About you

Contact Details

Young Person's Details

Young Person's Address

Young Person's Education

Campus/s of Interest *Note, not all programs are available at each campus

Please note: Whilst we endeavour to place student at their campus of choice, an enrolment may be offered at any campus dependent on program capacity, academic abilities, pathway options and social and emotional capacity of the young person.

Program of interest *Note, please indicate which program the young person is interested in

Please note: All students will be enrolled in Applied Learning Curriculum. This will either be Victorian Pathways Certificate or VCE Vocational Mayor.

Background Information (reason for expressing interest, strengths and areas for improvement and any barriers to participation)

Consent
Collection statement

The information provided by you here is collected purely for the purposes of processing an expression of interest for an individual to enrol in the Hester Hornbrook Academy. We need to collect this information in order to maintain accurate records of your name and contact details. Completion of this form/sharing this information with us constitutes explicit consent from you for us to process this data for this purpose which includes contacting the third parties you have nominated. The individual’s name, contact details and eligibility are recorded electronically on our system to maintain up to date records. This information will be kept for a maximum of six years or until such time as the data is reviewed by us or removed at your request.

By signing this form you are warranting that you have authorised Hester Hornbrook to collect the personal information of the individual, subject to this expression of interest as consented to in this form.