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2019 Newman Selective Gifted Education
Application Form
General Instructions:
❏ Please complete all sections of the application form.
❏ If available, please attach copies of up to 3 pieces of evidence to support your child’s application into the Newman Selective class (see examples listed on page 3)
❏ Return this form to the Newman Selective Secondary school your child is enrolled in by the 31st October, 2017.
YEAR/GRADE APPLIED FOR
STUDENT DETAILS
Student’s family name
Student’s given/first name
Date of birth Day Month Year
Gender ❏ Female ❏ Male ❏ Other
The student’s current academic year Year/Grade:
Student’s current school
Parent/Caregiver 1 name
Parent/Caregiver 2 name
Postal Address
Suburb Postcode
Home Phone Mobile (1)
Work Phone Mobile (2)
Email address Parent /Caregiver 1
Email address Parent /Caregiver 2
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STUDENT BACKGROUND
Is your child an Aboriginal and/or Torres Strait Islander student? ❏ Yes ❏ No
Has your child used the English language in school for less than 4 years?
❏ Yes ❏ No
If ‘yes’ to the question above, what month and year did your child start using English in school work?
Month Year
DIVERSE LEARNING NEEDS
Does your child have any known or suspected exceptionalities, disabilities, complex social and emotional needs or other needs?
❏ Yes ❏ No
If Yes, please specify:
If your child requires adjustments, please indicate the most relevant adjustments that will be required for your child when sitting the Newman Selective School Test.
❏ Large print ❏ FM transmission ❏ Coloured paper ❏ Separate seating / front of the room ❏ Other
If you selected ‘Other’, please specify;
OFFICE USE ONLY: Documentation verified by school delegate
NAME:
❏ Yes
❏ No
Date
PARENT’S / CAREGIVER’S DECLARATION
❏ I/We declare that, to the best of my/our knowledge, the information I/we have provided in this application form is accurate.
❏ I/We understand that, while our child is enrolled in a Newman Selective Gifted Education Secondary school, it does not guarantee our child a placement in the Newman Selective class.
❏ (If applicable) I/We have attached to this form copies of up to 3 piece of evidence to support our child’s application into the Newman Selective class.
Signature Parent/Caregiver 1
Date
Signature Parent/Caregiver 2
Date
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PORTFOLIO EVIDENCE:
Examples of SUITABLE evidence Examples of what NOT to submit as evidence
Copy of:
➢ Ê School Report showing Grade or
Subject Acceleration Eg: Year 4 student who is enrolled in Year 6 or
Year 4 student completing Yr5-6 work
➢ Ê IQ Assessment Report Eg: WISC IV, WISC V, Stanford-Binet
➢ Ê University competition achievement Eg: UNSW International Competitions and
Assessments for Schools (ICAS)
➢ Ê Other educational institution achievement
Eg: Maths Olympiad, Young Scientist of the Year
➢ Ê Participation in external extension programs
Eg: UNSW Scientia Program, UOW Early
Learning
Labs, Tournament of Minds
➢ Ê Government Challenges achievement Eg: Premier’s Reading Challenge, Debating
Challenge, National History Challenge
➢ Ê Student work sample evidencing high ability in any key learning area. This work sample must be marked/annotated by the class teacher Eg: Piece of writing, problem-solving task
➢ Ê Diagnostic test results (If child has come from a school outside
of Sydney Catholic Schools ) Eg: Raven’s Progressive Matrices, PAT Reading, PAT Math
➢ Ü Any original documentation
➢ Ü Audio-visual material
➢ Ü Thumbdrives / external hard drives
➢ Ü 3D structures / models / frames
➢ Ü Trophies / medals
➢ Ü Original photos
➢ Ü Work samples not marked or annotated by a teacher
● Please note, copies of evidence must be included with the application on submission. ● All copies of evidence will be placed in the student’s school file after the application process.
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