THE SWT SHP for intellectual excellence Director Ros Wolfers Building C, 8 Columbia Way Norwest Business Park Baulkham Hills 2153 Ph: (02) 9634-2000 Fax: (02) 9634-2842 Email: [email protected] ABN 31 050 562 902 Principal Anne Hodgkins APPLICATION FOR ENTRY TESTING I have read The Swot Shop brochure or visited the website and understand that:  The Swot Shop provides extension and enrichment programmes for students with academic potential  many students who are assessed are not offered enrolment  the results of the test will be valid for enrolment for the next three months  students can only sit another assessment after a period of 12 months  late students or students without a confirmation/receipt cannot be admitted to the examination  parents will be provided with raw test scores for their child but decisions relating to admission to programmes rest totally with the Principal and Director  the examination papers cannot be released or shown to parents  successful students may still be required to spend time on a waiting list until a position on a specific day becomes available.  applications must be received by us at least five days before the test date and will be processed subject to vacancies.  this assessment is not relevant for entry to the OC or Selective/Scholarship programmes Please choose the preferred date and time for your child’s assessment. The following test dates/times are for students seeking to commence programmes during Term 1, 2015  Sunday 7th December 2014 2:00pm – 3:30pm (for those in Grade 2 in 2015)  Sunday 7th December 2014  Sunday 14th December 2014 4:00pm – 5:30pm (for those in Grades 2 – 10 in 2015) 4:00pm – 5:30pm (for those in Grades 2 – 10 in 2015) I submit the non-refundable fee of $30.00 (cash, cheque or credit card) to cover the cost of the assessment. Parent’s signature: ___________________________________ Date: __________________  yes  no Has the student attempted an entry test in the last 12 months?  yes Is the student currently enrolled at Swot Shop?  no FOR CREDIT CARD PAYMENT (Visa and Mastercard only) Office use: Card No:__ __ __ __ / __ __ __ __ / __ __ __ __ / __ __ __ __ ca/cc/cq _____________ Amount: $30 Expiry Date: __ __ / __ __ Date: ______________ Card Holder’s Name: ____________________________________________ Conf: ______________ Card Holder’s Signature: __________________________________________ Comp: ______________ Child’s Name: __________________________________________________ PLEASE ENSURE BOTH PAGES ARE RETURNED TO US. STUDENT INFORMATION SURNAME:__________________________ FIRST NAME: ________________________ DATE OF BIRTH: _______________________ GENDER: male/female POSTAL ADDRESS: ______________________________________________________________ SUBURB:___________________________________________ POSTCODE: ________________ Home Address (if different) _________________________________________________________ HOME PHONE: ____________________ WORK PHONE(for emergencies): _______________ Mum’s Mobile: ____________________ Dad’s mobile _________________________ SCHOOL: ___________________________________________ 2014 SCHOOL GRADE: ______ 2015 SCHOOL GRADE: ______ Email address – (see Privacy Policy) _____________________________________________________________ ANY DISABILITIES OR HEALTH ISSUES (the teacher should know about): ______________________________________________________________________ ______________________________________________________________________ THE SWOT SHOP PRIVACY POLICY The Swot Shop will collect, manage, use and disclose personal information only in accordance with all relevant legislation and standards.    The information provided will never be given or sold to a third party with the exception of details of students competing in competitions organized by The Australian Maths Trust who are furnished with names and birth dates only. We will never contact a child’s school or disclose any information about a child to the school (unless requested by you). Email addresses will not be used to send general information or advertising. If you have submitted a query, or we have had trouble catching you at home on the phone, then the use of email seems efficient and sensible. PLEASE ENSURE BOTH PAGES ARE RETURNED TO US.