Form - St Philomena School

St Philomena School
61 Koplick Rd, Park Ridge QLD 4125
Reg. 1557
Tel.: (07) 3802 0088
Fax: (07) 3802 0360
www.stphilomena.qld.edu.au
Dear Parents/Guardians,
Thank you for your interest in enrolling your child/ren at St Philomena School, Park Ridge.
Please find following our enrolment package which includes an Application for Enrolment
Form and associated documentation.
Should you wish to proceed with an Enrolment Application, please complete the attached
forms and return to the school with a copy of the child’s birth certificate, and baptism
certificate if there is one (this does not have to be witnessed by a JP). A copy of the Birth
Certificate MUST be attached to the enrollment form as it is both State and Commonwealth
Government regulation that proof of the date of birth of all children enrolling be provided to,
and filed at, the school.
For the families who do not have a child currently enrolled at the school, an Enrolment
Application Fee of $50.00 is payable at the time of submission of your first enrolment
application.
Upon receipt and assessment of your application we will contact you further and, where
applicable, arrange an enrolment interview with the School Principal, Father Karl Pepping.
We look forward to meeting you,
Mrs Karen Scott
Head of Human Resources and Administration
St Philomena School
61 Koplick Road, Park Ridge 4125
Reg. 1557
Tel: (07) 3802 0088, Fax: (07) 3802 0360
www.stphilomena.qld.edu.au
ENROLMENT FORM
Surname: ………………………………………...
Given Name(s)…………………………………….................
Preferred Name: ……………………………..
Date of birth: …………………………………………..............
Male:
Female:
(please tick)
FOR OFFICE USE ONLY
CERTIFICATES SIGHTED Birth: Yes/No
First Holy Communion: Yes/No
Baptism: Yes/No
Confirmation: Yes/No
Entry Year: …………….....
Year Level: …………........................
Teacher: ……………………………
Student Number. ………..
Admission Date: …………………...
Town: ………………………………………….........
Previous School:…………………………………………
From .…/..…/…… To .…/…../……
Most Recent Year Level: (previous school) ………..
(Please provide a copy of the most recent report and/or other reports.)
Contacts:
Recent School Reports
Yes/No
(other than parents/guardians) Please give names, and phone numbers
of three (if possible) LOCAL PERSONS who could be contacted in case of an
emergency. eg Grandparents, neighbours, close friends.
Name
Phone
Relationship
........................................................
...........................................
...........................................................
.......................................................
...........................................
...........................................................
.......................................................
...........................................
...........................................................
Siblings attending this school: …………………………………………………………………………………………........
……………………………………………………………………………………………………………………………………............
Position in Family: ……………………………………..
COURT ORDERS:
Yes
eg BBIS = Older brother, older brother, I (student), sister]
C)
No
Are there any current Family Court or other court orders concerning the welfare, safety or parenting arrangements
of your child/children?. Please provide a copy of any relevant current court order.
Has your child been tested by a Guidance Officer:
(Yes/No)
If so, when: …………………………..
Where: ………………………………………
Has your child attended support lessons:
(Yes/No)
If so, when: …………………………..
Where: ………………………………………
Has your child ever attended a special school or special education unit?
(Yes/No)
Has your child received help from:
Speech Therapist
ESL Teacher
Teacher for the Hearing Impaired
Communication Teacher
Occupational Therapist
Teacher for the Physically Handicapped.
If so which one? ……………………………………………………………………………………………………………...........
Has your child been tested for any Autism Spectrum Disorders (ASD):
If so, when ..............................................
(Yes/No)
Where: ………………………………………
**If any ASD diagnosed, please provide copy of report & recommendations.
Child’s Doctor: …………………………………………………………………….…… Phone: ………………………….........
St Philomena School
61 Koplic Road, Park Ridge 4125
Reg. 1557
Tel: (07) 3802 0088, Fax: (07) 3802 0360
www.stphilomena.qld.edu.au
HEALTH INFORMATION FORM
STUDENT NAME: ……………………………….......
GIVEN NAMES: ……………….....................................
Has your child had a Tetanus Booster in the last 12 months?
(Yes/No)
What has your child been immunised against since birth, other than the above?................................................
………………………………………………………………………………………………………………………………………………………..
NATURE OF PROBLEM
HEART PROBLEMS
Yes/No
RESPIRATORY PROBLEMS
Yes/No

Asthma
Yes/No

Other
Yes/No
ALLERGIES
Yes/No

Food
Yes/No

Medication
Yes/No

Ointments
Yes/No

Other [eg Bee Stings]
Yes/No
DIABETES
Yes/No
BLOOD PRESSURE
Yes/No
HEADACHES/MIGRAINES
Yes/No
EPILEPSY
Yes/No
PHOBIAS
Yes/No
BED WETTING
Yes/No
ACTION NECESSARY
SPECIAL DIETARY REQUIREMENTS Yes/No
OTHERS (PLEASE LIST)
MEDICINES:
Please give details of any regular medicines (LONG TERM ONLY) being taken by your
child including dosage and frequency………………………………………………………………………………………………..
(An Authority for the Administration of Medication must be completed if your child requires administration
of any medication during the school day. Student Asthma forms are also available if your child suffers
from Asthma.
FURTHER INFORMATION:
Are there any further details that would be useful for us to know concerning physical problems.
a. Eyes ………………………………………………………………………………………………..………….............................................................
b. Ears ………………………………………………………………………………………………..……………….....................................................
c. Speech……………………………………………………………………………………..………………………....................................................
d. Physical disabilities………………………………………………………………………………………………...........................................
e. Motor coordination/balance: ………………………………………………………………………………………................................
f.
Other: …………………………………………………………………………………………………………….......................................................
…………………................
Date
……......…………………………………….
Signature of Parent/Guardian
FAMILY INFORMATION
PERSONAL DETAILS
Surname
Given Name/s
Preferred First Name
Title (e.g. Mr, Mrs)
Gender
CULTURAL BACKGROUND
Interpreter Required?
Country of Birth
Country of Citizenship
Main Language Spoken
At Home
Other Language Spoken
Religion
Parish
Student
Parent/Caregiver
Parent/Caregiver
Male
Female
Male
Female
Male
Female
Yes
No
Yes
No
Yes
No
Australia
Other - Please
complete next page
Australia
Other - Please
complete next page
Australia
Other - Please
complete next page
OCCUPATION
Employer
GENERAL DETAILS As required by the Ministerial Council for Education, Early Childhood Development and Youth Affairs
Group 1
Group 2
Group 1
Group 2
Occupation Type
What is the occupation group of
the parent/caregiver? (see Appendix 1)
Group 3
Not in paid work in last 12 months
Not in paid work in last 12 months
Highest School Level
Year 12 or equivalent
Year 11 or equivalent
Year 10 or equivalent
Year 9 or equivalent or below which includes never attended
Year 12 or equivalent
Year 11 or equivalent
Year 10 or equivalent
Year 9 or equivalent or below
which includes never attended
Bachelor Degree or above
Advanced diploma / Diploma
Certificate I to IV – including
trade certificate
No non-school qualification
Bachelor Degree or above
Advanced diploma / Diploma
Certificate I to IV – including
trade certificate
No non-school qualification
Yes
Yes
What is the highest year of primary
or secondary school the
parent/caregiver has completed?
Highest Qualification
Completed
What is the level of the highest
qualification the parent/caregiver
has completed?
Group 4
Group 3
Group 4
RESIDENTIAL ADDRESS
Street Address
Suburb/Town
State & Postcode
Country
Date moved to address
Does the student reside
at this address?
MAILING ADDRESS
Yes
No
No
No
If not different from Residential write ‘as above’
Post Box/Street
Suburb/Town
State & Postcode
Country
CONTACT DETAILS Indicate best contact order (1 -3) for phone numbers for each person (e.g. call work first 1, then mobile 2 etc)
Home Phone
Mobile Phone
Workplace Phone
Priority Contact Order
Who to contact first (write 1st, 2nd,)
Home Email Address
Workplace Email Address
OTHER INFORMATION
Relationship to Student
Receive Communication?
Yes
No
Yes
No
St Philomena School
61 Koplick Road, Park Ridge 4125
Reg. 1557
Tel: (07) 3802 0088, Fax: (07) 3802 0360
www.stphilomena.qld.edu.au
FAMILY ORIGIN DETAILS
INDIGENOUS STATUS
Is the student of Aboriginal or Torres Strait Islander origin?
( ) No
( ) Aboriginal
( ) Torres Strait Islander
( ) Both Aboriginal an Torres Strait Islander
COUNTRY OF BIRTH
In which country was the student born?
Australia Yes/No
Other (Please specify country) ………………………………………………….
Date of arrival in Australia ……../……../………..
EVIDENCE OF STUDENT’S IMMIGRATION STATUS (To be completed if student is NOT an Australian citizen)
Student Visa Holder: Date of arrival in Australia …./…./…. Date enrolment approved to:…/…./….
Permanent resident:
(
)
Complete passport and visa details section below.
Temporary Visa Holder: (
)
Complete passport and visa details section below.
Other:
)
Complete passport and visa details section below.
(
Passport and visa details (to be completed for a student who is NOT an Australian citizen)
NOTE: A permanent resident will have a passport with a permanent residency visa inside worded
‘Holder (s) permitted to remain in Australia indefinitely’. For students arriving in Australia as refugee or
humanitarian entrants, either PLO 56 immigration issued card or ‘Document to travel to Australia’ with ‘stay
indefinite recorded must be sighted by the school’
Passport number
Passport expiry date
Visa Number
Visa expiry date (if applicable)
_____/______/_____
_____/______/_____
Visa sub class
EVIDENCE OF PARENT 1 IMMIGRATION STATUS (To be completed if the parent is NOT an Australian citizen)
Permanent resident:
( )
Complete passport and visa details section below.
Temporary Visa Holder: ( )
Complete passport and visa details section below.
Other:
Complete passport and visa details section below.
( )
Passport number
Passport expiry date
Visa Number
Visa expiry date (if applicable)
_____/______/_____
_____/______/_____
Visa sub class
EVIDENCE OF PARENT 2 IMMIGRATION STATUS (To be completed if the parent is NOT an Australian citizen)
Permanent resident:
( )
Complete passport and visa details section below.
Temporary Visa Holder: ( )
Complete passport and visa details section below.
Other:
Complete passport and visa details section below.
( )
Passport number
Passport expiry date
Visa Number
Visa expiry date (if applicable)
Visa sub class
_____/______/_____
_____/______/_____
St Philomena School
61 Koplic Road, Park Ridge 4125
Reg. 1557
Tel: (07) 3802 0088, Fax: (07) 3802 0360
www.stphilomena.qld.edu.au
SCHOOL FEES POLICY
Acceptance of a position at Saint Philomena School assumes an ability and willingness
to pay school fees and levies as they fall due. However, no Catholic child will be denied
a place because of a genuine inability of parents or guardians to pay fees. Fees which
remain unpaid after thirty days will become subject to the fee collection procedures
outlined in this policy.
1.
2.
Payment of fees within thirty days of receipt of the School Fees Invoice
contributes to the efficient and sound financial management of the school.
Fees not paid within the thirty day period will become subject to the following
procedures:


After thirty days an Account Statement will be sent advising of a further fourteen
days to pay or make contact with the school principal to discuss a payment plan.
Options for payment will be available including periodic payment, direct
deposit, and if appropriate, school fee concession application.

If no suitable arrangements are made for payment of fees, a final notice will be
sent with a requirement to pay by the end of the invoiced term. This final
notice will advise that any unpaid fees at the end of said term will be sent to a
collection agent.

If by the end of said term, fees remain outstanding or the payment
arrangement has been broken, the account will then be sent to a collection
agent.
3.
Families who find themselves experiencing genuine financial hardship have the
opportunity to apply for a School Fee Concession on the form “Application for
Concessional Fees”. (to be requested from the Administration Office). This may
require:

Evidence of income, tax and housing costs

An appointment with the school principal

A determination of a just and equitable fee within the family’s ability to pay.
4.
A fee concession lasts for that school year only and new arrangements must be
negotiated and documented each year.
Failure to meet your fee obligations under an approved concession arrangement
may result in cancellation of the concession and a return to full-fee billing.
5.
…………………………………...
Signature of Father/Guardian
Date: ……………………………
…………………………………...
Signature of Mother/Guardian
Date: ……………………………
St Philomena School
61 Koplic Road, Park Ridge 4125
Reg. 1557
Tel: (07) 3802 0088, Fax: (07) 3802 0360
www.stphilomena.qld.edu.au
DECLARATION
We/I hereby apply for admission of the child whose details appear overleaf to the School
on the following terms and conditions.
Conditions of Enrolment
1. We/I hereby undertake to be responsible and to pay punctually as they fall due all
fees and expenses properly incurred in accordance with the terms set forth in the
Fees List and we/I acknowledge that we/I are/am liable to pay such fees and
expenses.
2. We/I undertake to give one term’s notice before the removal of our/my son/daughter
or to pay one term’s fees in lieu. In order to be valid and binding such notice must be
in writing signed by us/me and delivered to the Principal.
3. We/I undertake that every effort will be made to ensure that our/my son/daughter will
not be absent from School without leave of absence being granted by the School and
that the term dates, as advertised by the School, will be strictly adhered to. (Students
absent from School without leave having been granted may forfeit any credit for
assessment missed during their absence.)
4. We/I agree to be bound by the terms and conditions as set out in this application and
also agree to cooperate with the School authorities
in all matters of School discipline.
5. Saint Philomena School collects and records personal information, including sensitive
information about students and parents or guardians, before and during the course of a
student’s enrolment at our school. Laws governing or relating to the operation of
schools require that certain information is collected. These may include Public Health
and Child Protection laws. We may ask you to provide medical reports about students
from time to time. Health information about students is sensitive information within the
terms of the National Privacy principles under the Privacy Act (1998).
6. If we do not obtain the personal, sensitive or health information referred to above, we
may not be able to enrol or continue to enrol y our student. By completing and
submitting this application for enrolment form you have confirmed your understanding
of, and agreement with, the above.
…………………………………...
Signature of Father/Guardian
……. ………………………………….
Signature of Mother/Guardian
Date: ……………………………
Date:………………………………
APPENDIX 1 – List of Parental Occupation Groups
Group 1: Senior management in large business organisation, government administration and defence, and
qualified professionals
Senior executive/manager/department head in industry, commerce, media or other large organisation.
Public service manager (Section head or above), regional director, health/education/police/fire services administrator
Other administrator [school principal, faculty head/dean, library/museum/gallery director, research facility director]
Defence Forces Commissioned Officer
Professionals generally have degree or higher qualifications and experience in applying this knowledge to design, develop or
operate complex systems; identify, treat and advise on problems; and teach others.
Health, Education, Law, Social Welfare, Engineering, Science, Computing professional
Business [management consultant, business analyst, accountant, auditor, policy analyst, actuary, valuer]
Air/sea transport [aircraft/ship’s captain/officer/pilot, flight officer, flying instructor, air traffic controller]
Group 2: Other business managers, arts/media/sportspersons and associate professionals
Owner/manager of farm, construction, import/export, wholesale, manufacturing, transport, real estate business
Specialist manager [finance/engineering/production/personnel/industrial relations/sales/marketing]
Financial services manager [bank branch manager, finance/investment/insurance broker, credit/loans officer]
Retail sales/services manager [shop, petrol station, restaurant, club, hotel/motel, cinema, theatre, agency]
Arts/media/sports [musician, actor, dancer, painter, potter, sculptor, journalist, author, media presenter, photographer,
designer, illustrator, proof reader, sportsman/woman, coach, trainer, sports official]
Associate professionals generally have diploma/technical qualifications and support managers and professionals.
Health, Education, Law, Social Welfare, Engineering, Science, Computing technician/associate professional
Business/administration [recruitment/employment/industrial relations/training officer, marketing/advertising specialist,
market research analyst, technical sales representative, retail buyer, office/project manager]
Defence Forces senior Non-Commissioned Officer
Group 3: Tradesmen/women, clerks and skilled office, sales and service staff
Tradesmen/women generally have completed a 4 year Trade Certificate, usually by apprenticeship. All tradesmen/women are
included in this group.
Clerks [bookkeeper, bank/PO clerk, statistical/actuarial clerk, accounting/claims/audit clerk, payroll clerk, recording/registry/filing
clerk, betting clerk, stores/inventory clerk, purchasing/order clerk, freight/transport/shipping clerk, bond clerk,
customs agent, customer services clerk, admissions clerk]
Skilled office, sales and service staff.
Office [secretary, personal assistant, desktop publishing operator, switchboard operator]
Sales [company sales representative, auctioneer, insurance agent/assessor/loss adjuster, market researcher]
Service [aged/disabled/refuge/child care worker, nanny, meter reader, parking inspector, postal worker, courier, travel
agent, tour guide, flight attendant, fitness instructor, casino dealer/supervisor]
Group 4: Machine operators, hospitality staff, assistants, labourers and related workers
Drivers, mobile plant, production/processing machinery and other machinery operators.
Hospitality staff [hotel service supervisor, receptionist, waiter, bar attendant, kitchenhand, porter, housekeeper]
Office assistants, sales assistants and other assistants.
Office [typist, word processing/data entry/business machine operator, receptionist, office assistant]
Sales [sales assistant, motor vehicle/caravan/parts salesperson, checkout operator, cashier, bus/train conductor, ticket
seller, service station attendant, car rental desk staff, street vendor, telemarketer, shelf stacker]
Assistant/aide [trades’ assistant, school/teacher's aide, dental assistant, veterinary nurse, nursing assistant,
museum/gallery attendant, usher, home helper, salon assistant, animal attendant]
Labourers and related workers
Defence Forces ranks below senior NCO not included above
Agriculture, horticulture, forestry, fishing, mining worker [farm overseer, shearer, wool/hide classer, farm hand,
horse trainer, nurseryman, greenkeeper, gardener, tree surgeon, forestry/logging worker, miner, seafarer/fishing
hand]
Other worker [labourer, factory hand, storeman, guard, cleaner, caretaker, laundry worker, trolley collector, car park
attendant, crossing supervisor]
If the person is not currently working
If the person is not currently in paid work but has had a job in the last 12 months or has retired in the last 12 months,
please use the person’s last occupation.
If the person has not been in paid work in the last 12 months, select ‘Not in paid work in last 12 months’.
Appendix 1
St Philomena School
61 Koplick Rd,
Park Ridge QLD 4125
ABN 93 091 023 906
Reg. 1557
Tel.: (07) 3802 0088
Fax: (07) 3802 0360
www.stphilomena.qld.edu.au
Permission for Publication of Likeness.
I ………………………………………………………………….. do/do not authorize St Philomena
School to publish the likeness [photographs or other art form] of my child in any public
manner, be it printed or over the internet, for the purpose of promoting the school. This
is at the condition that the full name of my child is not joined to the picture.
STUDENT NAME
……………………………………………………………………….………………………………………………………..
PARENT SIGNATURE
……………………………………………………
DATE
……………………………………………
St Philomena School
Use of Computers Policy
Updated 8 August, 2014
The use of computers is required by the national curriculum but they are also recognised by St Philomena School
as useful tools in support of the education of our students. The use of computers however, especially with internet
access, has inherent risks to the spiritual and moral welfare of our students. The purpose of this policy is to limit
as much as possible these risks while at the same time giving our students an opportunity to enjoy the help which
technology can give to education.
St Philomena School considers information and computer technology as a tool with a very limited place in
education. It is the School’s philosophy that the vast majority of learning must be done in the classroom,
conformed to the classical approach to education, under the direction of the teacher who will use computers
occasionally as a learning tool. When using computers, teachers and students must follow this policy.
CONDITIONS FOR THE USE OF COMPUTERS AND INTERNET
1. Staff and students will use computers in such a way as to uphold the requirements of the law.
2. Students at school are only permitted to use computers protected by a filtering system and with the physical
presence and active supervision of a teacher.
3. Any use of computers shall be for educational purposes only. The use of computers at school is not for
recreational purposes such as for listening to music, watching movies, or playing games which have no
educational value. It is forbidden to search for, download, look at, or send material that is defamatory,
inaccurate, abusive, rude, obscene, profane, sexually oriented, threatening, harassing, racially offensive,
encourages the use of controlled or illegal substances, or is otherwise not consistent with the policies,
purposes and objectives of St Philomena School. Use of the internet in an offensive manner can result in
criminal prosecution.
4. The School reserves the right to monitor students’ computer usage, and have access to any files a student
may store on a school computer, laptop or USB, or any other data storage device a student brings onto school
premises.
5. The use of email may in certain circumstances be necessary for educational purposes, for example,
communicating with a teacher for a distance education course.
6. Students are expected to respect the privacy and ownership of others’ work at all times. This includes not
plagiarising information they find on the internet and presenting it as their own work, or copying work of other
students, with or without permission, which is held in the students’ computer files.
7. The following are not permitted when using computers and the internet at St Philomena School:
I.
Subscribing to message boards, discussion groups, chat groups, or similar services.
II.
Installing or uninstalling, or attempting to install or uninstall, any software on a school computer.
III.
Changing the setting on a computer without permission.
IV.
Accessing sites with tools, utilities and/or instructions and advice on how to circumvent or disrupt the school
computer system and/or application security.
V.
Distributing private information about other people.
VI.
Accessing sites offering ‘pirated’ access to copyrighted material of any nature - music, video, audio
streaming and documentation.
VII. Using personal external drives such as USB drives.
VIII. Using social media, such as Facebook or Twitter. Failure to comply with this rule will be treated as a
serious breach of school discipline.
Page 1 of 3
RESPONSIBILITY OF STAFF:
•
All staff share supervisory responsibility for students using the computers;
RESPONSIBILITY OF PARENTS:
•
•
Address with their students any additional boundaries as to what they consider acceptable use.
All parents are to sign an Acceptable Use Agreement prior to the student going online
RESPONSIBILITY OF STUDENTS:
•
All students are to sign an Acceptable Use Agreement prior to the student going online and students are
expected to comply with the guidelines for the use of computers and internet at all times.
Page 2 of 3
Acceptable Use Agreement
This section must be completed by the student. (If the student is too young to sign for
themselves, a parent may complete on their behalf, thereby confirming that they have read and
explained the policy to the child).
Before you may use computer facilities at St Philomena School, Park Ridge, you must sign this
agreement which binds you to the “Conditions for the Use of Computers and Internet” as set
out in the School’s Use of Computers Policy. If you break any of the conditions, appropriate
penalties will be applied.
Your Name: .....................................................................................
Year Level: ...................................
I have read the Policy and Guidelines for Acceptable Use of Computers and the Internet and
agree to obey the guidelines and conditions in it and take responsibility for my actions. I
understand that St Philomena School, Park Ridge, shall not be responsible for the
consequences of any misuse of the internet or electronic mail by me.
Signed: .....................................................................................
Student
Date: ......................................
This section must be completed by the parent or legal guardian of the student.
I, .............................................................................................., the parent or guardian
of ...................................................................................., have read and understood the Policy
and Guidelines for Use of Computers and Internet and I agree that my child is permitted to use
St Philomena School’s computers and have internet access and that he/she is aware of the
obligation to observe these guidelines and conditions and to be responsible for acceptable use.
I understand that the school shall not be responsible for the consequences of any misuse by
my child.
Signed: .....................................................................................
Parent/Guardian
Page 3 of 3
Date: …………………………
St Philomena School
Internet Use Agreement
th
Updated 8 August, 2014
Access to the internet and email is a privilege not a right.
This agreement outlines the guidelines for acceptable use and you are therefore accountable for misuse of
facilities.
Any use deemed unacceptable as outlined in this agreement will result in immediate loss of internet and email
privileges while the extent of the infringement is examined and an appropriate response is determined.
All web traffic (including use of email accounts) is logged and will be examined.
AGREEMENT
I hereby agree that while using the internet and email, I will not:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Attempt to retrieve, view or disseminate (give out) any obscene, offensive, pornographic or illegal
material
Threaten or abuse another user
Send offensive, racist or sexist messages
Send anonymous or falsely addressed email
Bring St Philomena School into disrepute in any way whatsoever
Allow anyone else to use my account or give my password to anyone else
Use another student’s account or tamper with another student’s account in any way
Use my account for business purposes or for financial gain
Use my account for political purposes
Tamper with the system in any way, including vandalism
Use email without permission in class time
Use my email account for purposes other than sending or receiving class work from a home address
or sending class work to a teacher
Access any social networking or instant messaging sites unless directed by a teacher for educational
purposes
I also agree that I will:
1.
2.
3.
4.
5.
6.
Page 1 of 2
Use the internet and email solely for educational purposes
Observe any copyright laws, including those that relate to computer software
Respect the rights and privacy of other users
Report any obscene or offensive material that I encounter
Report any vandalism to technology resources
Consent to my use of school computers being monitored by staff of St Philomena School
When accessing social networking sites outside the school, I will not:
1.
2.
3.
Use images of St Philomena School, including logos and images of the grounds or buildings, on any
social networking site
Place photos of students in uniform or school activities on social networking sites at any time
Use the name of any student in a negative or degrading way
I realize that, if I do not abide by the above rules, the following consequences will apply:
st
1 OFFENCE
nd
2 OFFENCE
rd
3 OFFENCE
My internet and email access may be withdrawn
I will be subject to other disciplinary action by Teaching Staff
I will be subject to other disciplinary action as determined by the Principal and
Faculty Heads.
In the event of a serious infringement of the above rules, any member of St Philomena Staff has the right,
irrespective of the number of previous offences, to refer the matter directly to the Principal and Faculty Heads for
rd
addressing as per the 3 Offence guidelines.
I have read the details of the agreement and agree to abide by the rules as outlined above.
This section must be completed by the student. (If the student is too young to sign for
themselves, a parent may complete on their behalf, thereby confirming that they have read and
explained the policy to the child).
Student Name:
___________________________________________________________
Student Signature:
___________________________________________________________
Date:
___________________________
This section must be completed by the parent or legal guardian of the student.
Parent/Guardian Name:
___________________________________________________________
Parent/Guardian Signature:
___________________________________________________________
Date:
Page 2 of 2
___________________________