Contact Details A Contact Details: B Contact Details: Can we contact Adult A at work? Yes No Can we contact B at work? Yes No Work Telephone: Work Telephone No: Other Work Contact Other Work Contact information: information: Is Is Adult A usually home AFTER Adult B usually home AFTER Yes No Yes No business hours? (tick) business hours? (tick) Home Telephone: Home Telephone No: Mobile: Mobile: Email address: Email address: Primary Family Details Parent Step-Parent Adoptive Parent Relationship of Adult A to Student: (tick one) Foster Parent Host Family Relative Friend Self Other Parent Step-Parent Adoptive Parent Relationship of Adult B to Student: (tick one) Foster Parent Host Family Relative Friend Self The student lives with the Primary Family: Always Mostly Balanced Occasionally Never Send Correspondence addressed to: (tick one) Adult A Adult B Both Adults Neither Emergency Contacts (NOT the Name Relationship Telephone Contact (Neighbour, Relative, Friend or 1 2 3
Contact Details A Contact Details: Can we contact Adult A at work? Yes No Work Telephone: Other Work Contact information: Is Adult A usually home AFTER business hours? (tick) Yes No Home Telephone: Mobile: Email address: B Contact Details: Can we contact B at work? Yes No Work Telephone No: Other Work Contact information: Is Adult B usually home AFTER business hours? (tick) Yes No Home Telephone No: Mobile: Email address: Primary Family Details Relationship of Adult A to Student: (tick one) Parent Step-Parent Adoptive Parent Foster Parent Host Family Relative Friend Self Other Relationship of Adult B to Student: (tick one) Parent Step-Parent Adoptive Parent Foster Parent Host Family Relative Friend Self The student lives with the Primary Family: Always Mostly Balanced Occasionally Never Send Correspondence addressed to: (tick one) Adult A Adult B Both Adults Neither Emergency Contacts (NOT the Name Relationship Telephone Contact (Neighbour, Relative, Friend or 1 2 3
2018_Enrolment-Form.docx