Balar Malar Tamil School

Given Name *

Family Name *

Given Name In Tamil *

Family Name In Tamil *

Date Of Birth *

Gender *
Male Female

Had any formal education in Tamil *
Yes No

Consent to receive Information through Email *
Yes No

Elective Class *

Self science class Library class None

Address Line 1 *

Address Line 2

Suburb *

State *

Postcode *

Name/s of sibling/s also attending this school

School Name

School Class

School Address

Suburb

Does the child suffer from Asthma?
Yes No

If Yes, Medication to be given/taken during asthma attack*

Does the child suffer from any Major Illness or disability? Yes No

If Yes, details*

Does the child suffer from any Allergies
Yes No

If Yes, details*

Does the child use any Medications
Yes No

If Yes, details*

Does the child have Allergies to Any medication
Yes No

If Yes, details*

Emergency Contact*
Father Mother

Enrolment Form - AY2021