Section Nine: FORMS AND DOCUMENTSFd
9.1 - 9.5
John Monash Science SchoolOrientation Camp 2021Consent Form
Department of EducationConfidential Medical Form for Camps and Excursions
John Monash Science SchoolOrientation Camp 2021Payment Form
John Monash Science SchoolParent Payment FormYear 10, 2021
John Monash Science SchoolStudent Information Forms
B FormsDUE AT COURSE CONFIRMATION
F1
F2
F3
9.1
9.1
9.1
i
i
i
i
Reference PointFor information that may assist in competing these forms, please refer to Section 3.5 - Orientation Camp
Reference PointFor information that may assist in competing these forms, please refer to Section 4.1 - Schedule of Fees and Payments
Reference PointsFor information that may assist in competing these forms, please refer to: Section 6 - Index of Available SubjectsSection 7 - Curriculum and Pathways
Example Pathways and Templates
Before completing these forms, it is highly recommended that students make use of the example pathways and pathway templates provided in Section 7.5 - Curriculum Pathways to help plan their course of study.
F1
F1
F1
9.2
9.4
9.5John Monash Science School
Parents and Friends Association Mailing List
John Monash Science SchoolRegional Science ExchangeExpression of Interest
iReference PointFor information that may assist in competing these forms, please refer to Section 5 - School Community and Outreach Programs
F1
F2
9.3
9.3
Index of Forms Due at Course Confirmation
John Monash Science School Course Selection – Year 10, 2021
John Monash Science School Music Application– Year 10, 2021
F19.5
F1 John Monash Science SchoolORIENTATION CAMP 2021– CONSENT FORM9.1
Part A Parent/Guardian Consent
I have read the information regarding the Year 10 Orientation Camp, and give my consent for my son/ daughter to attend on the following dates:
Camp commences at 8:30am on Monday 1 February at Farrer Hall, Normanby Road, Monash University. Camp concludes at 3:00pm on Wednesday 3 February 2021at John Monash Science School.
In the event of my son/daughter needing immediate medical treatment, and where it is impracticable to communicate with me, or when delay would seem to the Teacher In Charge to aggravate my son’s/ daughter’s condition, I authorise the Teacher In Charge to arrange for immediate medical treatment.
I undertake to bear the costs involved in the treatment received and to accept the decision of the Teacher In Charge as to the need for medical treatment.
I have read, understood and accept the above rules and procedures.
Student Name:_______________________________________________________________________________________
Student’s Signature: ________________________________________________ Date: ___________________
Parent/Guardian Signature: ________________________________________________ Date:: ___________________
Name of Parent/Guardian: _________________________________________________________________(Please Print)
Home Phone: _________________________________ Mobile Phone: ___________________________
Part B Acceptance of Rules
To ensure a happy camp for everyone, students are expected to behave according to school rules and show respect for others and their property. The rules of the camp are those insisted upon when the University Halls of Residence are made available to schools.
In particular:
• No student may enter the room of members ofthe opposite sex.
• No student is permitted to smoke.
• No alcohol or drugs are permitted.
• Students must be appropriately dressed for allactivities.
• The environment is to be cared for (includes nolittering or damage to property).
• After lights-out students must be quiet toenable others to sleep.
Serious misbehaviour may result in a student being sent home.
BRING THIS COMPLETED FORM TO COURSE CONFIRMATION IN NOVEMBER
Department of Education and TrainingCONFIDENTIAL MEDICAL FORM FOR CAMPS AND EXCURSIONS
This form is intended to assist John Monash Science School in case of any medical emergency with your child. All information is held in confidence.
Signature: _________________________________________________ Date: ________________________________
BRING THIS COMPLETED FORM TO COURSE CONFIRMATION IN NOVEMBER
Child’s Name: _____________________________________________Date of Birth: ________________________________
Parent/Guardian Full Name: ____________________________________________________________________________
Address: ____________________________________________________________________________________________
____________________________________________________________Postcode: _______________________________
Emergency Telephone After Hours: _______________________ Business Hours: ______________________
Mobile: ____________________________
Name and Address of Family Doctor _______________________________________________________________
___________________________________________________________________________________________________
Medicare Number:_____________________________ Ambulance Subscription Number :_______________________
Medical/Hospital Insurance Fund:_______________________________________________________________________
Medical Insurance Account Number: ____________________________________________________________________
What special care is recommended? _____________________________________________________________________
___________________________________________________________________________________________________
_________________________________________________________________________________________________
Tetanus Immunisation
Last Tetanus Immunisation was ________________________
If over 10 years since last immunisation, please tick if booster is to be arranged by parents before the camp.
Tablets and Medicines
Is your child presently taking tablets and/or medicines?
If yes, please state name of medication/dosage/other details
_______________________________________________________________________________________________________________________________________________________________
All medicine must be handed to the Teacher In Charge prior to leaving, with your child’s name, the dose to be taken and when it should be taken. (These will be kept in the first aid centre and distributed as required).
Consent to Medical Attention
I authorise the Teacher-in-Charge of the excursion/tour to consent, where it is impracticable to communicate with me, to the child receiving such medical or surgical treatment as may be deemed necessary.
Please tick if your child suffers from any of the following:
□ Fits of any type □ Heart Condition □ Anaphylaxis
□ Dizzy Spells □ Sleepwalking □ Asthma
□ Blackouts □ Migraine □ Diabetes
Allergies and Dietary Requirements
□ Penicillin □ Any Foods □ Other Drugs
□ Other Allergies
□ Booster Date __________________________________
□ Yes □ No
John Monash Science School Year 10 Orientation Camp Monash University Residential Hall Monday 1 February - Wednesday 3 February 2021
F29.1
John Monash Science SchoolORIENTATION CAMP 2021 – PAYMENT FORM
PAYMENT FOR ORIENTATION CAMP IS DUE BY END OF NOVEMBER
Please place together in an envelope, marked with the student’s name and ‘Orientation Camp’.
Include:
• 9.1-F3 – JMSS Orientation Camp - Payment Form ($300.00 – cheque or credit card details)
• 9.1-F2 – JMSS Orientation Camp - Consent Form
• 9.1-F1 – JMSS Orientation Camp - Medical Form (include any Medical Management Plan)
EFTPOS or CASH payments may be made in person at the Office between 8.30am and 3.30pm
Payment for Student Name: _________________________________________________________________________
Payment Method:
Credit Card Payment
Type of Card Amount: $300.00
Credit Card Number
Expiry Date: ______________________________
Cheque Cash Credit Card
Mastercard Visa
Name of Cardholder: _____________________________________________
Phone Number:_______________________
Signature: _____________________________________________ Date: _______________________________
BRING THIS COMPLETED FORM TO COURSE CONFIRMATION IN NOVEMBER
F39.1
CSEF Funds
John Monash Science SchoolPARENT PAYMENT FORM – YEAR 10 2021
Office Use Only
Less Deposit Paid ($440)
□ I authorise the School to deduct the followingonce-only credit card payment of: $
□ I authorise the School to deduct the followingquarterly credit card payments of: $
The total amount listed in the balance owing will be divided evenly between the four payments and deducted from your credit card during the week commencing the dates indicated below:
Card Number
Name of Cardholder _________________________________________________________
Contact Phone No. ___________________________ Signature _____________________________________
Expiry Date
Payment 1 Payment 2 Payment 3 Payment 4
15 February 2021 10 May 2021 22 July 2021 4 October 2021
□ Mastercard □ Visa
F19.2
Section 1 Essential Learning Items
School diary, ID Card and Handbooks $ 57.00
Monash Sports and Science Facilities $ 185.00
Monash High Speed Internet and Network $ 90.00
Required Online Subscriptions for Learning Platforms $ 73.00
Co-Curricular Program $ 220.00
Whole School Sports Events $ 40.00
Section 1 - Total Payable $ 665.00
Student Surname: _________________________________
Student First Name: _________________________________This form to be returned by Course Confirmation Day. Please return this form to the General Office
Section 2 Optional Items
Locker Hire and Padlock $ 43.00
Photocopier Credit $ 15.00
2021 School Magazine $ 35.00
Subscriptions to Online Learning Programs $ 77.00
JMSS Voice & Instrumental Learning Programs $ ____.00
VET Program (If applicable subject___________________________) $ TBA in 2021
Section 2 - Total Payable $
Section 3B Voluntary School Contributions
Building and Grounds Maintenance $ 145.00
Tax Deductible Building Fund (Suggested donation, you may choose other amount) $ 220.00
Tax Deductible Library Fund (Suggested donation, you may choose other amount) $ 220.00
Parents and Friends Association Membership (PFA) $ 25.00
Section 3B - Total Payable $
Section 3A Voluntary Learning Items
IT Support Program $ 133.00
Subjects Charge $ 420.00
Materials and Services Charge $ 330.00
Support Staff Charge $ 320.00
Section 3A- Total Payable $
Total Payable (SECTION 1+2+3A + 3B) $
CVC
NB: This will be deducted in the week of 8 February 2021 unless otherwise advised
Parents and Friends Association Email List
All parents and guardians are welcome to join the John Monash Science School Parents and Friends Association (PFA).
To receive regular information on PFA activities and keep up with important school events, join our email list by handing in this form at Course Counselling.
iJoin the PFA
To join the Parents and Friends Association, please ensure that you tick item 3B - PFA Membership on the Parent Payment Form - Year 10, 2021 (9.2-F1)
Advantages to joining the PFA
There are many advantages of joining and actively participating in the PFA, including:
• supporting your student’s school environment;• direct connection to school events and
activities;
• better understanding of the JMSS school andeducation system processes throughinteractions with school staff and other parents.
I/we would like to receive email updates from the JMSS Parents and Friends Association:
Parent Name/s:____________________________________________________________________________________
Email Address/es:________________________________________________ Date:____________________________
Home Phone:_________________________________ Mobile Phone:______________________________
Student Name/s:_________________________________ Year Level (2021): _______________________
John Monash Science SchoolPARENTS AND FRIENDS ASSOCIATION (PFA)MAILING LIST
BRING THIS COMPLETED FORM TO COURSE CONFIRMATION IN NOVEMBER
F19.3
John Monash Science SchoolREGIONAL SCIENCE EXCHANGE:HOMESTAY EXPRESSION OF INTEREST FORM
Regional Science Exchange Program
Each year John Monash Science School (JMSS) coordinates the Regional Science Exchange – a one-of-a-kind, immersive educational experience for students in regional Victoria.
Held early in Terms 2 and 3, the exchange program invites talented Year 10 students from across the state, with a passion for science, to attend and experience teaching and learning at JMSS for a three-week block.
To offer this valuable program, John Monash Science School relies heavily on the participation of parents and families, who are willing to accommodate the visiting students as part of a homestay arrangement for the duration of their time participating in the exchange program.
Homestay families host students for a three week period, providing a place for students to stay, as well as a connection to regular family life including meal times, getting to/from school and opportunities to experience Melbourne more broadly.
To assist with costs, homestay families receive a weekly financial contribution from JMSS to help cover the living expenses of each student.
Families who are interested in supporting John Monash Science School by participating in homestay arrangements as part of the Regional Science Exchange program are encouraged to complete the form below and return it at Course Confirmation.
I/We would be willing to host a regional student in our home as part of the Regional Science Exchange in 2021
I/We would be able to host:
1 x Student
2 x Students
3 x Students
More than 3 x Students
I/We would prefer to host students in
Term 2: Sunday 2 May to Friday 21 May 2021*
Term 3: Sunday 18 July to Friday 6 August 2021*
Either Term 2 or Term 3
Both Term 2 and Term 3
Family Name:____________________________________________________________________________________
Parents Name/s:____________________________________________________________________________________
Email Address:_____________________________________________________________________________________
Home Phone: _________________________________ Mobile Phone: ____________________________
Student Name/s: _________________________________ Year Level (2021): ________________________
iFurther Information
For further information on the Regional Science Exchange Program, please contact:
Ms. Erin Hayley [email protected]
BRING THIS COMPLETED FORM TO COURSE CONFIRMATION IN NOVEMBER
F29.3
* Dates correct at time of printing.
John Monash Science SchoolCOURSE SELECTION – YEAR 10, 2021
BRING THIS COMPLETED FORM TO COURSE CONFIRMATION IN NOVEMBER
In 2021 all students will study: English, Mathematics, Core Science, Data Science, Issues Studies, and Enrichment STEM Electives. Students will also study Physical Education unless they wish to study French or Japanese. Students choosing French or Japanese must have completed Year 9 French or Japanese at their previous school. If you choose French or Japanese, you need to complete one semester of Physical Education for Co-Curricular. We endeavor to give students their first preference, but be aware this is not always possible.
Please research your choices carefully because the opportunity to change later is very limited.
PE/LOTE Choose One
Physical Education
French
Japanese
Data Science Choose One
OneIntroduction to Games Programming
Introduction to programming, Machine Learning and Simulations
English Choose One
English
English as an Alternative Language (EAL)
Mathematics Choose One
Core Mathematics
VCE Mathematical Methods 1 + 2
Category 1 Choose 3 – Rank 1 to 3 in order of preference
STEM Electives – Category One Students must choose one elective from Category One to complete at Year 10 level.
7.7A Analytical Spectroscopy
7.7B Aquatic Fieldwork Science
7.7D Biotechnology
7.7H Microbiology
7.7J Disease, Disorders & Scientific Discovery
7.7K Pharmaceutical Science
Enrichment STEM Electives
Category 2 Choose 3 – Rank 1 to 3 in order of preference
STEM Electives – Category Two Students must choose one elective from Category Two to complete at Year 10 level.
7.7C Astrophysics
7.7F FLEET Science
7.7E Materials Science & Engineering
7.7G Medical Physics
7.7I Nature & Beauty of Mathematics
7.7L Terraforming Mars
Category 3 Choose 3 – Rank 1 to 3 in order of preference
STEM Electives – Category Three Students must choose an additional STEM elective to complete at Year 10 level. Students may choose any elective from Category 1 or Category 2, or from the additional electives listed in Category 3.
7.7A Analytical Spectroscopy
7.7B Aquatic Fieldwork Science
7.7C Astrophysics
7.7D Biotechnology
7.7F FLEET Science
7.7E Materials Science & Engineering
7.7G Medical Physics
7.7H Microbiology
7.7I Nature & Beauty of Mathematics
7.7J Disease, Disorders & Scientific Discovery
7.7K Pharmaceutical Science
7.7L Terraforming Mars
Student Name: _____________________________________________________ Date of Birth
Course Selections
F19.4
Do you intend to apply at the end of Term1 for entry into Advanced Chemistry or VCE Physics. (Select 1 only)
Advanced Chemistry
VCE Physics• Please note. The number of each elective class that runs will
depend on the number of enrolments and staffing
Semester One (S1) Semester Two (S2)
English
Mathematics
Science
Semester One (S1) Semester Two (S2)
Subject Selection Guidelines - Year One
Physical Education or LOTE
Students may take either PEor French or Japanese.
Data Science
Students must complete one semester of Data Science, as an Enrichment STEM Elective at Year 10 Level.
Pre requisites for Advanced Chemistry
Students must have completed Analytical Spectroscopy
or Pharmaceutical Science in Semester 1.
Enrichment STEM Electives
Students must complete three Enrichment STEM Electives at Year 10 Level, with a maximum of two (2) to be taken in a single semester.
When selecting Enrichment STEM Electives, student must ensure that they take one elective from each category (1, 2 and 3).
Additional Guidelines for selection of Enrichment STEM Electives can be found in Table 7.7-T1 Subject Selection: STEM Elective Subjects on page 59.
Languages Other Than English (LOTE)
Beyond 2020 – Curriculum Pathway
All LOTE (Languages Other Than English) studies at JMSS other than French and Japanese will be taken as part of the Year 10 Co-curricular program in 2020. If you are studying French or Japanese you cannot choose an additional LOTE in Co-curricular time. Please tell us if you are studying any languages either during school time or outside school.
Do you intend to study a LOTE subject at JMSS in 2020?
□ Yes If yes, please write language/level:
□ No
Do you intend to study a LOTE subject at another provider outside of JMSS in 2020?
□ Yes If yes, please write language/level/provider:
□ No
PE or LOTE
Semester One (S1) Semester Two (S2)
English 6.1 English English
Mathematics
Science 6.4 Core Science Core Science
Issues Studies 6.2 Issues Studies Issues Studies
Enrichment STEM Electives
Data Science
Student’s Signature:________________________________________________Date: _______________________
Parent/Guardian Signature: ________________________________________________
Year Two Year Three
Year One
VOICE AND INSTRUMENTAL MUSIC
2021 ENROLMENT APPLICATION To be returned during Course Confirma�on
Student First Name: ___________________________________
Student Family Name: ___________________________________
2021 Year Level: _______
Instrument: ___________________________________
Cost for Lessons – Full Year
Individual ½ hour $ 995-00
Individual ¾ hour $1,490-00
Individual 1 hour $1,990-00 NB Only available for students who are studying VCE Music units
Ensemble only $ 52-00 For students not taking Instrumental Music lessons at JMSS but wish to par�cipate in the Ensemble Program
JMSS Instrumental Music Department has an expecta�on that the student will con�nue with lessons, once they have commenced, for the year. This allows the Music Department to fulfil our commitment to our highly qualified instrumental staff whose services have been engaged for the year. Due to staffing commitments, there is no refund for early withdrawal .
I agree to the terms and condi�ons of enrolment in the JMSS Voice and Instrumental Music Program:
Student Signature: ______________________________________
Parent Signature: ______________________________________
Parent Name: ______________________________________
Date: _____ / _____ / 20___
-----------------------------------------------------------------------------------------------------------------------------------------
2021 Voice and Instrumental Music Program - Payment Method
Payment by: Cash Cheque Credit Card (details below)
CREDIT CARD DETAILS Mastercard Visa Total Amount: $ __________-00
Credit Card Number Expiry Date CVC
Authorisa�on is given for the deduc�on nominated above, to be processed against the above credit card account.
One off payment NB This payment will occur on 10 Feb 2021 unless otherwise agreed with JMSS General Office.
Four Instalments (added to my Fee Payment Plan on school charges sheet. No need to include card details here)
Card Holders Name: _______________________________________________
Day�me contact phone number: _____________________________________
Signature: ________________________________________________________ Date: ___ / ____ / 20___
F19.5
Semester One (S1) Semester Two (S2)
John Monash Science SchoolSTUDENT INFORMATION FORM
BRING THIS COMPLETED FORM TO COURSE CONFIRMATION IN NOVEMBER
Student Name: ________________________________________________________________________________
The intention of this form is to help us get to know your child and ensure their smooth transition into this school. Equipped
with this knowledge, we are best able to enhance the opportunities we provide to your child, and support our teachers to
deliver programs to best suit their needs.
In the past, has your child experienced difficulty with any of the following areas and/or may benefit from additional support from John Monash Science School:
Social Issues/Making new friends
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Attendance/Punctuality
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Time Management
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Organisational Skills
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Stress/Anxiety and other mental health concerns
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Approximate Distance from Home to School
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Time taken for travelling to and from school
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Health Issues
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
F19.5
Previous School: ________________________________________________________________________________
Please detail, where relevant, any testing / assessment relative to your child’s learning capacity that they have undergone. Please attach a copy of the relevant documentation, where appropriate.
___________________________________________________________________________________________________
_______________ ____________________________________________________________________________________
______________________________ _____________________________________________________________________
___________________________________________ ________________________________________________________
If there is any confidential information that you would like to make known, but would prefer not to include on this form,
please write to :
Ms. Sally Cheah-JohnsonAssistant Principal – Student Empowerment, Wellbeing and Achievement
03 9905 [email protected]
What is your mode of transport to and from school?:
___________________________________________________________________________________________________
_______________ ____________________________________________________________________________________
___________________________________________________________________________________________________
_______________________________________ ____________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________
Comments and any additional information that will help to facilitate your child’s smooth transition to John Monash Science School:
___________________________________________________________________________________________________
_______________ ____________________________________________________________________________________
___________________________________________________________________________________________________
_______________________________________ ____________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________
Any further comments?.
___________________________________________________________________________________________________
_______________ ____________________________________________________________________________________
______________________________ _____________________________________________________________________
___________________________________________ ________________________________________________________
___________________________________________________________________________________________________
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