Student Name*

DOB*

Sex
MaleFemaleRather not specify

Parent/Guardian Name*

Parent/Guardian Email*

Parent/Guardian Phone*

Address*

Current Secondary School*

Current Year Level*
789101112

Name of Year Level Leader/Coordinator at current school*

Requested Commencement Date*

Has your child experienced any difficulties relating to:
N/AEngagement in the classroom (completing work, understanding work, following teacher instructionsAttendance (truancy/school refusal)Relationships (with teaching staff and students-bullying etc.)

Have you discussed any above concerns with your current school?
N/AYesNo

Please describe (if any) learning, behavioural or other difficulties experienced by your child.

Has your child been suspended from school in the last 12 months?
NoYes

Do you learn a musical instrument?
NoYes

Please provide details

Do you have any sporting interests or achievements?

Other special interests and achievements?

Please upload any relevant documents.*

Most recent school report

Visa (if born overseas)

Evidence of residential address

FHC SPORT & PERFORMING ARTS ACADEMY PROGRAM

Please submit your expression of interest below to your chosen Academy Program

Academy of Interest:
---Australian Rules Football (Boys & Girls)NetballPerforming ArtsSoccerTennisBasketball

Why do you want to join the FHC Academy Program

Current Club/Organisation

Achievements

Please let us know about your achievements. Feel free to upload any certificates, photos of awards, articles or even a short video of your accomplishments.

References

Please add any letters from referees.