Update family details

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Complete the form below if your family contact details have changed since enrolling at our school.

Please complete a change form for each parent/carer as required.

The Department of Education through Victoria Park State School is collecting personal information in accordance with Education (General Provisions) Act 2006 in order to maintain student family contact records. The information will only be accessed by Department of Education. The information will not be given to any other person or agency unless consent is provided.

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Parent/guardian surname *

Parent guardian given name *

Gender *

Female

Male

Address *

Mobile *

Email *

Occupation *

Work location

Work phone number

Student surname *

Student given name *

Student preferred name

Student gender *

Female

Male

Has your student been immunised

First emergency contact name

First emergency contact relationsip

First emergency contact mobile

Second emergency contact name

Second emergency contact relationship

Second emergency contact mobile

Custody details (if applicable)

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Last reviewed 29 October 2021

Last updated 29 October 2021