Student Needs Profile
Our school offers a broad range of curricular and extra-curricular activities. Many of these activities necessarily challenge the students and, on occasion, any student with a disability may require special facilities or consideration in the student’s own best interests. For these reasons, it is imperative that the school is made aware of your child’s needs so that all appropriate measures can be taken for the welfare and benefit of the student.
| Child's Name | ||||||||||||||
| Year Level | ||||||||||||||
| Has your child ever received Learning Support / Special Aide Assistance? |
Yes |
No |
||||||||||||
| If yes, how many hours per day? | ||||||||||||||
| How many hours per week? | ||||||||||||||
| Has your child ever been ‘Ascertained’ or Assessed? |
Yes |
No |
||||||||||||
| If yes, please state level: | ||||||||||||||
| Has your child repeated a year? |
Yes |
No |
||||||||||||
| Has your child ever accelerated a year? |
Yes |
No |
||||||||||||
| Does your child have a disability that affects their learning? |
Yes |
No |
||||||||||||
| If yes, please identify what type of disability: |
|
|||||||||||||
| If your child has one of the above disabilities how does it impact on him/her as a learner? | ||||||||||||||
| Has a specialist ever assessed your child for development, learning or behavioural problems? | Yes | No | ||||||||||||
| If yes, please specify: |
|
|||||||||||||
| Do you have a report/s from the above specialist/s? If yes, please attach copies of reports to this application. |
Yes | No | ||||||||||||
| Does your child have any social difficulties with other children? | Yes | No | ||||||||||||
| If yes, please specify: | ||||||||||||||
| Has behaviour management ever been an issue with your child in the school setting? | Yes | No | ||||||||||||
| If yes, please specify: | ||||||||||||||
I/We authorise you to contact the previous schools listed if necessary.
I/We warrant the truth and accuracy of the above information.
___________________________________
Mother/Guardian's Signature
__________________
Date
___________________________________
Father/Guardian's Signature
__________________
Date