Page 1 of 6

Enrolment Application

  1. A $95 Application administration fee is payable for the first child and $50 is payable for each succeeding sibling. Payment is made through PayPal using your credit card details or your PayPal account. Please note that this form has been secured with a 256-bit SSL connection that encrypts the data before it is sent to our servers.

    Before beginning this online application please ensure you have electronic copies of the following ready for attaching to this application form:
    Accepted file types: pdf (and image formats for single page documents). Max File size is 5MB

    • Birth Certificate or passport
    • Latest three School Reports (Years 1 to 12 students)
    • Residency status (passport, visa, etc. for students born overseas)
    • Naplan results (where applicable)
    • Specialist Reports (where applicable)
    • Custody documentation (if applicable)
    • Minister/Personal Reference (attach if available or mail separately to the school)

    The system will not accept your submission until you complete all of the fields marked with a *

    We recommend using Chrome, Firefox or Safari web browsers for this form.
  2. Student's First Name*
    Please enter valid characters
  3. Student's Last Name*
    Please enter valid characters
  4. Preferred Name
    Invalid Input
  5. Date of Birth*
    Please enter a Date of Birth
    Date Selector (Click Month/Year for quick selection)
  6. Gender*
    Please select a gender
  7. Country of Birth*
    Invalid Input
  8. Nationality*
    Invalid Input
  9. Desired Year of Entry*
    Please select Year of Entry
  10. Desired Entry Term*
    Please select a start term
  11. Desired Level of Entry*
    Please select a Level of Entry
  12. Prep Options*
    Please select Prep Day Options
  13. Is this a Sibling Application?*
    Invalid Input
  14. Full Name(s) of Sibling(s)*
    Invalid Input
  15. Full Name(s) of Sibling(s)
    Invalid Input
  16. Is the Student an Australian Resident?*
    Invalid Input
  17. Is the student a full fee paying overseas student?*
    Invalid Input
  18. Is the student of Aboriginal or Torres Strait Islander origin?*
    Invalid Input
  19. Origin*
    Invalid Input
  20. Does the student speak a language other than English at home?*
    Invalid Input
  21. Language Spoken*
    Invalid Input
  22. Is English language tuition required?*
    Invalid Input
  23. Has the student received Special Education?*
    Invalid Input
  24. Has the student received Specialist Services?*
    Invalid Input
  25. Does the student have any Specialist reports e.g. Psychometric, Speech, etc?*
    Invalid Input
  26. Does the student have ADD or ADHD?*
    Invalid Input
  27. Disabilities: e.g. Intellectual, physical, behaviour disorder, autism
    Invalid Input
  28. Learning Difficulties
    Invalid Input
  29. Special gifts/talents
    Invalid Input
  1. How is the student managing academically at school?
    Invalid Input
  2. How is the student managing socially at school?
    Invalid Input
  3. Current School
    Invalid Input
  4. Current School Grade
    Invalid Input
  5. Reason for leaving
    Invalid Input
  6. Previous School (if applicable)
    Invalid Input
  7. Reason for leaving previous school (if applicable)
    Invalid Input
  8. Has the student ever been asked to leave a school or been refused enrolment?*
    Invalid Input
  9. Reason for refused enrolment*
    Invalid Input
  1. Religion
    Invalid Input
  2. Denomination
    Invalid Input
  3. Church
    Invalid Input
  4. Pastor/Minister
    Invalid Input
  5. Street Address
    Invalid Input
  6. Suburb
    Invalid Input
  7. Post Code
    Invalid Input
  8. Involvement
    Invalid Input
  1. Father/Guardian Details
    ----------------------------------------------------------------------------------
  2. Title
    Invalid Input
  3. First Name
    Invalid Input
  4. Last Name
    Invalid Input
  5. Address (if different from student)
    Invalid Input
  6. Country of Birth
    Invalid Input
  7. Language (if other than English)
    Invalid Input
  8. Nationality
    Invalid Input
  9. Occupation
    Invalid Input
  10. Work Phone
    Invalid Input
  11. Home Phone
    Invalid Input
  12. Mobile Phone
    Invalid Input
  13. Email Address
    Invalid Input
  14. Fax
    Invalid Input
  15. Did you attend Pacific Hills as a student?*
    Invalid Input
  16. Name enrolled under*
    Invalid Input
  17. Marital Status
    Invalid Input
  18. Information required by Commonwealth Government for statistical analysis of educational outcomes
  19. Highest level of schooling completed
    Invalid Input
  20. Highest level of qualification completed
    Invalid Input

  21. Mother/Guardian Details
    ----------------------------------------------------------------------------------
  22. Title
    Invalid Input
  23. First Name
    Invalid Input
  24. Last Name
    Invalid Input
  25. Address (if different from student)
    Invalid Input
  26. Country of Birth
    Invalid Input
  27. Language (if other than English)
    Invalid Input
  28. Nationality
    Invalid Input
  29. Occupation
    Invalid Input
  30. Work Phone
    Invalid Input
  31. Home Phone
    Invalid Input
  32. Mobile Phone
    Invalid Input
  33. Email Address
    Invalid Input
  34. Fax
    Invalid Input
  35. Marital Status
    Invalid Input
  36. Did you attend Pacific Hills as a student?
    Invalid Input
  37. Name enrolled under*
    Invalid Input
  38. Information required by Commonwealth Government for statistical analysis of educational outcomes
  39. Highest level of schooling completed
    Invalid Input
  40. Highest level of qualification completed
    Invalid Input
  1. Student Residential Address
  2. Street Address
    Invalid Input
  3. Suburb
    Invalid Input
  4. Post Code
    Invalid Input
  5. Student Postal Address (if applicable)
  6. Postal Address
    Invalid Input
  7. Suburb
    Invalid Input
  8. Post Code
    Invalid Input
  9. Phone
    Invalid Input
  10. Home Fax
    Invalid Input
  11. ---------------------------------------------------------------------------
  12. Emergency Contact (if unable to reach parents)
  13. Title*
    Invalid Input
  14. First Name*
    Invalid Input
  15. Last Name*
    Invalid Input
  16. Relationship to student*
    Invalid Input
  17. Daytime Phone
    Invalid Input
  18. Mobile Phone
    Invalid Input
  19. ---------------------------------------------------------------------------
  20. Student Lives With*
    Invalid Input
  21. Lives with*
    Invalid Input
  22. Is there a court order pertaining to the custody of your child/children?*
    Invalid Input
  23. Court Order Document (5MB max file size - pdf only)*
    Invalid Input
  24. ---------------------------------------------------------------------------
    Comments
  25. Why do you want your children educated at a Christian School?
    Invalid Input
  26. Why did you choose Pacific Hills Christian School?
    Invalid Input
  27. Where did you hear about Pacific Hills Christian School
    Invalid Input
  1. Do you intend your child to finish their schooling at Pacific Hills?*
    Invalid Input
  2. Are you prepared to support the uniform code of the school?*
    Invalid Input
  3. Are you prepared to support your child doing regular homework?*
    Invalid Input
  4. Are you prepared to attend Parent/Teacher meetings?*
    Invalid Input
  5. Do you anticipate any financial difficulty with the Enrolment or Tuition Fees?*
    Invalid Input
  6. Do you give permission for photos taken at school of your child/children to be used by the school for promotional/publication purposes?*
    Invalid Input
  7. ---------------------------------------------------------------------------

    Attachments- (Accepted file types: pdf and image formats. Max File size is 5MB)

  8. Copy of Birth Certificate or Passport
    Please upload a Birth Certificate
  9. Copy of three most recent School Reports - pdf only (Years 1 to 12 students only)
    Invalid Input
  10. Second School Report - pdf only (if not combined above)
    Invalid Input
  11. Third School Report - pdf only (if not combined above)
    Invalid Input
  12. Details of residency status (passport, visa, etc.) for students born overseas (pdf only)
    Invalid Input
  13. Copy of Naplan Results where applicable (pdf only)
    Invalid Input
  14. Copies of specialist reports where applicable (pdf only)
    Invalid Input
  15. Minister/Personal Reference
    Invalid Input
  16. DECLARATION
    I have attached all relevant documents concerning my child's learning, physical & emotional needs, including all specialist reports.
    I agree to support the ethos, philosophy and practices of Pacific Hills and be responsible for the payment of all fees and charges. I am aware that the Application Fee and Enrolment Fee are not refundable. If a place is offered I agree to pay the Enrolment Fee within two weeks of receiving the offer. I understand that if withdrawing a student from the School, one full term's notice should be supplied in writing to the Principal, or one term's appplicable fee will be charged. I understand that acceptance of my child/children will depend on the outcome of an interview and availability of places in the School, and that this Enrolment Application does not ensure enrolment.
  17. I agree with this Declaration*
    Invalid Input
  18. Full Name*
    Invalid Input
  19. Email Address*
    Invalid Input
    Form submission confirmation will be sent to this email address.
  20. ---------------------------------------------------------------------------

    Payment
  21. Application Fee*
    Invalid Input
  22. Choose Payment Method
  23. ---------------------------------------------------------------------------
  24. Please let us know that you're human
    Please prove you're not a robot

  25. Please enter your child's name under "Instruction to Seller" when paying
    Press the Submit button only once to submit this form.
    Please be patient while any attachments upload.