Ancient Greek For Secondary-School Students
 
1. Student Details
First Name:*
Please enter your first name.

Last Name:*
Please enter your last name.

Gender*
Invalid Input

Date of Birth:*
Invalid Date of Birth

2. Details Required by the Department of Education
Is the Student a Temporary VISA holder?*
Invalid Input

Mainstream School Name for 2017:
Invalid Input

Mainstream School Campus for 2017:
Invalid Input

Mainstream School Year Level for 2017:
Invalid Input

3. Student Medical Details
Allergies:*
Invalid Input

Allergies Details:
Invalid Input

Anaphylaxis:*
Invalid Input

Does the student have Anaphylaxis requiring an Auto-Injector?
If yes you need to provide us with THREE COLOURED copies of the Action Plan For Anaphylaxis.

Asthma:*
Invalid Input

Does the student have Asthma?
If yes you need to provide us with a copy of the Asthma Action Plan.

Special Requirements / Needs / Illness / Disability:*
Invalid Input

Does the student have any needs that require special attention from the staff / teachers?

Special Requirements / Needs / Illness / Disability Details:
Invalid Input

(please provide details)

Doctor's Name:
Please enter the name of your emergency contact.

Doctor's Address:
Invalid Input

Doctor's Phone:
Please enter the contact number of your emergency contact.

4. Home / Family Details
Street Address:*
Please enter your address.

Home Suburb:*
Invalid Input

Home PostCode:*
Invalid Input

Home Phone:*
Please enter your phone number.

Family Email:*
Please enter the family's email address.

5. Parent / Guardian #1
Name:*
Please enter the name of your emergency contact.

Mobile Phone:*
Please enter the Parent/Guardian's personal telephone number.

Parent/Guardian Relationship:*
Please provide the nature of the relationship.

Occupation:
Please enter the relationship you have with your emergency contact.

Work Phone:
Please enter the contact number of your emergency contact.

6. Parent / Guardian #2
Name:
Please enter the name of your emergency contact.

Mobile Phone:
Please enter the contact number of your emergency contact.

Parent/Guardian Relationship:
Please provide your contact number.

Occupation:
Please enter the relationship you have with your emergency contact.

Work Phone:
Please enter the contact number of your emergency contact.

7. Emergency Contact (in case guardians are not available)
Name:*
Please enter the name of your emergency contact.

Phone Number:*
Please enter the contact number of your emergency contact.

Relationship:*
Please enter the relationship you have with your emergency contact.

8. Legal Restrictions
Legal Restrictions:*
Invalid Input

Are there any legal restrictions such as court orders in relation to the student or parents?
If yes you need to provide us with a copy of the Court's Orders.

Legal Restrictions Details:
Invalid Input

9. Photo Permission
Photo Permission:*
Invalid Input

  1. I consent to and provide permission for the photographic, video or audio recording of my child / student, to be used by authorized personnel in various communications and media (e.g. School Newsletter, Website, Displays and Folders of the Greek Afternoon Schools, etc).
  2. I understand that my child / student will not be personally identified in any use of the material.
  3. I authorize the use or reproduction of any recording referred to above without acknowledgment and without being entitled to remuneration or compensation.
10. Select a course
Select Course:*
Please select a course

Tuition Amount:
Please select a course

Course Book Amount:
Please select a course

Course Book Details:
Please select a course

Book Option:
Invalid Input

Total Amount $*
Please enter a number.

11. Payment Details
Name on Card:*
Please confirm your Credit Card Details.

Cardholder Address:*
Please confirm your Credit Card Details.

Card Number:*
Please confirm your Credit Card Details.

Visa or MasterCard

Card Expiry (mm/yy):*
Please confirm your Credit Card Details.

Card CVC:*
Please confirm your Credit Card Details.

Human Verificiation:
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Please press only ONCE and WAIT for a response.

Alphington Grammar Koinotika Nea - the Greek Community newsletter Requirements for Greek Citizenship

 

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