Fill and Sign the Furniture Quotation Format in Word

The Kooralbyn International School Ogilvie Place, Kooralbyn, QLD 4285, Australia Telephone :: (07) 5544 5500 Fax :: (07) 5544 6108 Kooralbyn Campus Incorporated ABN :: 22 449 947 887 Email :: admissions@tkis.qld.edu.au BOARDER - DIETARY & OTHER NEEDS FORM FORM B2 OFFICE USE ONLY See also APPLICATION FOR ENROLMENT OF A NEW STUDENT (FORM A1) MEDICAL INFORMATION ADVICE (FORM A2) APPLICATION FOR BOARDING (FORM B1) APPLICATION FOR MASTERY PROGRAMS (FORM M1) STUDENT ID :: CLIENT ID :: NOTE :: If you have not already submitted a FORM A1 (Application for Enrolment of a New Student) and/or FORM A2 (Medical Information Advice), and/or FORM B1 (Application For Boarding) please complete and attach FORMS A1, A2 and B1 together with this application. Student Name: Date Of Birth: .........../............/......................... The school's catering staff try to provide appetising, nutritious meals for all boarders. We acknowledge however that everyone is an individual and we attempt to accommodate any special dietary needs. Please indicate by ticking YES or NO to the following and providing any relevant details : Is the above named student.... Details Diabetic NO YES Vegetarian NO YES Lactose intolerant NO YES Peanut allergic NO YES Wheat allergic NO YES Dairy allergic NO YES Seafood allergic NO YES Are any learning or behavioural problems likely to arise due to consumption of certain foods? NO YES Is there anything else we should know regarding dietary needs? Eg: Certain food restrictions due to Religious or Cultural beliefs etc. NO YES Form B2 :: Boarding - Dietary & Other Needs Form :: Page 1 of 2 OTHER IMPORTANT INFORMATION: (Please make sure you have completed and submitted the separate FORM A2 (Medical Information Advice) Does this student suffer from any medical conditions such as depression / anxiety, sleep disorders, bed wetting etc? NO YES Are there any television shows screened before 8:30 PM in Brisbane/Gold Coast that you forbid this student to watch? NO YES Are there any television shows screened before 8:30 PM that you encourage this student to watch? NO YES Are you aware of any social problems or disorders that this student experiences, (e.g. Shyness, Anger Management, etc)? NO YES PERMISSION DENIED : Throughout the year, the school attempts to provide a wide range of supervised weekend activities for Boarders. Please tick the boxes to indicate any activities you do NOT want this student to participate in... NO Theme Park Trips NO Swimming NO Sailing NO Golf NO Hang Gliding NO Flying NO Shooting NO Tennis NO Sky Diving NO Horse Riding NO Archery NO Rowing NO Scuba Diving NO Camping NO Boating/Fishing NO Defensive Driving NO Snorkeling NO Mountain Climbing NO Shopping Trips NO Theatre/Movies Is there anything else we should know? NO YES I/We declare the above information to be true to the best of my/our knowledge and that any necessary Medical Information will be provided (or has been provided) on FORM A2 (Medical Information Advice). Signature of parents/carers/guardians :................................................................................................. Date ; ......../........./............. ................................................................................................. Date ; ......../........./............. Please return this form with RECENT PHOTOGRAPH (new boarders only) and FORM B1 to : The Kooralbyn International School (TKIS) Ogilvie Place, Kooralbyn QLD 4285 Phone : +61 7 5544 5500 Fax : +61 7 5544 6108 Email : admissions@tkis.qld.edu.au Form B2 :: Boarding - Dietary & Other Needs Form :: Page 2 of 2