Students Registration Form 2025

Coram Deo micro-school provides an alternative academic outlet for parents seeking quality classical Christian education in Perth, Western Australia.

In order to register a student for enrolment, you will need to fill in this form (which usually takes 15-20 minutes) and pay a fee of $50.00.

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- Step 1 of 12

Location of interest (primary) *

Location of interest (secondary) *

Note: Fremantle will be considered as expression of interest and will only be a viable option after the minimum number of students is reached.

Student's name *

First

Last

DOB *

Date of Birth (Please email us a copy of the birth certificate)

Class / commencement Year (e.g. "Kindy / 2025") *

Sex *

Male
Female

Name of previous school *

Country of birth / nationality *

Is your child of Aboriginal or Torres Strait Islander origin? *

No
Yes, Aboriginal
Yes, Torres Strait Islander
Yes, both Aboriginal and Torres Strait Islander

Primary language spoken at home

Name *

First

Last

Phone (mobile preferred) *

Address (including postcode) *

Email *

Nationality

Church you currently attend (please include location)

Does your child attend this church with you?

Yes
No
Not anymore

Name

First

Last

Phone (mobile preferred)

Address (including postcode)

Nationality

Church you currently attend (include location)

Does your child attend this church with you?

Yes
No
Not anymore

If separated, who is the custodial parent?

Mother
Father
Not applicable

Name of the volunteer and their relationship to the child

Note: If this volunteer is not a parent, then a Working with Children Check would be required and evidence provided.

Do you have any special interests or skills that you think might be useful at Coram Deo micro-school?

Sibling 1: please provide age and school

Sibling 2: please provide age and school

Sibling 3: please provide age and school

Sibling 4: please provide age and school

Name and contact details of GP and / or medical centre (if applicable)

Are you a member of an ambulance fund? *

Immunisation status *

Fully immunised
Incomplete
Not immunised
Personal objection (or exemption)

Please send a copy of current immunisation history to cceperth@gmail.com. Please note that it is required that all children enrolled in Kindy are fully immunised.

Does your child have any special needs? *

If yes, please provide details

Does your child have any allergies? *

If yes, please provide details of the procedure which is to be followed if the condition needs to be attended to at the micro-school

Please send a separate sheet to cceperth@gmail.com if additional space is needed.

Does your child take any regular medications? *

If yes, please provide details

Emergency contact (primary) *

Relationship with child *

Phone number *

Address

Emergency contact (secondary)

Relationship with child

Phone number

Address

I give permission for my child to participate in walks in the areas surrounding the school from time to time. I understand there will be adequate supervision of my child in areas near water / traffic. *

I give permission for my child to be given first aid from the school first-aid staff *

I give permission for my child to be given paracetamol, if required. *

I understand that if my child is seriously injured or needs medical attention and parents are not able to be contacted my child will be transported by ambulance to hospital and I agree to cover ambulance costs. *

I give permission for my child to participate in all school sporting activities. *

I give permission for my child to be photographed and that these photos be used in school newsletters, magazines, social media and other such publications. If I change my mind about this I will notify the school in writing. *

Note: photos will not be used for promotional purposes without further parental consent.

What is your educational goal for your child ?

Do you have a membership at a local library?

Note: The micro-school will not have its own library on premises.

Your child's special abilities, hobbies, interests etc.

How much screen time is your child permitted at home?

Please specify hours per day and per week. Please include smartphones, TV and any other devices.

Is there anything else you would like us to know to help your child on their educational journey?

In order to register a student for enrolment, this online Registration Form must be completed and a fee of $50.00 paid. This fee is non-refundable and covers the enrolment administration costs. Payment of the application fee does not guarantee a place in the Micro-school. If your preferred locations are no longer a viable option, this fee will then be refunded to you. *

Ok, I understand.

The payment of the fee of $50 is to be paid to the following account please: Account Name: CCE Perth Inc // Bank: CBA // BSB: 066-165 // Account N0: 1047 8819 // Ref: "Surname + enrol fee"

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WORKING hours

8 AM – 4 PM

Address

Billabong Community Centre – 40 Liffey St, Canning Vale WA 6155

Email

cceperth@gmail.com

Phone

0422 122 545

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