Test Form Please enable JavaScript in your browser to complete this form. - Step 1 of 7Seeking Enrolment for Grade *JARJUM DETAILSName *FirstLastDate of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender *SelectSelectMaleFemalePrefer not to sayAddress *Address Line 1Address Line 2CityState / Province / RegionPostal CodePostal Address (if different from above) SelectSelectYesNoPostal Address Address Line 1Address Line 2CityState / Province / RegionPostal CodeIs the Jarjum of Aboriginal or Torres Strait Islander origin: *Yes, AboriginalYes, Torres Strait IslanderYes, both Aboriginal and Torres Strait IslanderNo, neitherOther Jarjums at Hymba YumbaSelectSelectYesNoif yes please specify name and gradeName 1FirstLastGrade 1other 2Other Jarjums at Hymba YumbaYesNoif yes please specify name and gradeName 2FirstLastGrade 2other 3Other Jarjums at Hymba YumbaYesNoif yes please specify name and gradeName 3FirstLastGrade 3Other 4Other Jarjums at Hymba YumbaYesNoif yes please specify name and gradeName 4FirstLastGrade 4NextParent / Guardian detailsName *FirstLastPhoneEmail *CheckboxesAdd Parent / Guardian detailsParent / Guardian detailsName (copy) *FirstLastPhone (copy)Email (copy) *Hymba Yumba ConnectionsSelectSelectYesNoDo you have any connections with any existing jarjums at Hymba Yumba? Yes/ No; if yes please specifyPlease specifyPrevious SchoolsWhat schools has your jarjum attended? *Is your jarjum currently attending school? *SelectSelectYesNoPreviousNextAcademic ResultsJarjums will need to demonstrate a good academic ability at their year level to enrol. Please attach school report cards, NAPLAN results and any other relevant information. Click or drag files to this area to upload. You can upload up to 8 files. What are your favorite subjects?The ArtsMathEnglishScienceHumanitiesHPEWhat subjects do you need help with?The ArtsMathEnglish ScienceHumanitiesHPEWhat are your learning goals?improve literacyimprove numeracyimprove study habitsbecome more confident graduatenot sureWhy do you want to enrol at Hymba Yumba? What can you bring to the school community?PreviousNextCultural Connections Tell us about your cultural identityLand- What country/language group are you from?Language- Do you speak any languages other than English?SelectYesNoWhat other languages do you speakCulture- What aspects of your culture are you interested in? e.g. Music, Art, Dance, HistoryPreviousNextWellbeing and SupportHymba Yumba is not resourced to provide a wide range of differentiated learning support.Are there any medical, wellbeing or learning support issues we need to know about? *SelectSelectYesNoYes/ No: if yes please specifyPlease specifyDoes the jarjum have any learning support needs? *SelectSelectYesNoYes/ No: if yes please specifyPlease specifyDoes the jarjum have a verified disability requiring learning support? *SelectSelectYesNoYes/No: if yes please specify Please specifyDoes the jarjum have a good attendance and behavior record? *SelectSelectYesNoJarjums will need to have a good attendance and behavior record to enroll. Attendance- Does the jarjum attend school regularly? *SelectSelectYesNoBehaviour- Does the jarjum interact positively with others? *SelectSelectYesNoPreviousNextSupport NetworksAre there any community services that support your family? SelectSelectYesNoYes/ No: if yes please specifyPlease specifyIs there anything you need to get your jarjum to school every day? SelectSelectYesNoYes/ No: if yes please specifyPlease specifyParents & Friends CommitteeWe are always looking for parents and carers to engage with the school. If you would like to add your name to the list please select. We are always looking for parents and carers to engage with the school. TuckshopCultural activities and knowledgeTidda & BandjiYarning circleTutoring/ classroom readingFundraising PreviousNextConsent to contact previous schoolsI seek enrollment for *Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Consent *I verify that I have included all relevant information. I give consent for Hymba Yumba to contact previous schools for information.I understand that Hymba Yumba Independent School Is not able to enrol all jarjums. Parent/ Carer Name *Clear SignatureDate *PreviousSubmit
