Enrolment Form

Please enter the details below and press submit to complete step 1 of the enrolment process.
Student Name*:
Date of Birth*:
Postal Address*:
Preferred Parent Mobile Contact Number*:
Current School Attended*:
Current Year Level*:
Name of person(s) who is/are permitted to collect your daughter*:
Name of Next of Kin in case of Emergency*:
Contact Number(s) in case of Emergency*:
Please indicate any food allergies or describe any restrictions due to religion:
Please indicate any medication that your child will be carrying with her to class: eg: Ventolin, Epipen, etc:
Please indicate any medical conditions that may be of relevance to class activity (eg: hearing impairment, asthma, etc)
Program Selection

Would you please indicate your top three preferences for the SHINE program in which you would like to enrol. Due to demand we cannot guarantee you will be successful in your first choice.

Please visit Program Choices for more information on our programs.
Is your child up to date with vaccinations?
I have discussed this enrolment with my child and they are committed and willing to attend
1st choice:
2nd choice:
3rd choice:
Age Selection
Person who nominated:
If you are applying for a scholarship please name the school/organisation and person who nominated you below.
Name of Parent/Carer A:
Name of Parent/Carer B:
How did you hear about SHINE Academy for Girls?
Is your child ready to kiss and go?
Are you ready to kiss and go?
Enter Security Code*: