Admissions

Adventure

Water Sports

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Snow Adventure

Winter Sports

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Forest Tours

Camping

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Application Form – Domestic Student

Student

Given Name:

Preferred Name:

Date of Birth:

Lives with Mother/Father/Both/Other:

Gender:

Male Female Other

Ethnicity:

Home Address:

Student’s mobile:

Student’s Email:

Current School:

Current Year Level:

Year 9 Year 10 Year 11 Year 12 Year13

Proposed Year of Entry to school:

Year Level: (Y8, Y9 etc):

Mother/Guardian

Given Name:

Title: Ms/Mrs/other:

Ms Mrs Other

Phone Number:

Phone Number

Phone Number:

Email:

Occupation:

Father/Guardian

Given Name:

Title: Mr/Other:

Mr Other

Phone Number:

Phone Number

Email:

Occupation:

Alternative Emergency Contact:

Relationship to Student:

Mobile:

Signature of Parent/Legal Guardian:

Date:

By signing this Application Form, I/we agree with and accept the following:

I/We have provided full disclosure of all information (including health and learning assessments and challenges) that may be required by Wentworth Computer Science College to make a decision regarding this application.
I/We authorize the School to collect any additional information it may require during the enrolment process and during the period in which the student is enrolled at Wentworth Computer Science College.
I/We understand that this information is intended for use in connection with assessing the suitability of the applicant and the subsequent education and wellbeing of the student during their time at Wentworth Computer Science College.
Wentworth has, as its primary purpose, the academic and general education of students and shall obtain such information as necessary to achieve this purpose. The information collected may be used by any of the staff at Wentworth Computer Science College, and any other organization or group that functions under the auspices of Wentworth College, for any lawful activity undertaken by these bodies.
Applicants have the right to access and request correction of any personal information collected by Wentworth Computer Science College.

Declaration

I/We declare that I am legally entitled to make this application.
I/We declare that all information provided in support of this application for admission is true, complete and correct.
I/We understand that acceptance of this form does not constitute admission of the student.
I/We understand that I/we will be required to agree to the conditions of entry at the time an offer is made.