South West Academic Scholarship Before you complete this form you will need to scan and save the following important documents in PDF format: Hand-written letter by the applicant to the Principal, outlining why they would like to become part of the Christ Church community The student's two most recent school reports (if currently attending school) Any specialist reports and Australian curriculum assessments, for example NAPLAN, speech therapist, educational psychologist etc A character reference by a person (not related) who has known the student over time Birth certificate If born overseas, your child’s Permanent Residency or citizenship papers Any family court or parenting papers Please note that incomplete applications will not be accepted and that all applicants are required to be an Australian Citizen or Permanent Resident.Student detailsAcademic year of entry you are seeking* Year 7 Year 8 Year 9 Attendance type* Boarder Student first name*Student preferred first name*Student middle name/sStudent surname*Date of birth* DD slash MM slash YYYY Country of birth*Citizenship status* Australian Citizen Permanent Resident Scanned copy of Citizenship/Permanent Residency* Drop files here or Select files Max. file size: 384 MB. Current school*Student current year level*Year 5Year 6Year 7Year 8Year 9School reports (last two reports required)* Drop files here or Select files Max. file size: 384 MB. Most recent NAPLAN results Drop files here or Select files Max. file size: 384 MB. Language spoken at home* English Is the student of Aboriginal or Torres Strait Islander origin?* Yes No Supporting documentationLetter to the Principal*Max. file size: 384 MB.Hand-written letter by the applicant to the Principal, outlining why they would like to become part of the Christ Church community.Character reference*Max. file size: 384 MB.A character reference by a person (not related) who has known the student over time.Student birth certificate (translated version if not in English)*Max. file size: 384 MB.Specialist reports (if applicable)Max. file size: 384 MB.E.g. Speech therapist, educational psychologist etcContact detailsBoys' primary residential address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Postal Address Postal address same as home address Postal Address Street Address/Post Box Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Parent/Guardian detailsParent/Guardian 1 details* Mr.Mrs.MissMs.Dr.Prof.Rev. Title First Name Surname Relationship to student*Occupation*Company*Mobile*Work phoneHome email* Work email* Preferred email* Home Work Do you live at the same address as your son?* Yes No If no, what is your residential address?*Are you a single parent/guardian Single Parent Two Parents Unless you have sole custody of your son, both parents must submit their details to confirm they are in agreement with their son being registered at Christ Church.Parent/Guardian 2 details* Mr.Mrs.MissMs.Dr.Prof.Rev. Title First Name Surname Relationship to applicant*Occupation*Company*Mobile*Work phoneHome email* Work email* Preferred email* Work Home Do you live at the same residential address as your son?* Yes No If not, please advise your residential address below*Family circumstancesDo you have sole custody of your son?* Yes No Court ordersShould there be any court order in relation to access/custody of your son, please attach here. Drop files here or Select files Accepted file types: pdf, doc, docx, Max. file size: 384 MB. Is a parenting or restraint order applicable Yes No Parent/Restraint Order attachmentMax. file size: 384 MB.Other conditions/or details on family circumstancesPlease provide any other conditions enforced by law.Family detailsDo you have other sons registered or enrolled at the school? Yes No Name of son registered or currently attending Christ ChurchAddRemoveFamily connection to the SchoolDo you have a family connection to the School?* Yes No What is their relationship to Christ Church?Family member's nameSpecial needsDoes your son have educational challenges such as giftedness or learning difficulties, hearing or vision impairment?* Yes No Details*Does your son have a diagnosed intellectual disability and you wish him to be considered for support through our Peter Moyes Centre (PMC).* Yes No If yes, you will be required to also complete a Peter Moyes Centre Application here. Peter Moyes Centre ApplicationPeter Moyes Centre (PMC) application*Please scan and upload your PMC application below. Drop files here or Select files Max. file size: 384 MB. Specialist reports*Please upload your son's latest specialist reports here. Drop files here or Select files Max. file size: 384 MB. How did you hear about this scholarship?* Family member Referral by word of mouth Admissions Office Field Day Community event Newspaper advertisement School website Facebook Other Which newspaper?Please specify:Declaration* Should my son’s educational or health circumstances change between date of application and entry to the School, I/we will inform the School. We are aware that failure to do so may jeopardise my son's enrolment. * I / We confirm we have read and accept the School’s Terms and Conditions of Enrolment and Privacy Policy. * I confirm my son is not currently attending Christ Church Grammar School. * I / We understand and accept that: By clicking the box immediately below I am confirming that all information I have provided to the School is correct and current.
