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Expression of Interest Form

Yeronga State School

YEAR OF ENTRY 20_ _ *

STUDENT DETAILS
Family Name (as per
birth certificate)
Given Names (as per
birth certificate)
Preferred Given
Preferred Family Name
Names

Sex Male Female Date of Birth


What year level is the
student seeking to Proposed start date
enrol in?

SIBLING REGISTER
Does the student have any younger siblings who will also attend this school?
Family Name (as per
birth certificate)
Given Names (as per
birth certificate)
Sex Male Female Date of Birth
Family Name (as per
birth certificate)
Given Names (as per
birth certificate)
Sex Male Female Date of Birth

CONTACT DETAILS
Parent/Carer Family Parent/Carer Given
Name Name
Email address
Mobile number
Address
Suburb State Postcode

OFFICE USE ONLY


Date received Time received

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Thank you for completing an Expression of Interest form at Yeronga State School.

Please ensure you keep the school up-to-date with any changes in your contact details.

* Note: form only accepted for either the current year


or the next year (once Expressions of Interest have opened)