attendance if the prospective student has any medical conditions. The school administration staff must also be informed of any new medical conditions or a change to medical conditions as soon as they are known.

Should the prospective student need to take medication during school hours, an Individual Health Plan, including Emergency Health Plan if relevant, or Authority to Administer Medication Form will need to be completed each year and retained at the office.

No known medical conditions

Medical condition (including allergies/sensitivities), symptoms and management (please refer to the list of Medical Condition categories provided)

Medical condition (including allergies/sensitivities), symptoms and management (please refer to the list of Medical Condition categories provided)

Medical condition (including allergies/sensitivities), symptoms and management (please refer to the list of Medical Condition categories provided)

Does the prospective student require any medical aids or devices (such as glasses, contact lenses, prosthetics or orthotics)? This is for the purpose of informing planning for school activities such as sport and school excursions.

No Yes, please specify

Name of prospective student's medical practitioner (optional)

Contact number of medical practitioner

I authorise school staff to contact the prospective student’s medical practitioner for the puposes of seeking advice in cases where an immediate but non-life threatening response is required (for instance, when the prospective student may be on an excursion or sporting event)? (answer only if medical practitioner details have been provided above)

Yes

No

Medicare card number

(optional)

Position Number

Cardholder name (if not in name of prospective student)

Private health insurance company name (if covered)

(optional)

Private health insurance membership number (leave blank if company name is not provided)

COURT ORDERS*

Out-of-Home Care Arrangements*

Under the Child Protection Act 1999, when a Child Protection Order is approved by the Children’s Court, the child is placed in out-of-home care (OOHC).

Out-of-home care includes short or long term placement with an approved kinship or foster carer; in a supported independent living arrangement; in a safe

house; and in residential care.

Is the prospective student identified as residing in out-of-home care?

Yes No

If yes, what are the dates of the court order? Please provide a copy of the court order and/or the Authority to Care.

Commencement date / /

End date / /

Contact details of the Child Safety Officer (if known) Name

Phone number

Family Court Orders*

Are there any current orders made pursuant to the Family Law Act 1975 concerning the welfare, safety or parenting arrangements of the prospective student?

Yes No

If yes, what are the dates of the court order? Please provide a copy of the court order. Commencement date / /

End date / /

Other Court Orders*

Are there any other current court orders, such as a domestic violence order, concerning the welfare, safety or parenting arrangements of the prospective student?

Yes No

If yes, what are the dates of the court order? Please provide a copy of the court order. Commencement date / /

End date / /

TRAVEL DETAILS

Mode of transport to school

Walk Car Bus Bicycle Train

Other

APPLICATION TO ENROL*

I hereby apply to enrol my child or myself at _.

I understand that supplying false or incorrect information on this form may lead to the reversal of a decision to approve enrolment. I believe that the information I have supplied on this form is true and correct in every particular, to the best of my knowledge.

Parent/carer 1 Parent/carer 2 Prospective student

Signature

Date

/

/

/

/

/

/

Parental occupation groups for use with parent/carer details

Group 1: Senior management in large business organisation, government administration and defence, and qualified professionals

Senior executive/manager/department head in industry, commerce, media or other large organisation.

Public service manager [section head or above], regional director, health/education/police/fire services administrator

Other administrator [school principal, faculty head/dean, library/museum/gallery director, research facility director]

Defence Forces commissioned officer

Professionals generally have degrees or higher qualifications and experience in applying this knowledge to design, develop or operate complex systems; identify, treat and advise on problems; and teach others

Health, education, law, social welfare, engineering, science, computing professional

Business [management consultant, business analyst, accountant, auditor, policy analyst, actuary, valuer]

Air/sea transport [aircraft/ship’s captain/officer/pilot, flight officer, flying instructor, air traffic controller].

Group 2: Other business managers, arts/media/sportspeople and associate professionals

Owner/manager of farm, construction, import/export, wholesale, manufacturing, transport, real estate business

Specialist manager [finance/engineering/production/personnel/industrial relations/sales/marketing]

Financial services manager [bank branch manager, finance/investment/insurance broker, credit/loans officer]

Retail sales/services manager [shop, petrol station, restaurant, club, hotel/motel, cinema, theatre, agency]

Arts/media/sports [musician, actor, dancer, painter, potter, sculptor, journalist, author, media presenter, photographer, designer, illustrator, proof-

reader, sportsperson, coach, trainer, sports official]

Associate professionals generally have diploma/technical qualifications and support managers and professionals

Health, education, law, social welfare, engineering, science, computing technician/associate professional

Business/administration [recruitment/employment/industrial relations/training officer, marketing/advertising specialist, market research analyst, technical sales representative, retail buyer, office/project manager]

Defence Forces senior Non-Commissioned Officer.

Group 3: Tradespeople, clerks and skilled office, sales and service staff

Tradespeople generally have completed a four year trade certificate, usually by apprenticeship. All tradespeople are included in this group

Clerks [bookkeeper, bank/PO clerk, statistical/actuarial clerk, accounting/claims/audit clerk, payroll clerk, recording/registry/filing clerk, betting clerk, stores/inventory clerk, purchasing/order clerk, freight/transport/shipping clerk, bond clerk, customs agent, customer services clerk, admissions clerk]

Skilled office, sales and service staff:

Office [secretary, personal assistant, desktop publishing operator, switchboard operator]

Sales [company sales representative, auctioneer, insurance agent/assessor/loss adjuster, market researcher]

Service [aged/disabled/refuge/childcare worker, nanny, meter reader, parking inspector, postal worker, courier, travel agent, tour guide,

flight attendant, fitness instructor, casino dealer/supervisor].

Group 4: Machine operators, hospitality staff, assistants, labourers and related workers

Drivers, mobile plant, production/processing machinery and other machinery operators

Hospitality staff [hotel service supervisor, receptionist, waiter, bar attendant, kitchen hand, porter, housekeeper]

Office assistants, sales assistants and other assistants:

Office [typist, word processing/data entry/business machine operator, receptionist, office assistant]

Sales [sales assistant, motor vehicle/caravan/parts salesperson, checkout operator, cashier, bus/train conductor, ticket seller, service

station attendant, car rental desk staff, street vendor, telemarketer, shelf stacker]

Assistant/aide [trades’ assistant, school/teacher aide, dental assistant, veterinary nurse, nursing assistant, museum/gallery attendant, usher, home helper, salon assistant, animal attendant]

Labourers and related workers

Defence Forces ranks below senior NCO not included above

Agriculture, horticulture, forestry, fishing, mining worker [farm overseer, shearer, wool/hide classer, farmhand, horse trainer, nurseryman,

greenkeeper, gardener, tree surgeon, forestry/logging worker, miner, seafarer/fishing hand]

Other worker [labourer, factory hand, storeman, guard, cleaner, caretaker, laundry worker, trolley collector, car park attendant, crossing supervisor].

Group 8: Have not been in paid work in the last 12 months

State Schools Standardised Medical Condition Category List

Acquired brain injury

Allergies/Sensitivities

Anaphylaxis

Airway/lung/breathing - Oxygen required (continuously/periodically)

Airway/lung/breathing - Suctioning

Airway/lung/breathing - Tracheostomy

Airway/lung/breathing - Other

Artificial feeding - Gastrostomy device (tube or button)

Artificial feeding - Nasogastric tube

Artificial feeding - Jejunostomy tube

Artificial feeding - Other

Asthma

Asthma – student self-administers medication

Attention-deficit /Hyperactivity disorder (ADHD)

Autism Spectrum Disorder (ASD)

Bladder and bowel - Urinary wetting, incontinence

Bladder and bowel - Faecal soiling, constipation, incontinence

Bladder and bowel - Catheterisation (continuous, clean intermittent)

Bladder and bowel - Stoma site, urostomy, Mitrofanoff, MACE, Chair

Bladder and bowel - Other

Blood disorders - Haemophilia

Blood disorders - Thalassaemia

Blood disorders - Other

Cancer/oncology

Coeliac disease

Cystic Fibrosis

Diabetes - type one

Diabetes - type two

Ear/hearing disorders - Otitis Media (middle ear infection)

Ear/hearing disorders - Hearing loss

Ear/hearing disorders - Other

Epilepsy - Seizure

Eye/vision disorders

Endocrine disorder - Adrenal hypoplasia, pituitary, thyroid

Heart/cardiac conditions - Heart valve disorders

Heart/cardiac conditions - Heart genetic malformations

Heart/cardiac conditions - other

Mental Health - Depression

Mental Health - Anxiety

Mental Health - Oppositional defiant disorder

Mental Health - Other

Muscle/bone/musculoskeletal disorders - spasticity (Baclofen Pump)

Muscle/bone/musculoskeletal disorders - Other

Skin Disorders - eczema

Skin Disorders - psoriasis

Swallowing/dysphagia - requiring modified foods

Swallowing/dysphagia - requiring artificial feeding

Transfer & positioning difficulties

Travel/motion sickness

Other

Application to enrol in a Queensland State School

This sheet contains information on how to complete the Application for Student Enrolment Form (SEF-1 Version 7).

Entitlement to enrolment Under the Education (General Provisions) Act 2006 (Qld) a state school must enrol an applicant if they are entitled to enrolment. While not exhaustive, a list of matters which may affect an applicant’s entitlement to enrolment are included on the front cover of the enrolment form.

Questions which must be answered* The Application for Student Enrolment Form contains a number of questions marked with an (*) which must be answered. These include – Prospective student demographic details, Prospective student address details, Family details, Religion – Religious Instruction, Country of birth, Emergency contact details, Prospective student medical information, Court orders and the Application to enrol. These questions and consent are considered necessary to ensure the school can undertake its administrative and care responsibilities.

Sections of the form not marked (*) are optional. However, failure to complete these sections may result in the school not being eligible for important Federal and State Government funding.

Parent’s occupation and education All parents across Australia, no matter which school their child attends, are being asked to provide information about family background (answering this question is optional). The main purpose of collecting this information is to promote an education system which is fair for all Australian students regardless of their background.

Sighting of birth certificate Schools are required to sight a prospective student’s birth certificate. An alternative to a birth certificate will be considered where it is not possible to obtain a birth certificate (e.g. person born in a country without a birth registration system – passport or visa documents will suffice). Prospective mature age students that provide appropriate photographic proof of identity do not need to present a birth certificate.

Court Orders Any court orders concerning the prospective student’s welfare, safety or parenting arrangements should be provided to the school, and the school should also be provided with any new or updated orders.

Name on enrolment form A prospective student should be enrolled under their legal name as per their birth certificate. There is provision to also record a preferred family and/or given name. The preferred name will be used on internal school documents such as class rolls. The legal name will appear on semester reports unless there is a specific request to use the preferred name only. This request can come from parents/carers or the student (if the student is independent/mature age).

Evidence of Prospective Student’s Immigration Status This section is required to be completed when a prospective student is not an Australian citizen and information is required to be recorded about their passport and visa.

Medical information and emergency contacts A prospective student’s medical condition, symptoms, management and medication/s must be documented. Medical conditions may include (but are not limited to) seizures/epilepsy, fainting, diabetes, asthma, heart problems, anaphylaxis and allergies (such as food or insect stings). Parents must indicate if they are an emergency contact. Three additional emergency contacts are also required.

Religion – Religious Instruction Applicants are asked if they would like the prospective student to participate in religious instruction. From Year 1, the prospective student may participate in religious instruction if it is available.

If you tick ‘No’ or if the nominated religion is not represented within the school’s religious instruction program, the prospective student will receive other instruction in a separate location during the period arranged for religious instruction.

Parents/carers may change these arrangements at any time by notifying the principal in writing.

Office use This section is to be completed by the school and will assist in documenting specific details in relation to enrolment, including confirmation of the sighting of documentary evidence such as a prospective student’s birth certificate, passport or visa and prospective student’s mature age status

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Cleveland District State High School

Education Agreement for

Students in Years 7, 8 & 9

Section A: Student

I, ___________________________________________________ (student) wish to enrol at Cleveland District

State High School from _____________________________________________________ (previous school).

I recognise that the conditions of enrolment are as follows and I will:

Obey all school rules/policies as outlined in the school prospectus, School Behaviour Management Plan,

homework diary and from time to time other school documentation

Wear appropriate school dress as per the school prospectus

Be in fulltime attendance unless absence is approved by a member of the school administration team

Work to the best of my ability

Attend for the entire school day

Behave in a manner that does not

- interfere with the rights of others to learn

- threaten the safety of any other students

I accept that after school detention is an integral part of the school’s behaviour management plan and may be

applied at the discretion of the teaching staff. I recognise that failure to keep the conditions of this agreement

may place my enrolment at risk.

Student signature: ..………………………………………………………….… Date: ……………………………..

Section B: Parent/Guardian As parent/guardian, I undertake to support the school in ensuring that my son/daughter fulfils the above

conditions to the best of his/her ability.

Parent/Carer name: ……………………………………………………………………………………………….…….

Parent/Carer signature: ………………………………………..……….……… Date: …………………………….

Section C: Staff As members of the staff of Cleveland District State High School, we will endeavour to provide a school in

which:

1 The atmosphere is supportive of all students desirous of attaining their full potential

2 There is a range of courses that will allow students to receive a broad general education with some

specialisation.

3 Advice on educational matters is provided to assist students to make decisions about their educational

futures.

4 There are opportunities through co-curricular activities and personal development programs to prepare

students for citizenship.

Member of Administration’s signature: ……………………………………. Date: …………………………….

Cleveland District State High School Education Agreement for

Students in Years 10, 11 & 12

Section A: Student

I, ___________________________________ fully understand that as a member of the Senior school, I have completed the compulsory stage of my education. Further secondary education will be provided for me by Cleveland District State High School upon my acceptance of and adherence to the rules and conditions set by Education Queensland, the Board of Senior Secondary School Studies and this school.

As a Senior student of Cleveland District State High School, I will aim to bring credit to myself and my school in all that I say and do and provide a positive role model for all other students. I will be guided in this by the School Code of Behaviour. In particular, I will try to uphold the high standards this school seeks in work habits, behaviour and dress and appearance.

I agree to: 1. Conduct myself in all classes in such a way as to ensure my progress and not hinder the progress of my

fellow students. 2. Complete, by the due date, all classwork, homework, assignments, field reports, oral reports and tests

required for valid assessment of any program of study. 3. Attend classes punctually on a full time basis and present written documentation of any absences I may

have. I recognise that approval for absence must be endorsed by a member of the school administrative team.

4. Be familiar with the school examination and assignment policy as outlined in the student diary 5. Wear the appropriate school uniform at all times. 6. Behave appropriately at all times whilst wearing the school uniform.

I understand that if I fail to meet these commitments, my enrolment at Cleveland District State High School may be at risk.

Student signature: ..……………………………………………………………. Date: ……………………………..

Section B: Parent/Guardian As parent/guardian, I undertake to support the school in ensuring that my son/daughter fulfils the above conditions to the best of his/her ability.

Parent/Carer name: ……………………………………………………………………………………..……………….

Parent/Carer signature: ..………………………………………………….…. Date: ……………………………….

Section C: Staff As members of the staff of Cleveland District State High School, we will endeavour to provide a school in which: 1 The atmosphere is supportive of all students desirous of attaining their full potential

2 There is a range of courses that will allow students to receive a broad general education with some

specialisation.

3 Advice on educational matters is provided to assist students to make decisions about their educational

futures.

4 There are opportunities through co-curricular activities and personal development programs to prepare

students for citizenship.

Member of Administration’s signature: ..…………………………………. Date: ……………………………….

Cleveland District State High School Technology Agreement

The Technology Agreement at Cleveland District State High School comprises TWO documents:

The Responsible Use of Technology Agreement

The Third Party Website Consent Form

These documents can be accessed on the school website –

https://clevelanddistrictshs.eq.edu.au/Ourschool/Rulesandpolicies/Pages/Rulesandpolicies.aspx

The following is to be read and completed by both the STUDENT and PARENT/CARER:

- I have read and understood The Responsible Use of Technology Agreement and agree to abide by

the guidelines. I am aware that non-compliance or irresponsible behaviour, as per the this agreement and

the school’s associated Responsible Behaviour Plan for Students and BYOD Charter will result in

consequences relative to the behaviour which may include loss of Internet access for some time.

- I have read and understood the Third Party Website Consent Form. I understand that my child’s

personal information (as described in this document) may be provided to third party software providers for

the purpose of my child’s registration and use of the software programs and that this information may be

stored outside of Australia. This approval applies to the whole time that my child is enrolled at Cleveland

District State High School.

- I agree to contribute for my child to access the Technical Solution network connection component of the

program (included in Student Resource Scheme - SRS).

Student name (please print): ……………………………………………… Home Group: ………………………

Student signature: ………………………………………………………… Date: ………………………………...

Parent/Carer name (please print): ……………………………………………………………………………………

Parent/Carer signature: ....................................................................... Date: ………………………………..

Privacy Notice The Department of Education and Training is collecting your personal information on this form in order to obtain consent for disclosure of a student’s personal information to facilitate registration and use of third party web based software identified on the form. The information will be used and disclosed by authorised school employees for the purposes outlined on the form. Student personal information collected on this form may also be used or disclosed to third parties where authorised or required by law. This information will be stored securely. If you wish to access or correct any of the personal student information on this form or discuss how it has been dealt with, please contact your student’s school in the first instance.

The Responsible Use of Technology Agreement

This agreement is informed by the Cleveland District State High School Responsible Behaviour Plan for

Students and the Bring Your Own Device (BYOD) Charter located on the school’s website.

https://clevelanddistrictshs.eq.edu.au/SupportAndResources/FormsAndDocuments/Documents/Computer%2

0Documents/student-byod-charter.pdf#search=byod%20charter

Cleveland District State High School has an extensive network of computer equipment including student

laptops, school owned laptops, desktop computers, data projectors, interactive white boards, printers,

scanners and video conferencing equipment.

Students have certain rights and responsibilities in relation to the use and care of this equipment. Students

must understand that the computer network is a shared resource that contains information belonging not only

to them but also to other students, teachers and clerical staff. Much of the data on the system is vital for the

operation of the school and students must not do anything that would place the data at risk.

Students must not divulge their school account username and/or password.

Use of mobile telephones (or other personal devices) by students: This policy reflects the importance the school places on students displaying courtesy, consideration and

respect for others whenever they are using personal technology devices. Cleveland District State High school

has established the following Acceptable Use Policy for mobile phones and electronic equipment that

provides teacher, student and parent guidelines and instructions for the appropriate use of mobile phones and

electronic equipment during school hours.

Cleveland District State High School accepts that parents give their children mobile phones to protect them

from everyday risks involving personal security and safety. There is also increasing concern about children

travelling alone on public transport or commuting long distances to school. It is acknowledged that providing a

child with a mobile phone gives parents reassurance that they can contact their child if they need to speak to

them urgently. Parents are reminded that in cases of emergency, the school office remains a vital and

appropriate point of contact and can ensure your child is reached quickly and assisted in any appropriate way.

It is at the individual teacher’s discretion how and when a student owned electronic device would be used

within their classroom. A student not following the teacher’s directions about appropriate use within their

classroom may be required to hand the device to the teacher for later collection from the office by a parent.

Acceptable uses of mobile phones:

- Mobile phones should be switched off and kept out of sight during classes, where these devices are not

being used in a teacher directed activity to enhance learning.

- While on school premises (and outside of designated class time), students should use soundless features

such as text messaging, answering services, call diversion and vibration alert to receive important calls.

Examples of unacceptable uses of mobile phones:

- Unless express permission is granted, mobile phones/electronic equipment should not be used to make

calls, send SMS messages, surf the internet, take photos or use any other application during school

lessons and other educational activities, such as assemblies. Students should only use their mobile

phones/electronic device before or after school or during recess and lunch breaks.

- Using mobile phones/electronic equipment to bully and threaten other students is unacceptable and will

not be tolerated. In some cases it can constitute criminal behaviour.

- No images or videos of students or teaching staff may be taken without permission or uploaded to any

social networking or media sharing site without the written permission from the school Principal.

- Posting comments, photographs or other material on any website or media platform which brings the

school into disrepute.

Use of school devices, BYOD’s and ICT’s by Students:

When using digital technologies students understand:

- The responsibility and behaviour requirements (as outlined by the school) that come with accessing the

school’s ICT network facilities - The responsibility to report and discontinue access to harmful information if presented via the internet or

e-mail - At any time, the Principal may determine that student privately owned devices may not be used at the

school - Students who use a school’s ICT facilities in a manner which is not appropriate may be subject to

disciplinary action by the school, including (but not limited to) restricting network access - Teachers will always exercise their duty of care, but avoiding or reducing access to harmful information

also requires responsible use by the student

What is acceptable/appropriate use/behaviour for students when using school devices, BYOD’s and

ICT’s?

It is acceptable for students to use school computers and network infrastructure for:

- Assigned class work and assignments set by teachers

- Developing appropriate literacy, communication and information skills;

- Authoring text, artwork, audio and visual material for publication on the Intranet or Internet for educational

purposes as supervised and approved by the school

- Conducting general research for school activities and projects;

- Accessing online references such as dictionaries, encyclopaedias,

- Researching and learning through the Department’s e-learning environment.

The following are examples of irresponsible use of school devices, BYOD’s and ICT’s by students:

- Using the device in an unlawful manner - Creating, participating in or circulating content that attempts to undermine, hack into and/or bypass the

hardware and/or software security mechanisms that are in place (this includes mobile phone pairing) - Disabling settings for virus protection, spam and/or internet filtering that have been applied as part of the

school standard - Downloading (or using unauthorised software for), distributing or publishing of offensive messages or

pictures - Downloading (or using unauthorised software for), distributing or publishing copy written content in the

form of movies, images and audio files - Using obscene, inflammatory, racist, discriminatory or derogatory language - Using language and/or threats of violence that may amount to bullying and/or harassment, or even

stalking - Insulting, harassing or attacking others or using obscene or abusive language - Deliberately wasting printing and Internet resources - Intentionally damaging any devices, accessories, peripherals, printers or network equipment - Committing plagiarism or violate copyright laws - Using unsupervised internet chat - Sending chain letters or spam email (junk mail) - Accessing private 3G/4G networks during school time - Using proxy sites and Virtual Private Network software to access content that is filtered by our network - Knowingly downloading viruses or any other programs capable of breaching the department’s network

security - Using the mobile device’s camera anywhere a normal camera would be considered inappropriate, such

as in change rooms or toilets

- Invading someone's privacy by recording personal conversations or daily activities and/or the further

distribution (e.g. forwarding, texting, uploading, Bluetooth use etc.) of such material - Using the mobile device (including those with Bluetooth functionality) to cheat during exams or

assessments - Take into or use mobile devices at exams or during class assessment unless expressly permitted by

school staff.

Parents/Carers understand:

The Internet can provide students with valuable learning experiences and that it gives access to information

on computers around the world; that the school cannot control what is on those computers; and that a very

small part of that information can be illegal, dangerous or offensive. Parents/Carers accept that, while

teachers will always exercise their duty of care, protection against exposure to harmful information should

depend finally upon responsible use by students. Parents/Carers also accept that teachers have access to the

contents of any portable storage devices that a student connects to the network. Parents/Carers understand

that the upload of photos or video of students or teachers in this school to any video sharing or social media

site without the written permission of the Principal may be subject to disciplinary action by the school.

Third Party Website Consent

The use of web based educational resources has risen steadily over the last decade and are increasingly being used by teachers across Queensland to improve student learning outcomes. The purpose of this form is to gain consent for student use of websites in the day-to-day schooling at Cleveland District State High School.

Our school and teachers confidently make decisions about the best technology to meet the needs of our students. For students to use the service, teachers may need to register them as a user. Registering with these providers requires student personal information to be disclosed to the provider of the service. We aim to use as minimal student information as possible to limit student identification as much as possible. In the case of the services outlined on our school website they are private companies that are hosted onshore in Australia/and/or/outside of Australia. Outside of Australia means that data that is entered to register for these sites will be stored on servers that are not based in Australia and therefore are not bound by Queensland’s privacy laws.

Registration may include disclosing the following information about students:

Student name

Year group

Student Education Queensland Email

Class teacher

Age (age appropriate access) We need parent permission for the registration and use of these sites by the student. Parents/Carers are invited to access the comprehensive list of hyperlinks to websites used school-wide, each website’s terms and conditions and/or privacy policy can be found on their site. NOTE: This web page is updated each semester. https://clevelanddistrictshs.eq.edu.au/SupportAndResources/FormsAndDocuments/Documents/Computer%20Documents/websites.pdf#search=third%20party%20website%20consent Parents/Carers are requested to please ensure they understand the implications of using each service before giving consent. If Parents/Carers have any queries around the storage of student information, please feel free to contact Mr Shane Mason – Deputy Principal on smaso53@eq.edu.au

State School Consent Form (from July 2019) Introduction to the State School Consent Form (attached) for Cleveland District SHS.

This letter is to inform you about how we will use your child’s personal information

and student materials. It outlines:

what information we record

how we will use student materials created during your child’s enrolment.

Examples of personal information which may be used and disclosed (subject to consent) include part of a person’s name, image/photograph, voice/video recording or year level.

Your child’s student materials:

are created by your child whether as an individual or part of a team

may identify each person who contributed to the creation

may represent Indigenous knowledge or culture.

Purpose of the consent

It is the school’s usual practice to take photographs or record images of students and

occasionally to publish limited personal information and student materials for the

purpose of celebrating student achievement and promoting the school and more broadly

celebrating Queensland education.

To achieve this, the school may use newsletters, its website, traditional media, social

media or other new media as listed in the ‘Media Sources’ section below.

The State School Consent Form may, at your discretion, provide consent for personal

information and a licence for the student materials to be published online or in other

public forums. It also allows your child’s personal information and student materials to

be presented in part or alongside other students’ achievements.

The school needs to receive consent in writing before it uses or discloses your

child’s personal information or student materials in a public forum. The attached

form is a record of the consent provided.

It should be noted that in some instances the school may be required by the Education

(General Provisions) Act 2006 or by law to record, use or disclose the student’s

personal information or materials without consent (e.g. assessment of student

materials does not require further consent).

Voluntary

There will not be any negative repercussions for not completing the State School

Consent Form or for giving limited consent. All students will continue to receive their

education regardless of whether consent is given or not.

Consent may be limited or withdrawn

Consent may be limited or withdrawn at any time by you.

If you wish to limit or withdraw consent please notify the school in writing (by email or

letter). The school will confirm the receipt of your request via email if you provide an

email address.

If in doubt, the school may treat a notice to limit consent as a comprehensive

withdrawal of consent until the limit is clarified to the school’s satisfaction.

Due to the nature of the internet and social media (which distributes and copies

information), it may not be possible for all copies of information (including images of

student materials) once published by consent, to be deleted or restricted from use.

The school may take down content that is under its direct control, however, published

information and materials cannot be deleted and the school is under no obligation to

communicate changes to consent with other entities/ third parties.

Media sources used

Following is a list of online and social media websites and traditional media sources

where the school may publish your child’s personal information or student materials

subject to your consent.

School website: www.clevelanddistrictshs.eq.edu.au

Facebook: www.facebook.com/clevelandshs

YouTube: www.youtube.com/cleveland+district+state+high+school

Instagram: not applicable

Twitter: not applicable

Other: not applicable

Local newspaper

School newsletter

Traditional and online media, printed materials, digital platforms, promotional materials, presentations and displays.

The State School Consent Form does not extend to P&C run social media accounts or activities, or external organisations.

Duration

The consent applies for the period of enrolment or another period as stated in the State School Consent Form, or until you decide to limit or withdraw your consent.

During the school year there may be circumstances where the school or Department of Education may seek additional consent.

Who to contact

To return a consent, express a limited consent or withdraw consent please contact the school office on 3824 9222 or email principal@clevelanddistrictshs.eq.edu.au .

Student records officer should be contacted if you have any questions regarding consent. Please retain this letter for your records and return the signed consent form.

Uncontrolled copy. Refer to the Department of Education Policy and Procedure Register at http://ppr.qed.qld.gov.au/ to ensure you

have the most current version of this document.

State School Consent Form

IDENTIFY THE PERSON TO WHOM THE CONSENT RELATES

Parent/carer to complete

Mature/independent students may complete on their own behalf (if under 18 a witness is required).

(a) Full name of individual: ..........................................................................................................................

(b) Date of birth: ........................................................

(c) Name of school: Cleveland District State High School

(d) Name to be used in association with the person’s personal information and materials* (please select):

Full Name First Name No Name Other Name ............................................................

*Please note, if no selection is made, only the Individual’s first name will be used by the school. However, the school may choose not to use a student’s name at its discretion.

PERSONAL INFORMATION AND MATERIALS COVERED BY THIS CONSENT FORM

(a) Personal information that may identify the person in section 1:

Name (as indicated in section 1) Image/photograph School name

Recording (voices and/or video) Year level

(b) Materials created by the person in section 1:

Sound recording Artistic work Written work Video or image

Software Music score Dramatic work

APPROVED PURPOSE

If consent is given in section 6 of the form:

The personal information and materials (as detailed in section 2) may be recorded, used and/or disclosed (published) by the school, the Department of Education (DoE) and the Queensland Government for the following purposes:

- Any activities engaged in during the ordinary course of the provision of education (including assessment), or other purposes associated with the operation and management of the school or DoE including to publicly celebrate success, advertising, public relations, marketing, promotional materials, presentations, competitions and displays.

- Promoting the success of the person in section 1, including their academic, sporting or cultural achievements.

- Any other activities identified in section 4(b) below.

The personal information and materials (as detailed in section 2) may be disclosed (published) for the above purposes in the following:

- the school’s newsletter and/or website;

- social media accounts, other internet sites, traditional media and other sources identified in the ‘Media Sources’ section of the explanatory letter (attached);

- year books/annuals;

- promotional/advertising materials; and

- presentations and displays.

TIMEFRAME FOR CONSENT

School representative to complete.

(a) Timeframe of consent: duration of enrolment.

(b) Further identified activities not listed in the form and letter for the above timeframe: will be advised at the time of the activity.

LIMITATION OF CONSENT

The Individual and/or parent wishes to limit consent in the following way:

CONSENT AND AGREEMENT

CONSENTER – I am (tick the applicable box):

parent/carer of the identified person in section 1

the identified person in section 1 (if a mature/independent student or employee including volunteers)

recognised representative for the Indigenous knowledge or culture expressed by the materials

I have read the explanatory letter, or it has been read to me. I have had the opportunity to ask questions about it and any questions that I have asked have been answered to my satisfaction. By signing below, I consent to the school recording, using and/or disclosing (publishing) the personal information and materials identified in section 2 for the purposes detailed in section 3. By signing below, I also agree that this State School Consent form is binding. For the benefit of having the materials (detailed in section 2) promoted as DoE may determine, I grant a licence for such materials for this purpose. I acknowledge I remain responsible to promptly notify the school of any third party intellectual property incorporated into the licensed materials. I accept that attribution of the identified person in section 1 as an author or performer of the licensed materials may not occur. I accept that the materials licensed may be blended with other materials and the licensed materials may not be reproduced in their entirety.

Print name of student ............................................................................................................................

Print name of consenter...........................................................................................................................

Signature or mark of consenter................................................................... Date ...............................

Signature or mark of student (if applicable)................................................ Date ...............................

WITNESS – for consent from an independent student or where the explanatory letter and State School Consent Form were read

I have witnessed the signature of an independent student, or the accurate reading of the explanatory letter and the State School Consent Form was completed in accordance with the instruction of the potential consenter. The individual has had the opportunity to ask questions. I confirm that the individual has given consent freely and I understand the person understood the implications.

Print name of witness .........................................................................................................................................

Signature of witness .................................................................................................

Date ...............................................................

Statement by the person taking consent – when it is read

I have accurately read out the explanatory letter and State School Consent Form to the potential consenter, and to the best of my ability made sure that the person understands that the following will be done:

1. the identified materials will be used in accordance with the State School Consent Form

2. reference to the identified person will be in the manner consented

3. in accordance with procedures DoE will cease using the identified materials from the date DoE receives a written withdrawal of consent.

I confirm that the person was given an opportunity to ask questions about the explanatory letter and State School Consent Form, and all the questions asked by the consenter have been answered correctly and to the best of my ability. I confirm that the individual has not been coerced into giving consent, and the consent has been given freely and voluntarily.

A copy of the explanatory letter has been provided to the consenter.

Print name and role of person taking the consent ..............................................................................................

Signature of person taking the consent .....................................................................

Date ...............................................................

Privacy Notice The Department of Education (DoE) is collecting your personal information on this form in order to obtain consent for the use and disclosure of the student’s personal information to facilitate registration and use of third party web based software identified on the form. The information will be used and disclosed by authorised school employees for the purposes outlined on the form. Student personal information collected on this form may also be used or disclosed to third parties where authorised or required by law. This information will be stored securely. If you wish to access or correct any of the personal student information on this form or discuss how it has been dealt with, please contact your student’s school in the first instance.

SPECIAL CIRCUMSTANCES

If the form is required to be read out (whether in English or in an alternative language or dialect) to a parent/carer or Individual student; or when the consenter is an independent student and under 18 the section below must be completed.

STUDENT RESOURCE SCHEME FOR 2020

Year 7 Year 8 Year 9 Year 10 Year 11 Year 12

$250 $280 $280 $280 $300 $300

ADDITIONAL CHARGES Please

tick

Film, Television & New Media (per year) (Years 11 and 12) $100

Visual Arts (Years 11 and 12) $70

Visual Arts in Practice (Years 10, 11 and 12) $70

General Music – Musition 5 Online Software (Years 9 – 11) (only if SRS is paid) $30

Drama – Performances (Years 11 and 12) (only if SRS is paid) $30

Science – Excursions (Year 10 Marine $15, Year 11 Biology $40, Years 11 & 12 Marine $40) $40

Social Sciences – Excursions (Years 10 & 11 Senior Geography $30) $30

INSTRUMENTAL MUSIC: If your student is accepted into this program the cost will be as follows: $100 per student (Choir fees are included in this program.)

CHOIR: $50 if your student is not enrolled in the Instrumental Music Program

NAME OF STUDENT Resource Scheme

Additional Charges

TOTAL

Please indicate your method of payment by ticking one box below. Please be aware an early payment discount of $30.00 will be applied if your SRS fees for Year 8 – Year 12 student/s are paid in full and received by our office by Friday, 6th December 2019. Regardless of the payment method you choose, please email details of your payment to: accounts@clevelanddistrictshs.eq.edu.au To ensure your payment is correctly allocated include your student’s full name, year level and class. Please indicate which fees and additional charges you are paying (eg SRS, Visual Arts and Choir).

BPoint -Register with QParents by obtaining an email invitation from the school office. Follow the emailed instructions to establish your QParents account. To make a payment, select the PAYMENTS Tab, select the SRS invoice you wish to pay and follow the prompts to complete your payment. Direct Credit Via Internet Banking Account Name: Cleveland District State High School General a/c BSB Number: 064 138 CBA Cleveland Account Number: 00090051 Reference Details: Student name, year level, SRS (eg BJones 12SRS) Payment Window - Visit the school office payment window to pay by cash, eftpos, cheque or money order. Open Tuesday to Friday from 8.00am – 10.45am and 12.45pm – 3.15pm. CLOSED MONDAY. Phone Payments - Call the automated 24hour payment line on 1300 631 073 and have your credit/ debit card details available, together with your CRN and invoice number (available from the school office). Centrepay Automatic Deductions - Fortnightly deductions can be made from Family Tax Benefit, Pension or Newstart payments. Collect a form from the school office, complete the form and return it to the school office for processing. Please note: the minimum Centrepay payment amount is $30.00 per fortnight. The early payment discount does not apply if you use this option.

Student Resource Scheme Participation Agreement Form

For Secondary School Curriculum Cleveland District State High School

Participation

The Student Resource Scheme (SRS) provides parents with a convenient and cost-effective way to access educational resources their children need for school. These resources supplement the school’s resources students’ learning experience at school Please indicate your intention to participate or not by selecting “yes” or “no” and completing the information in the relevant box below:

Yes No

I wish to participate in the above-named Student Resource Scheme for the duration of my child’s enrolment at the school. I have read and understand the Terms and Conditions (see reverse) and agree to abide by them and to pay the annual participation fee. I understand that the school will publish information about the SRS costs and inclusions each year. I understand that I can opt out of SRS participation in any year by completing a new Participation Agreement Form before the invoice due date. I wish to make payment each year by: A single payment for the full years’ fee Term instalments (paid over the first 3 terms) An instalment plan as negotiated with the school

(eg. via direct debit, centrepay or other payment method)

Please contact our Accounts Receivable Manager

on 3824 9222 I am experiencing financial hardship and wish to

meet with the school to discuss my options (see clauses 10-14 overleaf)

I do not wish to participate in the above-named Student Resource Scheme. I have read and understand the Terms and Conditions (see reverse). I understand I must provide my child with all items that would otherwise be provided to my child by the SRS as detailed on the information provided by the school. I understand that if my child is eligible for the Textbook and Resource Allowance (TRA) the school will contact me. For more details regarding the TRA and eligibility criteria enter “Textbook and Resource Allowance” into the search tool on the Department’s Policy and Procedure Register at http://ppr.det.qld.gov.au I understand that I can choose to join the SRS in future years by completing a new Participation Agreement Form.

Student Details

I agree to the above made selection, until such point as I inform the school otherwise.

Student name: Year level:

Parent name:

Parent signature: Date:

School use only:

Negotiated instalments: Approved by:

Terms and Conditions of the Student Resource Scheme Privacy Statement The Department of Education collects this information in accordance with section 51 of the Education (General Provisions) Act 2006 ("the Act") in order to administer the Student Resource Scheme (SRS). The information will only be accessed by school employees administering the SRS. However, if required, some of this information may be shared with departmental employees for the purpose of debt recovery.

Definitions 1.Reference to a “parent” is in accordance with the definition in the Act and refers equally to an independent student.

The Student Resource Scheme (SRS) 2.The cost of providing instruction, administration and facilities for the education of students enrolled at state schools is met by the State. 3.The school is not responsible for providing textbooks, in-class consumables and personal resources for students. 4.The SRS enables parents to access certain resources, as detailed by the school, for an annual fee. 5.Participation in the SRS is optional: parents are under no obligation to participate.

Textbook and Resource Allowance (TRA) 6.The State provides the TRA annually to parents of eligible secondary students to assist with the costs of education. 7.The TRA is paid to the school based on enrolment data and will reduce the cost of participating in the SRS. 8.Parents who choose NOT to participate in the SRS and whose children are eligible for the TRA have the option to receive the TRA as a credit to their child’s school account or directly from the school.

Parents and Citizens’ (P&C) Association support of the SRS 9.All parents are invited to participate in the annual meeting of the P&C Association at which the income and expenditure report is presented and the proposed SRS inclusions and fees are tabled for approval.

Parents experiencing financial hardship 10.Principals may vary payment options and/or waive all or part of the participation fee for parents experiencing financial hardship. 11.Parents experiencing financial hardship who wish to participate in the SRS should contact the Principal to discuss options. 12.The onus of proof of financial hardship is on the parent. 13.The school may require annual proof of continuing financial hardship. 14.All discussions will be held in the strictest confidence.

Parents participating in the SRS 15.Parents indicate whether or not they wish to participate in the SRS by completing this Participation Agreement Form. 16.[An] invoice/s for the amount of the annual participation fee will be issued to the parent providing consent to participate in the SRS. 17.This agreement is for the duration of the student’s enrolment at the school, unless a new Participation Agreement Form is completed. 18.Parents must notify the school before the invoice due date if they intend to cease their participation in the SRS in any year. 19.Where a parent chooses to participate, they are agreeing to pay the annual participation fee, in accordance with the payment frequency option selected on the form. There is no provision for part-participation. 20.All SRS resources provided for the student’s temporary use remain the property of the school and must be returned when requested by the school or if the student leaves the school. 21.Parents are responsible for ensuring that any SRS resources provided for the student’s temporary use are kept in useable condition. Where an issued item is lost, not returned, or negligently damaged, parents will be responsible for payment to the school of the value of the item or its repair. 22.Parents must inform the school if items on the list of resources are not received.

23.Non-payment of the participation fee by designated payment date(s) may result in debt recovery action in accordance with the Department’s Debt Management procedure. In such cases, the Principal may: •withdraw the student’s participation in the SRS •require the return of items provided by the SRS •withhold the provision of any further items under the SRS •refuse participation in the SRS where participation fees are overdue from the previous year(s), and/or •exclude the student from optional, non-curricular activities and/or •initiate debt recovery action.

Parents NOT participating in the SRS 24.Parents indicate whether or not they wish to participate in the SRS by completing this Participation Agreement Form. 25.This agreement is for the duration of the student’s enrolment at the school, unless a new Participation Agreement Form is completed. 26.Where a parent has previously indicated that they will participate in the SRS, but wishes not to participate in any year(s), the parent must notify the school prior to the invoice due date of their intention to cease participation. 27.Parents who choose not to participate in the SRS are responsible for providing their child with all items that would otherwise be provided by the SRS. School-produced resources (e.g. Student Diary) will be available for separate purchase from the school for non-participants.

Operating the SRS 28.Schools will provide all parents with a list of resources provided by the SRS to enable parents to assess the cost effectiveness of participation. 29.Schools will also provide non-participating parents with detailed lists of resources to supply for their child. 30.All items included in the SRS must be able to be independently sourced by parents who choose not to participate in the SRS, either from a third party supplier or by purchasing a school-specific resource (such as a diary or workbook) from the school. 31.Schools may distribute information and invoices to parents in the year preceding the SRS but invoices must not be due before the end of the first week of term 1 of the SRS year. All invoices must have a minimum of 30 days for payment. 32.Parents must be given the option annually to choose not participate in the SRS. 33.In return for payment of the participation fee, the SRS will provide participating students with the resources and materials as outlined in the school SRS documents. 34.SRS moneys received are to be expended only on student resources outlined in the school’s SRS and must not be expended on other items or used to raise funds for other purposes. 35.As the SRS operates for the benefit of participating parents and is funded primarily from participation fees, the school retains control of the resources and determines the rules around their availability to non-participants. 36.A student entering the school during the school year is entitled to pay a pro-rata fee to participate. 37.Where participation fees have been paid and a student leaves the school during the year, schools must determine if parents will be eligible for a pro-rata refund. This calculation will also take into account any pro-rata allocation of the TRA (if eligible) and any outstanding SRS debts (including any debts from damaged or non-returned items). Where the cost of outstanding debts is higher than the calculated refund, parents will be liable to pay this balance of funds. 38.The replacement cost of any resource will be up to the maximum value (subject to depreciation where appropriate) of the acquisition cost to the school, as detailed on the annual SRS information provided to parents. 39.Schools may initiate debt recovery action in accordance with the debt management procedure where a parent has an outstanding debt

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Cleveland District State High School

Enrolment Management Plan

Catchment Exemption Application Form (You must complete this form if your student resides outside of our Catchment Area)

Details

Student Name:

Residential Address

Criteria

1 Does the student have a sibling currently enrolled at this school ? If Yes, please provide the name and year level of the sibling:

Yes No

Name: Year Level:

2 Is the student in the care of the Department of Child Safety ? Yes No

3 Is the student an applicant for one of the following specialist programs ?

Academic Extension (Years 7 and 8)

Creative Arts (Music Extension) (Years 7 and 8)

Languages including Chinese, Japanese and French (Years 7 and 8)

Sport Development – Football (Soccer), Touch Football, Volleyball (Year 7only)

International Baccalaureate Diploma Programme (Years 10 – 12)

Please be aware that some of these specialist programs require separate documentation, for

example, an audio visual recording for the Creative Arts Excellence Program.

4 Is the student’s parent employed at this school ? Yes No

5 Which school (if applicable) does the student currently attend ?

6 Is there other information with regard to your student that you feel may be relevant?

Signed (Parent)

Name (Please print clearly)

Date

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Cleveland District State High School

Class Allocation Summary Sheet Please complete and submit with your enrolment pack

Student Name First name

Family name This column for Office Use Only

Year Level of Enrolment (please circle)

7 8 9 10 11 12

Year of Enrolment: 2020

Interviewer: (mid-year enrolments only)

Parent/Carer 1 Email

Name:

Parent/Carer 2 Email Date:

Name:

Your last school attended before Cleveland District State High School:

Report Card Information – Summary (please tick one box per subject) English / Literacy Mathematics / Numeracy

Requires Support Requires Support

Average Achiever Average Achiever

High Achiever High Achiever

Very High Achiever Very High Achiever

Year 7 & 8 only – Language currently being studied in Year 6

Japanese French Chinese Other:

Language study preference for Year 7 & 8: Please indicate your first preference by ticking one box.

Japanese French Chinese Please note that this is used as a guide only and we cannot guarantee placement in a particular language.

Other Subjects – strengths, weaknesses or special needs

Subject Comment

Student Support Services : Special Education Program / Learning Support: Is your child currently on an Individual Curriculum Plan (ICP)? Yes No

Does your student currently receive learning support assistance at their

primary/secondary school? Yes No

Does your child have a current verification? Yes No (If yes, please tick category) Autism Spectrum Disorder Hearing Impairment Intellectual Disability Speech – Language Impairment Physical Impairment Visual Impairment

Other medical conditions / medications? (ADHD / Dyslexia / Ritalin) (please provide current reports if available)

English as a Second Language: Are the parents from a non-english speaking background? Yes No

If yes, which language? …………………………………………………………………….

Parent/s name: …….…………………………………………………………………………

What is the main language spoken at home?................................................................

Getting to Know You – All students to complete

Student to complete in own handwriting

Why did you and your family decide that you should attend Cleveland District SHS?

What activities do you enjoy doing at school ? Include any activities from class or out of class

What classroom / school activities do you sometimes find difficult?

Are there ways that work to help you with this difficulty?

What are your hobbies / interests / extra curricular / sporting activities?

What do you believe are your greatest strengths and successes?

Have you held any leadership positions ? These could be either at school or elsewhere? Please provide details.

Have you been involved in any community service activities?

What can we do to help you make the most of school?

Future Year 7 Students to complete

What are you looking forward to about High School?

What are the concerns you have about attending High School?

Name one or two friends you would like to have in your class:

Future Year 10 – 12 Students to complete

What is your intended pathway / post Year 12 Goals:

Are you currently enrolled in a VET Qualification with an external RTO or undertaking a School Based Apprenticeship or Traineeship ? Please give full details: What: Where: When:

For your Parents to complete

As a parent(s) what is the most important thing you want for your child for his/her High School experience?

What else do we need to know to best support your family at high school?

Are you interested in involvement with the School Community:

Parents & Citizens Association (P&C)

Learning Support Programme - Volunteering

Tuckshop - Volunteering

Library – Volunteering

Creative Arts Support Team

Chaplaincy Activities

I give permission to pass my details onto the P&C, Head of Department, Teacher where relevant :

Yes No

Name:

Email:

Daytime Phone Number:

The day/s I prefer to volunteer / work :

Monday Tuesday Wednesday Thursday Friday

Your Questions

To connect with Cleveland District State High School and stay up-to-date with what’s happening at our busy school, please:

Subscribe to the school newsletter via the quicklinks section of our school website home page https://clevelanddshs.schoolzineplus.com/subscribe

Like us on Facebook https://www.facebook.com/clevelandshs/

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Cleveland District State High School Redland City Libraries Membership Form

We require each enrolled Cleveland District State High School student to hold valid membership with the Redland City Libraries. Please fill out this form and return it with your Enrolment Pack.

Option 1 - If you already have a library card please record the details here

Child’s name: The 14 digit code from the back of the library card is:

Option 2 – I don’t have a library card

Please fill out the details below and we will arrange a card for you

Child surname Child first name Gender Date of Birth

Male / Female

Male / Female

Male / Female

Male / Female

Residential address:

Postal address: Only required if different to above residential address

Mobile number or other daytime contact number

Parent/Carer email:

Parent/Carer name:

Parent/Carer signature:

Office Use Only:

Completed form forwarded to CDSHS Library for processing

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Cleveland District State High School – Year 7 only Additional information for specialist program

Expression of Interest Form

Student surname:

First name: Gender:

Male / Female

Date of Birth:

Academic Extension Program

Cleveland District State High School has an active Academic Extension Program that offers more able students the opportunity to extend themselves with a wide range of activities both inside and outside the classroom. This class studies the same range of subjects as other students however due to their greater abilities, different, more challenging activities and teaching strategies can be used as well as different assessment where necessary. This class offers an environment where individual talents are valued and can be openly displayed among likeminded students. Although extension opportunities are provided to all classes, year 7 students with exceptional skills and abilities across all academic areas can become a member of our Academic Extension Class. This class is by invitation only. If you believe your student meets the academic requirements, has a positive attitude towards their studies and a record of good behaviour, please complete the details below. This form must be returned with your other enrolment forms if you would like your student to be considered for this program. Applicants from a non-feeder school (Bay View, Thornlands, Cleveland, Ormiston, Dunwich and Mt Cotton Primary Schools) may be required to attend Cleveland District State High School to complete literacy and numeracy testing in Term 4, 2020. This date will be advised upon successful application. I am interested in my child being placed in the Year 7 Academic Extension Class. I believe that my child has exceptional skills and abilities across all academic areas.

Included latest school report, NAPLAN results and any other supporting academic evidence (participation in extension programs)

Yes No

Residential address:

Mobile number or other daytime contact number

Parent/Carer email:

Parent/Carer name:

Parent/Carer signature:

Cleveland District State High School – Year 7 only Additional information for specialist program

Expression of Interest Form

Student surname:

First name: Gender:

Male / Female

Date of Birth:

Sports Development Program

The Sports Development Program provides students who have exceptional sporting skills and abilities, an opportunity to become a member of our specialised Sport Development classes for their studies in Health and Physical Education. Students in these classes study the same range of Health and Physical Education topics as other students but because of their higher physical skills and abilities, the students in these classes participate in more advanced and challenging activities during their Sport Development classes. Students involved in the Sport Development classes are expected to meet the Sports Development Program expectations for example: Follow the Code of Conduct, Participate and compete in school sports, and attend any team training sessions that coach’s schedule. Students chosen in the Football, Touch Football and Volleyball development programs will be allocated to specific Sport Development classes. The trials for these programs will be advised at a future date. Positions in the development programs are subject to satisfactory effort and behaviour results on the student’s Semester 1 Report Card from their current school. While students in the Sports Development Program will get first preference into the Sport Development classes, those students who excel in other chosen sports may also be considered for these development classes based on sporting achievements. If your child has been selected in the Football, Touch or Volleyball programs or excels in his/her chosen sport, please complete and return this form with your enrolment pack.

Sport Football (Soccer) Touch Football Volleyball Other: Highest level represented (ie. Club, District, Met East etc):

Residential address:

Mobile number or other daytime contact number

Parent/Carer email:

Parent/Carer name:

Parent/Carer signature:

Cleveland District State High School – Year 7 only Additional information for specialist program

Expression of Interest Form

Student surname:

First name: Gender:

Male / Female

Date of Birth:

Music Extension Program

As in previous years, we will establish a group of advanced instrumental music students. This group will be involved in a more comprehensive Year 7 music course. This course will incorporate elements of composition, music technology, performance, ensemble experience and extending listening experience. In order to be considered as part of the Music extension program applicants are required to submit a three (3) minute audio visual footage of two (2) short contrasting pieces (this may be sections of a song). Within this footage applicants must display two (2) examples of any scales that they can perform. This should be saved in a MP4 format and included on a USB or downloaded when submitting your application. Students who are accepted into the Extension Music Program must commit to the Instrumental Music Program for Year 7 and 8. Experience Details - Indicate which instrument/s you are proficient in:

Please outline your musical experience – include what bands you have played in and books you are presently learning from (eg. Standard of Excellence Book 2 or Rubank Intermediate etc):

USB/MP4 to be submitted with enrolment pack *** Please ensure the USB is clearly labelled with your students name and note that this USB may not be returned***

Residential address:

Mobile number or other daytime contact number

Parent/Carer email:

Parent/Carer name:

Parent/Carer signature:

Cleveland District State High School – Year 7 to 12 Additional information for specialist program

Expression of Interest Form

Student surname:

First name: Gender:

Male / Female

Date of Birth:

Instrumental Music and Choir Students – Years 7 to 12

All instrumental Music and Choir students should complete this form and return with the enrolment package. You can also complete the “Music Extension Program” form if you wish to be considered for the music extension class (this is separate to being involved with the Instrumental Music Program). The Instrumental Music and Choral programs are important co-curricular activities provided at Cleveland District State High School. Our aim is for all students to experience a seamless transition into high school from their Primary School music program. All students, regardless of level and ability, can join our Instrumental Music Program. An interview process takes place at the start of each year in order to place students into their appropriate ensemble and instrumental music lesson. You will be sent an email during the first week of school regarding the start of year procedures. Please note ‘Instrumental Music’ includes the following instrument families: strings, percussion, brass and woodwind. Instrumental music students receive one group lesson per week and will also participate in at least one ensemble. Choir students will participate in one ensemble rehearsal a week. There are approximately fourteen ensembles available at Cleveland District State High School which will rehearse before and after school. Fees are $100 a year for Instrumental Music and $50 for Choral.

Indicate which instrument/s or voice type you have been learning:

Indicate which instrument/s or voice type you would like to learn:

Do you have your own instrument? Yes No

Please outline your musical experience – include what bands you have played in and books you are presently learning from (eg. Standard of Excellence Book 2 or Rubank Intermediate etc):

Residential address:

Mobile number or other daytime contact number

Parent/Carer email:

Parent/Carer name:

Parent/Carer signature: