Copy Enrolment Record Request Form

Copy Enrolment Record Request Form Version 1.0. Last reviewed Oct 2021.

Parent/Carer to complete

Current Service Name:

Children's Names:

Parent/Carer Consent. Check the box and sign below:

YES, I give consent for the online Xplor enrolment records/profile for my child/ren listed above to be copied from the above current service to the new service listed below.

I acknowledge by signing below:

This will only copy the current enrolment information stored electronically in Xplor, and if the information is not up to date, it is my responsibility to ensure the updated information is provided to the service.

I will be required to approve a new Complying Written Arrangement and confirm the enrolment in MyGov, set up new payment direct debit details at the new service, as the enrolment at the new service will be separate from the enrolment at the current service.

I will continue to abide by all policies and procedures in relation to enrolment at the new service.

New Service Name:

Please select the name of the new service you would like your children to attend.

Parent/Carer Details:

Parent/Carer Name:

First

Last

Parent/Carer Email:

Parent/Carer Signature – please sign with mouse or finger

Clear Signature

Date