Hester Hornbrook Academy - Expression of Interest

About you

Are you applying on someone else's behalf?

NoYes

Contact Details

Name of person completing the form

Org Name

Relationship to young person

Email Address

Phone

Young Person's Details

First Name

Middle Name

Last Name

Preferred Name

Date Of Birth

Identifies As

Mobile

Young Person's Address

Address Type

Address Street 1

Address Street 2

Address City

Address State

Address Postcode

Young Person's Education

Most Recent School or Education Provider

Best Contact Person

Best Contact Email

How many days did you attend this education in the last 3 months?

Highest School Level Completed

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.

Campus Of Interest

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.

Program Of Interest

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.

Party Providing Consent

Person Providing Consent

Legal Consent

Physical Mental Health Consent

Education Employment Training Consent

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Child Safe Standards

Our school actively promotes the safety and wellbeing of all students, and all school staff are committed to protecting students from abuse or harm in the school environment, in accordance with their legal obligations including child safe standards. HHA has a child safe code of conduct which must be completed by all staff. Further, all employees are required to comply with the Child Safe Standards.

Privacy

Hester Hornbrook Academy is committed to protecting the privacy, confidentiality and security of personal information. All personal information provided to Hester Hornbrook will be collected, used and disclosed as set out in this consent form, the law (namely the Privacy Act 1988 (Cth), the Privacy and Data Protection Act 2014 (Vic) and the Health Records Act 2001 (Vic)) and Hester Hornbrook Academy and Melbourne City Mission’s Privacy Policies.

Security and retention of personal information provided as part of the application process

The Hester Hornbrook Academy stores personal data on multiple secure systems across Hester Hornbrook Academy and Melbourne City Mission. Personal information collected on this form will be retained to progress your expression of interest for enrolment at Hester Hornbrook Academy and to keep a record that you applied. Once this process has been completed, the form will be stored on record as supporting documentation for the application process or securely destroyed if the application is not progressed.

Hornbrook Academy’s Philosophy

In accordance with Hester Hornbrook Academy’s Philosophy, we must only seek to enrol students who are disengaged, or are at risk of disengaging from education, and are deemed to be in need of the flexible learning environment that Hester Hornbrook Academy provides.
The Principal of Hester Hornbrook Academy retains the discretion to make a final decision on the enrolment of students in line with Hester Hornbrook Academy’s Philosophy and Strategic Plan. Full disclosure, by prospective students, of information throughout the enrolment process allows us to meet our duty of care obligations and facilitate the smooth transition of individuals into our school. This will also assist the school to implement appropriate adjustments and strategies to meet the particular needs of individuals. If certain information is not provided, is incomplete, incorrect or misleading, an individual’s current or ongoing enrolment may be reviewed.