Expression of Interest

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Step 1 of 4 - Student Personal Details

Student Name *

First Last

Birth Date *

Gender *

Country of Birth *

Interpreter Needed? *

Home Address *

Street Address Suburb State Postcode

Parent/Carer #1

Parent/Carer Name #1 *

First Last

Relationship to Child *

Email *

Phone

Parent/Carer #2

Parent/Carer #2 Name *

First Last

Relationship to Child *

Email *

Phone

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We would like to acknowledge the traditional custodians of this land, the Bunurong people of the Kulin nation and pay our respects to Elders both past, present and future for they hold the memories, the traditions, the culture and hopes of Aboriginal Australia.