Please fill out all of the fields below and press the SUBMIT button at the end. We will get in contact with you shortly.

Student's Full Name *
Student's Full Name
Proposed Commencement Date
Proposed Commencement Date
Boarding *
Student details
Gender
Date of Birth
Date of Birth
Cultural Identity
Please select all that apply.
Language
Please select all that apply.
Specify here is you selected "Other" above.
Has the student attended Djarragun College previously?
Birth parent details - Mother
Full Name *
Full Name
Date of Birth *
Date of Birth
Living With Student
Home Address
Home Address
Postal Address
Postal Address
Home Phone
Home Phone
Mobile Phone
Mobile Phone
Work Phone
Work Phone
Birth parent details - Father
Full Name *
Full Name
Date of Birth *
Date of Birth
Living With Student
Home Address
Home Address
Postal Address
Postal Address
Home Phone
Home Phone
Mobile Phone
Mobile Phone
Work Phone
Work Phone
Guardian
Is the guardian the same as the parents above? *
If you select "Yes" skip this section.
Full Name
Full Name
Date of Birth
Date of Birth
Living With Student
Home Address
Home Address
Postal Address
Postal Address
Home Phone
Home Phone
Mobile Phone
Mobile Phone
Work Phone
Work Phone
Emergency contact 1 (must be different from parent or guardian)
Full Name
Full Name
Home Phone
Home Phone
Mobile Phone
Mobile Phone
Work Phone
Work Phone
Home Address
Home Address