APGS Booklet

APGS Student Information Submission

STUDENTS FULL DETAILS
Please ensure all details are fully completed for the school’s records. Parents/guardians are responsible for promptly notifying the school, either in writing or via the Sentral Parent Portal, of any changes to the information provided below.

Students Full Name as appears on passport/birth certificate *

Preferred Name

Date of Birth (DD/MM/YYYY) *

Gender *

Student Email Address *

Student Mobile Number *

Year Level *

STUDENT CITIZENSHIP AND RESIDENCY

Country of Birth *

Nationality *

Country of Citizenship *

Student's First Language *

Student ATSI *

Student Mainly Speaks English at Home *

Language Other than English Spoken at Home

Residential Status *

STUDENT ADDRESS – SCHOOL TERM MAIN RESIDENTIAL ADDRESS

Street Number and Name *

Suburb *

State *

Postcode *

Postal Address - same as main residential address *

Yes

If No, please provide details

Street Number and Name

Suburb

State

Postcode

PARENTS/GUARDIANS FULL DETAILS

PARENT/GUARDIAN 1

Relationship to Student *

Title e.g. Mr. Mrs. Ms. *

FULL NAME *

Preferred Name

Gender *

Date of Birth (DD/MM/YYYY) *

Country of Birth *

Nationality *

Residential Status *

Parent ATSI *

Language Spoken at Home *

Language Other

School Education Level *

Tertiary Education Level *

Employment Type *

Mobile *

Work Phone

Email *

Residential Address *

PARENT/GUARDIAN 2

Relationship to Student *

Title e.g. Mr. Mrs. Ms *

FULL NAME *

Preferred Name

Gender *

Date of Birth (DD/MM/YYYY) *

Country of Birth *

Nationality *

Residential Status *

Parent ATSI *

Language Spoken at Home *

Language Other

School Education Level *

Tertiary Education Level *

Employment Type *

Mobile *

Work Phone

Email *

Residential Address *

Family Status *

Please Specify any specific details of living arrangements if required

Additional EMERGENCY CONTACTS

EMERGENCY CONTACT - 1

Emergency Contact 1 - Name *

Emergency Contact 1 - Phone *

Emergency Contact 1 - Email

EMERGENCY CONTACT - 2

Emergency Contact 2 - Name *

Emergency Contact 2 - Phone *

Emergency Contact 2 - Email

MEDICAL INFORMATION
DOCTOR CONTACT DETAILS

Doctor/Practice Name *

Doctor/Practice Address *

Doctor/Practice Phone *

Consent to contact Doctor/Practice *

Medicare Number *

Medicare Position on Card *

Private Medical Fund

PERMISSION FOR SALBUTAMOL (Ventolin) TO BE ADMINISTERED

Do you agree to give permission for your child/ward to be administered with Ventolin (as per the standard dosage) by an APGS staff member should the occasion arise *

Yes

PERMISSION FOR PARACETAMOL (Panadol) TO BE ADMINISTERED

Do you agree to give permission for your child/ward to be administered with Panadol (as per the standard dosage) by an APGS staff member should the occasion arise *

Yes

PERMISSION FOR IBUPROFEN (Nurofen) TO BE ADMINISTERED

Do you agree to give permission for your child/ward to be administered with Nurofen (as per the standard dosage) by an APGS staff member should the occasion arise *

Yes

PERMISSION FOR ANTIHISTAMINE (Claratyne) TO BE ADMINISTERED

Do you agree to give permission for your child/ward to be administered with Claratyne (as per the standard dosage) by an APGS staff member should the occasion arise *

Yes

PERMISSION FOR EMERGENCY MEDICINES TO BE ADMINISTERED WHILE AT SCHOOL
Parents/guardians are responsible for providing any emergency medication their child may require to the front office. All medication must be supplied in a clear, resealable plastic bag, clearly labelled with the child’s name, date of birth, medication type, expiry date, dosage, any special handling instructions, and the symptoms or conditions under which the medication should be administered.

Medicine 1

Details of instances when and how medicine 1 should be administered (PLEASE INCLUDE ANY ALLERGIES & THEIR SYMPTOMS)

Medicine 2

Details of instances when and how medicine 2 should be administered (PLEASE INCLUDE ANY ALLERGIES & THEIR SYMPTOMS)

PARENT / GUARDIAN 1

Name

Mobile

PARENT / GUARDIAN 2

Name

Mobile

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