INSTRUCTIONS
This form is to be read in conjunction with the Guide to the minimum standards and other requirements for
school registration.
Complete this form if you are applying to register a new campus for the 2016 school year.
This document is an electronic form. You can fill it out and save it as with any Microsoft Word document.
Some text in the document is locked and cannot be altered. Areas shaded in grey indicate where you can
enter text or select a check box. You can practise using the examples below.
Free text field
Tick box
About this application
Part A
School information
Part B
SECTION 1
Information to be forwarded by all schools
SECTION 2
Information to be forwarded for any listed item if it varies from the current
registration details of the school
SECTION 3
Information to be forwarded if the campus proposes to offer a senior
secondary qualification, e.g. the VCE, VCAL or the International
Baccalaureate (IB) Diploma.
Note:
This section does not apply to schools already accepted by the VCAA to offer the VCE or VCAL before 1 July
2007, or by the International Baccalaureate (IB) to offer the IB Diploma before 1 July 2007.
Part C
SECTION 1
Declarations
To be signed by all schools
SECTION 2
Declarations
To be signed by schools offering a senior secondary
qualification
Appendix 1
Attestation of school’s not-for-profit status
Closing dates
The application must be received by the VRQA no later than close of business on the following dates:
31 March 2015
30 June 2015
Acceptance of Application
The VRQA will only accept applications that have all required evidence, are well organised and include the
Evidence Checklist.
Incomplete applications that do not have all required evidence are not well organised and do not include the
Evidence Checklist will not be accepted by the VRQA and will be returned to the school without being
assessed.
Payment of the application fee
The VRQA will acknowledge completed applications via an electronic invoice for the amount payable. This
must be paid in full before your application will be assessed.
The fees can be paid online by credit card (Mastercard or Visa), BPAY or by Postbillpay. To pay the fees
online, follow the instructions found on your invoice.
The VRQA cannot assess your application until the fee is paid and your application cannot be considered
valid until this is paid.
Notes
1
Schools are required to inform the VRQA of any change to the particulars or information
(including accompanying documentation) provided in the application for registration within
14 days of the relevant change.
2
An application for registration will not be assessed if there are outstanding compliance issues.
3
The VRQA works in cooperation with the VCAA when assessing applications for registration to deliver
the VCE and/or VCAL.
Multiple registrations
Schools seeking registration as a registered training organisation (RTO) and/or to deliver courses to
full fee-paying overseas students in addition to school registration need to seek further advice from the
VRQA’s Quality Assurance Schools Unit.
Commencement of operation
Under the Education and Training Reform Act 2006 a new campus must not commence operation unless
it has been registered by the VRQA.
PRIVACY DISCLAIMER
All information collected in this application is required by State or Commonwealth legislation and associated
regulatory frameworks. Some information will be made available on the State Register. The Victorian
Registration and Qualifications Authority may share information about this application and your organisation
with other relevant agencies in accordance with the provisions of the Education and Training Reform Act
2006. All other information will be kept secure and confidential.
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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PART A – SCHOOL INFORMATION
A.1 School details Please complete
Name of school
Street address, including any campuses
Postcode
Postal address
(if different from
above)
Postcode
Phone
Fax
Email
Email address for
invoices
Legal Entity Name1
Legal entity type
Incorporated association
Unincorporated association
Company limited by guarantee
Company limited by shares
Co-operative
Other
1
Please note that invoices will be addressed to this name
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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A.2 Details of new campus
Please note the name provided below will be the registered name of this campus. Please ensure that the
name is accurate.
Name of new campus
Street address, including any campuses
Postcode
Postal address
(if different from
above)
Postcode
Phone
Fax
Email
A.3 New campus principal details (if applicable)
Full name of campus principal
Postal address
Postcode
Phone
Mobile
Fax
Email
A.4 Details of any governing body of the campus that reports to the
governing body of the school or the chair of any sub-committee
of the governing body that governs the campus
Full name
Postal address
Postcode
Phone
Mobile
Fax
Email
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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A.5 Details of the contact person for this application
Full name of contact person
Postal address
Postcode
Phone
Mobile
Fax
Email
A.6 Proposed type of new campus (tick as appropriate)
Primary
Secondary
Co-educational
Single sex
Boys
Girls
Specific purpose*
Specialist*
*Refer to the Guide page 3 for definitions.
A.7 Proposed date of commencement of new campus
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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A.8 The age range and number of students to be enrolled in the campus at
the year levels for which the school is seeking registration
Note: If this information is not available at the time of the application, details must be provided by the
school when they are known or before the school commences operation at the latest.
Year level
Age range
No. of students
eg Year 7
eg age 11 – 13.5 years
eg 17 students
Total no. students:
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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A.9 Senior Secondary: Units of Study at Year 10
If applying to add Year 10 in 2016, are you proposing to offer any Units of Study/Subjects at Senior
Secondary level, i.e. VCE, VCAL?
Yes
No
N/A
Tick as appropriate.
It is my intention to offer only a limited number of Senior Secondary Units of Study/Subjects at Year 10 in
2016 and not to amend my registration to offer Year 11 in 2017 and Year 12 in 2018 to deliver a full Senior
Secondary Qualification.
Please indicate the number of Units of Study/Subjects to be delivered in 2016:
It is my intention to amend my registration to deliver a full Senior Secondary Qualification at Year 11 and
Year 12 in 2017 and 2018.
Please indicate the number of Units of Study/Subjects to be delivered in 2016:
A.10 Existing registrations held by the school with the VRQA
RTO (TOId
)
Yes
No
Yes
No
Senior Secondary Provider – VCE
Yes
No
Senior Secondary Provider – VCAL
Yes
No
Senior Secondary Provider– IB Diploma
Yes
No
CRICOS Provider (No
)
A.11 Other registrations the school is currently seeking with the VRQA
RTO
Yes
No
CRICOS Provider
Yes
No
Senior Secondary Provider
Yes
No
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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A.12 Premises
The new premises are:
Owned
Rented
Length of lease
Name of landlord
Is there a relationship
between the school and
the landlord (other than
the lease agreement)?
No
Yes (please specify)
A.13 Previous amendments to registration (tick as appropriate)
The school has:
amended their registration since 1 July 2007
not amended their registration since 1 July 2007
Office use only:
RTO: VRQA regulated
Yes
No
Checked
RTO: ASQA regulated
Yes
No
Checked
CRICOS Provider
Yes
No
Checked
Senior Secondary Provider
Yes
No
Checked
Office sign-off:
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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PART B – INFORMATION TO BE FORWARDED WITH APPLICATION
Schools are required to forward documentation that provides evidence that they meet the minimum
standards to amend registration to include an additional campus.
Schools are advised to read the Guide to the minimum standards and other requirements for school
registration. This Guide is designed to provide advice on the documentation that is required with this
application to meet the standards and requirements for registration. Listed below, are the items and evidence
which are to be forwarded with this application.
PART B is in three sections
SECTION 1
Information to be forwarded by all schools
SECTION 2
Information to be forwarded for any listed item if it varies from the current registration details
of the school
SECTION 3
Information to be forwarded if the campus proposes to offer a senior secondary qualification,
eg the VCE, VCAL or the IB Diploma.
Note: This section does not apply to schools already accepted by the VCAA to offer the
VCE or VCAL before 1 July 2007, or by the IBO to offer the IB Diploma before 1 July 2007.
SECTION 1 – Information to be forwarded by all schools
1.
School governance
1.1
Structure
The campus governance structure must enable the school to develop its strategic direction, manage its
finances and fulfil its legal obligations.
 Please attach
1.1a
1.2
the campus or school’s strategic plan and business plan incorporating the new campus certified
by a qualified accountant, ensuring that it includes:
•
enrolment estimates and assumptions
•
the estimated socioeconomic status of students and assumptions underpinning this
status
•
estimated State and Commonwealth grant funding
•
five year forecast financial statements
•
a description of any service agreements between the school and third parties.
Not-for-profit status
The school must be a not-for-profit school.
 Please attach a copy of:
1.2a
the school’s constitution
1.2b
the constitution of the legal entity or proprietor
1.2c
the Attestation of the school’s not-for-profit status (see Appendix 1).
Note: The attestation of a school’s not-for-profit status is not applicable to schools that have amended
their registration since 1 July 2007.
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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2.
Curriculum and student learning
2.1 Curriculum framework (Do not complete if proposing to offer a senior secondary qualification
only.)
A curriculum framework must be in place for the organisation, implementation and review of the campuses
curriculum and teaching practices and to ensure that the learning areas are substantially addressed. (Refer
to the Guide page 8.)
 Please attach documentation which must include:
2.1a
an explanation of how appropriate time will be allocated across the eight learning areas
2.1b
an explanation of how and when curriculum and teaching practice will be reviewed
2.1c
an outline of how the school will deliver its curriculum, whether through the Australian
Curriculum, AusVELS or other approved curriculum programs, integrated programs or online
learning
2.1d
a whole-school curriculum plan showing how the curriculum will be organised.
 Other evidence may include:
2.1e
yearly curriculum program plans for each cohort of students
2.1f
an indication of how the eight learning areas will be addressed across the years of schooling.
3.
Student welfare
3.1
Care, safety and welfare of students
A school must ensure that the care, safety and welfare of students is in accordance with any applicable
State and Commonwealth laws.
 Please attach for the campus:
3.1a
policies and procedures for the on-site supervision of students
3.1b
arrangements for ill students
3.1c
policy and procedures for the distribution of medicine.
 Please attach:
3.1d
3.2
a copy of the emergency management plan for the new campus which must be reviewed at
least annually and immediately after any significant incident. (This must be site specific and
include guidelines on emergency bushfire management).
Emergency Bushfire Management
To confirm whether your school should be placed on the Bushfire At-Risk Register, contact
bushfires@edumail.vic.gov.au
For all schools
 Please attach evidence in the form of:
3.2a
a schedule for monitoring and removal of materials that may be easily ignited, including
branches overhanging buildings, debris and rubbish around and under buildings, including
gutters, and dry grass and vegetation
3.2b
procedures to ensure safe storage of flammable materials.
 Please attach evidence that:
3.2c
building exits will be continuously kept clear of obstructions
3.2d
assembly points are designated and have appropriate access to emergency equipment
3.2e
there is access to facilities and grounds for emergency vehicles.
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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For a school on the Bushfire-At-Risk Register extra procedures in addition to the above apply
 Please attach evidence of the school’s:
3.2f
Emergency Management Plan (EMP) that details the school’s response to managing bushfire
risk including:
•
closing the school on days declared Code Red
•
on non-Code Red days in the event of bushfire or elevated risk:
o maintaining a heightened state of readiness
o ensuring open lines of communication from local emergency services
o be prepared/on standby to enact their EMP by:

relocating students and staff to a nominated ‘shelter-in-place’
within the school site that is compliant with relevant regulations,
and/or

evacuating students and staff to an off-site safe area
o responding appropriately to instructions from emergency services.
 Please attach evidence of the school’s:
3.2g
provision of information on bushfire preparedness policy and procedures to staff (including
relief staff) and parents/guardians
3.2h
closure arrangements for Code Red days as per the school’s Emergency Management Plan
3.2i
training of staff with specific roles and responsibilities in preparing for, monitoring and
executing emergency bushfire procedures, including the effective operation of relevant
emergency equipment
3.2j
practice of evacuation procedures and drills at least once per term during the October- April
bushfire season. School evacuation drills must involve all students and staff moving to either
a nominated on-site ‘shelter-in-place’ or an off-site evacuation point as per the school’s
Emergency Management Plan.
 Please attach evidence of:
3.2k
a register of bushfire emergency equipment, in working order, which may include water
systems and equipment; fire hydrants; hose reels and extinguishers; sprinkler systems;
alarms; first aid materials and medical equipment; fire blankets and communication systems.
3.2l
notices of bushfire evacuation procedures and bushfire emergency contact numbers located
appropriately around the school.
 Please attach evidence that the school will maintain:
3.2m
a record of annual visitation or consultation with relevant local agencies, (the Country Fire
Authority, Metropolitan Fire and Emergency Services Board, local Council) on bushfire
preparedness and compliance with local bushfire regulation of buildings, facilities and
grounds.
 Please attach evidence of:
3.2n
3.3
documentation certifying that any on-site ‘shelter in place’ is compliant with relevant agency
minimum standards.
Discipline
The school must provide its behaviour management policy and procedures, including policies in relation to
student engagement and the suspension or expulsion of students, together with an outline of how the school
will communicate these policies and procedures to the school community. These policies must be based on
principles of procedural fairness and must explicitly state that corporal punishment is not permitted.
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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 Please attach:
3.3a
a policy that explicitly states that corporal punishment is not permitted
3.3b
the school’s behaviour management policy and procedures which includes how the policy
and procedures ensure procedural fairness
an outline of how the school communicates these policies and procedures to the school
community (refer to the Guide page 12 for further details).
3.3c
Such policies and procedures may, but will not necessarily, include:
•
an explanation of the school’s approach to discipline and how it ensures procedural fairness
•
procedures for suspension, expulsion and exclusion
•
procedures for imposing penalties
•
documentation and communication processes.
4
Staff employment
4.1
Teachers’ requirements
All teachers employed to teach at the campus must be registered or have permission to teach, and comply
with any conditions or limitations of that registration.
 Please attach:
4.1a
an indication of the number of teaching staff to be employed at the campus
4.1b
a statement of intent to maintain a register containing each teacher’s name, academic
qualifications and their Victorian Institute of Teaching (VIT) registration number and VIT
category of registration (provisional registration, full registration, permission to teach) and the
expiry and renewal date of the teacher’s registration.
4.1c
the list of all teachers containing each teacher’s name, academic qualifications, their
Victorian Institute of Teaching (VIT) registration number and VIT category of registration
(provisional registration, full registration, permission to teach) and the expiry and renewal
date of the teacher’s registration.
Note: If this information is not available at the time of the application, details must be provided by the
school when they are known or before the campus commences operation at the latest.
4.2
Compliance with the Working with Children Act 2005
The requirements of the Working with Children Act 2005 must be complied with in respect of the employment
of all non-teaching staff at the campus.
 Please attach:
4.2a
4.2b
4.2c
procedures to ensure that all staff required to do so by the Working with Children Act 2005
have a current Working with Children Check
a register of the Working with Children Check for all non-teaching staff (a proforma is
acceptable)
procedures for maintaining the register (refer to the Guide page 13 for further details).
5
School infrastructure
5.1
Buildings, facilities and grounds
The school’s buildings, facilities and grounds must comply with any laws that apply to the school including
local laws and building, planning and occupational health and safety laws.
 Please attach a copy of the:
5.1a
permit to operate an education centre on site (In some cases, a certificate of continual use
can be provided in lieu of a planning permit.)
5.1b
maintenance schedule for buildings, facilities and grounds
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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5.1c
occupational health and safety policy and procedures
5.1d
rental or lease arrangements (if applicable).
The items listed below must be provided by the school when they are known or, at the latest, before the
school commences operation:
5.2
5.1e
documentation showing that buildings and facilities comply with local planning regulations
and the Building Code of Australia, including a 9B occupancy certificate. (If the school is on
the Bushfire At-Risk Register [BARR] with an on-site ‘shelter-in-place,’ it must comply with
the VRQA Guidelines for Registered Schools on Bushfire Preparedness).
5.1f
essential services register.
Educational facilities
The educational facilities of the school must be suitable for the programs offered by the school and the age
levels of the students.
 Please attach relevant documentation. Evidence must include:
5.2a
a plan of the school showing the location of facilities available for each program offered
across the school day.
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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SECTION 2 – Information to be forwarded for any listed item if it varies from
the current registration details of the school
6
School governance
6.1
Structure
The campus governance structure must enable the school to develop its strategic direction, manage its
finances and fulfil its legal obligations.
 Please attach:
6.1a
an outline of the governing body’s structure and membership, including details of the
experience and expertise of the members of the Board, and the name and registered type of
the legal entity (where applicable)
6.1b
the company or association's constitution or rules of association which outline the structure and
legal obligations of the Board of the company or association
6.1c
the most recent financial statement for the company or association which must be audited
6.1d
the school’s governance charter, outlining the key functions and responsibilities of the school
board
 Other evidence may include:
6.1e
6.2
policies relating to the operation, professional development, review and induction of the
governing body and its members.
Philosophy
The campus must have a clear statement of its philosophy.
 Please attach:
6.2a
a copy of the school’s philosophy which includes the vision, mission, values and objectives of
the school
6.2b
an explanation of how the school’s philosophy is enacted.
7
Enrolment
7.1
Enrolment policy
The campus must have a clearly defined enrolment policy that complies with all applicable State and
Commonwealth law.
Note: A school established by a particular religious denomination or by a group of religious
denominations may have an enrolment policy that gives preference to adherents of that religious
denomination/s or their children.
 Please attach:
7.1a
Please attach a copy of the school’s enrolment policy which is consistent with all legal
requirements, and details of how it will be implemented.
8
Curriculum and student learning
8.1
Student learning outcomes
The campus must have processes in place that enable it to plan for, and achieve improvement in, student
learning outcomes.
 Please attach:
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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8.1a
8.2
the school’s documented strategy to improve student learning outcomes. Such a strategy must
include statements of:

what data (such as National Assessment Program – Literacy and Numeracy
(NAPLAN) testing, senior secondary and On Track data) the school will collect to
monitor outcomes

how the school will analyse and use data to set goals and targets for outcomes,
including for students at risk

how the data will be analysed, used and reported. (Refer to page 9 of the guide for
further details.)
Monitoring and reporting on students’ performance
The campus must ensure that there is ongoing assessment, monitoring and recording of each student’s
performance and provide each student and parent with access to accurate information about the
performance. Access to information must include at least two written reports to parents per year.
 Please attach:
8.2a
the school’s assessment and reporting policies and procedures, including how it will meet
Commonwealth Government student reporting requirements.
9
Student welfare
9.1
Care, safety and welfare of students
A school must ensure that the care, safety and welfare of students is in accordance with any applicable
State and Commonwealth laws.
Staff must be advised of their obligations under these laws.
 Please attach student welfare policies and procedures for:
9.1a
student welfare
9.1b
bullying and harassment, including cyber bullying
9.1c
management of complaints or grievances.
 Please attach student safety policies and procedures for:
9.1d
supervision of students when engaged in off-site activities and which includes consideration of
the risk of bushfire in the activity location
9.1e
ensuring the safety and welfare of students learning with an external provider, when the school
contracts with another school or RTO, or an organisation not registered as an education and
training provider (if relevant).
 Please attach student care documentation for:
9.1f
anaphylaxis management policy containing matters required by Ministerial Order 706 and the
(associated) Anaphylaxis Guidelines issued by the Department of Education and Training
(DET). The website
http://www.education.vic.gov.au/school/teachers/health/Pages/anaphylaxisschl.aspx may
assist schools to develop this plan.
9.1g
register of staff trained in first aid (a proforma is acceptable)
9.1h
records of student medical conditions and management (a proforma is acceptable).
 Please attach the campus’:
9.1i
mandatory reporting policy and procedures
9.1j
accidents and incidents register
9.1k
first aid policy and procedures
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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9.1l
internet use policy and procedures
9.1m
critical incident plan
9.1n
emergency management plan which must be reviewed at least annually and immediately after any significant
incident. (This must be site specific and include guidelines on emergency bushfire management.)
 Please attach:
9.1o
9.2
evidence of how the school communicates policies and procedures on the care, safety and
welfare of students to staff, students, parents and the school community.
Attendance monitoring
Policy and procedures must exist to monitor daily attendance, identify absences from school or class, follow
up unexplained absences, and notify any parent or guardian regarding unsatisfactory attendance and record
unsatisfactory attendance information on student files.
 Please attach the campus’ documented procedures to:
9.2a
the school’s documented procedures to:
 check attendance at least twice per day
 monitor daily attendance and to identify absences from school or class
 follow up unexplained absences
 notify parents or guardians of unsatisfactory attendance
 record unsatisfactory attendance on each student’s file.
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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SECTION 3 – Information to be forwarded if the new campus proposes to
offer senior secondary qualifications, eg the VCE, VCAL or the IB Diploma
Note: This section does not apply if the school already offers the VCE, VCAL or the IB Diploma at
another campus.
Accredited senior secondary qualification
Indicate which accredited senior secondary qualification you are applying to deliver. Authorisation to deliver
the VCE, the VCAL and the IB Diploma will be processed in conjunction with the application.
Victorian Certification of Education (VCE)
Victorian Certificate of Applied Learning (VCAL)
International Baccalaureate Diploma (IB).
Partnership
Will any part of the accredited course be delivered through a partnership arrangement?
No
Yes – please provide the name of the proposed partner organisation/s below.
Proposed partner organisations
Name of proposed partner organisation
10
Responsibilities of partner organisation – course to be delivered
Student learning outcomes
A school must ensure that it understands the awarding body’s requirements and course outlines.
 Please attach:
10a
current student and staff handbooks and course outlines for the accredited qualification
10b
sample student learning sequences or plans for the accredited qualification
10c
procedures and documentation to indicate that staff and students have been provided with
current and accurate information about the awarding body’s requirements including course
standards, timelines and qualification requirements
10d
If the school shares responsibility for a senior secondary course with another provider, there
must be evidence of a copy of a written agreement between the providers stating how the
requirements of the student learning outcomes standard will be met.
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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11
Student records and results
A school must ensure that it has policies and procedures for senior secondary assessment, administration of
records and monitoring and analysis of results.
 Please attach a copy of:
12
11a
the policy and procedures for senior secondary assessment, administration of records and
monitoring and analysis of results to meet the requirements of the standard
11b
If the school shares responsibility for a senior secondary course with another provider, there
must be evidence of the written agreement between the providers stating how the
requirements of the student records and results standard will be met.
Student welfare
A senior secondary education provider must ensure that it has policies and procedures in place to provide
students with a safe environment and opportunities for students with special needs to access courses.
A senior secondary education provider must ensure that there are appropriate procedures in place for
students where two or more senior secondary education providers share responsibility for providing an
accredited senior secondary course.
 Please attach:
13
12a
an outline of how students with special needs will be provided with opportunities to access
the course
12b
If the school shares responsibility for a senior secondary course with another provider, there
must be evidence of a written agreement between providers stating how each manages its
legal responsibilities for students who attend the course, travel between providers or go on
excursions
Teaching and learning
A senior secondary provider must ensure that it has competent and qualified staff to teach and assess the
course and to ensure there are suitable teaching resources and physical facilities to provide the course.
 Please attach a copy of:
13a
a register of teachers’ qualifications or the principal’s attestation of teachers’ qualifications
13b
a plan of the school showing the location of physical facilities to support the course
13c
an overview of teaching resources
13d
the policy and procedures to ensure the consistent application of assessment criteria and
practices and to oversee the conduct of assessments of the course.
13e
If the school shares responsibility for a senior secondary course with another provider, there
must be evidence in the form of a copy of a written agreement between the providers stating
how the requirements of the teaching and learning standard will be met.
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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PART C – DECLARATION FOR SCHOOLS AMENDING REGISTRATION TO
INCLUDE AN ADDITIONAL CAMPUS
PART C is in two sections
SECTION 1
Declarations
To be signed by all schools
SECTION 2
Declarations
To be signed by schools offering a senior secondary qualification
Section 1 – To be completed by all schools
Enrolment
The enrolment numbers provided in the Application to amend registration:
additional campus are a true and accurate record.
Yes
No
The school will maintain a register of enrolments that contains the following information in relation to each
student enrolled at the school:
a) the student’s name, age and address
Yes
No
b) the name and contact details of any parent or guardian of the student
Yes
No
c) the date of enrolment of the student
Yes
No
d) the date that the student ceases to be enrolled at the school (if applicable).
Yes
No
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
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Other requirements
Information on school’s performance to be available
1 Information concerning the school’s performance will be made available to the
community of the school at least once a year.
Yes
No
2 The information will include:
a) a description and analysis of student learning outcomes achieved by the school’s students
in statewide tests and examinations in which the school participates for
(i) the current year
Yes
No
(ii) if the school has been established for more than 2 years, the
previous 2 years
Yes
No
b) a description and analysis of the rates of student attendance for the
year
Yes
No
c) a report of the school’s financial activities
Yes
No
d) copies of any other reports that the school is required to prepare for
the school community under any funding agreements with the State
or the Commonwealth.
Yes
No
The school will comply with the requirements of the Education and Training
Reform Act 2006 and the Education and Training Reform Regulations 2007.
Yes
No
The school will comply with any condition imposed on its registration by or under
the Education and Training Reform Act 2006 or the Education and Training
Regulations 2007.
Yes
No
The school will have policies and procedures in place to enable it to comply
with the prescribed minimum standards for registration that are applicable
to the school.
Yes
No
Yes
No
Changing a school’s particulars
The principal of a registered school must notify the VRQA within 30 days of any
changes to specified details of a school.
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
20
Declaration to be signed by person, or on behalf of the body, proposing to establish or
conduct the school
I declare the information contained in this application is true and correct.
Name
(Please print)
Position
Signature
Date
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
21
SECTION 2 – To be completed only by schools applying to amend
registration to include a campus offering senior secondary qualifications
Note: This section does not apply to schools already accepted by the VCAA to offer the VCE or VCAL
before 1 July 2007, or by the IB to offer the IB Diploma before 1 July 2007.
Governance and probity
A school must ensure that its governing structure manages its responsibilities well in relation to senior
secondary provision The evidence for this standard is addressed in the standard for a registered school
under School governance-Structure on page 9 of the Guide to the minimum standards and other
requirements for school registration. In addition:
The provider will ensure that there are suitable arrangements in place:
a) to enable the provider to respond to and supply any information requested
by the VRQA in regard to probity of the provider
Yes
No
b) to enable the provider to comply with any relevant guidelines issued
by the VRQA
Yes
No
c) to enable the VRQA to conduct an audit on the operation of the person,
body or school in relation to the minimum standards.
Yes
No
Ensure that if a senior secondary education provider is not the owner of an
accredited senior secondary course, that the provider is authorised by the owner
of the course to provide the course and complies with the conditions relating to
that authorisation.
Yes
No
The provider will not provide instruction in an accredited senior secondary course
unless the school is registered.
Yes
No
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
22
Declaration to be signed by person, or on behalf of the body, proposing to establish or
conduct a new campus for the school
I declare the information contained in this application is true and correct.
Name
(Please print)
Position
Signature
Date
APPLICATION TO AMEND REGISTRATION: ADDITIONAL CAMPUS March 2015
23
APPENDIX 1: ATTESTATION OF SCHOOL’S NOT-FOR-PROFIT STATUS
About this attestation
Under the Education and Training Reform Regulations 2007 (Regulations 2 and 7), a school must not be
established or conducted for the purpose of profit or gain if it:
•
was registered on or after 1 July 2007
•
was registered before 1 July 2007 and, on or after 1 July 2007, the registration of the school is
amended by the VRQA to include an additional campus or year level.
How to use this attestation
Complete this attestation if the school is applying to:
•
register for the first time
•
(if the school was registered before 1 July 2007) amend its registration by including an
additional campus or year level.
For further information, contact the VRQA on 9032 1546
Definitions
The following definitions are used in this attestation.
‘Proprietor’ (in relation to a school) includes the governing body of the school.
‘Conduct’ of a school includes:
•
fund-raising activities conducted solely for the school
•
the provision of goods and services and other matters or things to students attending the school
•
the provision of other educational or similar services.
‘Entity’ includes a trust.
‘Prohibited agreement or arrangement’ means an agreement or arrangement that is made with an entity that
carries on business for profit or gain where:
•
the purpose of the agreement or arrangement is to pay or divert any profit or gain made in the
conduct of the school to that entity or any other entity (other than a payment made in good faith
for goods provided or services rendered to the school); or
•
the agreement or arrangement:
–
involves a payment by the school or the proprietor of the school for a purpose where
the payment is excessive compared to the charges, fees, rates or costs for the time being
prevailing in the community for payment for that purpose (other than a payment made in
good faith for that purpose); or
–
involves a gift, loan or similar payment by the school or the proprietor of the school
(other than deposits made to a bank in connection with the conduct of the school); or
–
involves a payment by the school or the proprietor of the school that is not a payment
made in good faith for goods provided or services rendered to the school.
APPENDIX March 2015
24
ABOUT THE SCHOOL’S NOT-FOR-PROFIT STATUS
Answer ALL the following questions by crossing the correct box.
1 Is the school established for the purpose of profit or gain?
Yes
No
Yes
No
Yes
No
Answer ‘No’ if the school is not established for the purpose of profit or gain as that
concept is explained in this application form and the Regulations. The constitution
or governing documents of the school must specify that its assets and income be
applied solely toward the conduct of the school.
2 Does the proprietor of the school conduct the school for the purposes of
profit or gain?
Answer ‘No’ if proprietor of the school does not conduct the school for the
purpose of profit or gain.
A proprietor of a school is not to be taken to conduct the school for the purpose of
profit or gain if the proprietor makes a financial surplus in the course of the proper
administration of the school.
3 Is any part of the profit or gain made in the conduct of the school
distributed to any entity?
Answer ‘No’ if no part of the profit or gain made in the conduct of the school is or
may be distributed to any entity.
A proprietor of a school is not to be taken to conduct the school for the purposes
of profit or gain if the proprietor makes a financial surplus in the course of the
proper administration of the school.
Continued on next page
APPENDIX March 2015
25
4 Is any money and property received by the school or the proprietor of the
school for the conduct of the school NOT applied solely towards the
conduct of the school?
Yes
No
Yes
No
Yes
No
Yes
No
Answer ‘No’ if all money and property received by the school or the proprietor of
the school for the conduct of the school is applied solely towards the conduct of
the school.
5 Is the proprietor of the school a party to a prohibited agreement or
arrangement?
Answer ‘No’ if the school’s proprietor is not a party to a prohibited agreement or
arrangement.
6 If the school is a non-government school, on the closure of the school
are any surplus assets of the school remaining after payment of the
school’s liabilities NOT required by the constitution or rules governing the
school to be:
•
used by the proprietor of the school for providing education
services to school-age children or for other not-for-profit
purposes
•
given to a not-for-profit entity operating within Australia that
provides education services to school children or that has
similar purposes to the proprietor?
or
Answer ‘No’ if the school is a non-government school, and on the closure of the
school, any surplus assets of the school remaining after payment of the school’s
liabilities are required by the constitution or rules governing the school to be:
•
used by the proprietor of the school for providing education
services to school-age children or for other not-for-profit purposes
•
given to a not-for-profit entity operating within Australia that
provides education services to school children or that has similar
purposes to the proprietor.
or
7 Did you answer ‘No’ to questions 1-6?
By answering ‘Yes’ to this question, you are confirming that the school for which
you are completing this attestation complies with the not-for-profit requirements of
the Regulations. If you answer ‘No’, it means your school does not comply with
the not-for-profit requirements.
Please complete the declaration on the next page.
APPENDIX March 2015
26
School’s not-for-profit status attestation statutory declaration
See information below regarding the Evidence (Miscellaneous Provisions) Act 1958
Date and sign the following statutory declaration.
I,
(Full name of declarant)
of
(Address of declarant)
do solemnly and sincerely declare that I acknowledge that the contents of this document are true and
correct and I make it in the belief that a person making a false declaration is liable to penalties of perjury.
Declared at
(Location of signing)
in the State of Victoria
This
day of
20
(Day, month and year)
I hereby confirm that the contents of this document are true and correct in every particular.
X
(Signature of declarant)
before me X
(Signature and authority
of authorised witness)
I hereby confirm that the board / committee / trustee of the school authorises the declarant to make this
statutory declaration and attach a copy of that authority.
X
(Signature of person
authorised by the school’s
board / committee / trustee)
(Authorised person’s office)
APPENDIX March 2015
27
Authorised persons
List of persons who may witness statutory declarations in Victoria

a justice of the peace or a bail justice

a public notary

an Australian lawyer (within the meaning of the Legal Profession Act 2004)

a clerk to an Australian lawyer

the prothonotary or a deputy prothonotary of the Supreme Court, the registrar or a deputy registrar
of the County Court, the principal registrar or a registrar or deputy registrar of the Magistrates' Court
or the principal registrar or a registrar or deputy registrar of the Children’s Court

the registrar of probates or an assistant registrar of probates

the associate to a judge of the Supreme Court or of the County Court

the associate of an Associate Judge of the Supreme Court or of an associate judge of the County
Court
a person registered as a patent attorney under Chapter 20 of the Patents Act 1990 of the
Commonwealth


a police officer

the sheriff or a deputy sheriff

a member or former member of either House of the Parliament of Victoria

a member or former member of either House of the Parliament of the Commonwealth


a councillor of a municipality
a senior officer of a Council as defined in the Local Government Act 1989

a person registered under the Health Practitioner Regulation National Law to practise in the medical
profession (other than as a student)

a person registered under the Health Practitioner Regulation National Law — (i) to practise in the
dental profession as a dentist (other than as a student); and (ii) in the dentists division of that
profession

a registered veterinary practitioner within the meaning of the Veterinary Practice Act 1997

a person registered under the Health Practitioner Regulation National Law to practise in the
pharmacy profession (other than as a student)

a principal within the meaning of the Education and Training Reform Act 2006

the manager of an authorised deposit-taking institution

a person who holds a prescribed membership of a prescribed accounting body or association

the secretary of a building society

a minister of religion authorised to celebrate marriages

a Victorian Inspectorate Officer within the meaning of the Victorian Inspectorate Act 2011

a person employed under Part 3 of the Public Administration Act 2004 with a classification that is
prescribed as a classification to which this section applies or who holds office in a statutory authority
with such a classification

an IBAC Officer within the meaning of the Independent Broad-based Anti-corruption Commission Act
2011

a fellow of the Institute of Legal Executives (Victoria).
APPENDIX March 2015
28
EVIDENCE CHECKLIST TO BE COMPLETED AND FORWARDED WITH THE APPLICATION
1.
Complete the Information Submitted column indicating whether the information has been submitted as part of the
application.
2.
Insert the Tab Number (or tab description) submitted for each evidence requirement in the appropriate column.
3.
If evidence is applicable to more than one evidence requirement, submit it once and insert the Tab number in the
relevant column (s).
4.
Items marked with an asterisk (*) may be submitted after the application closing dates.
SECTION 1
1
School Governance
1.1
Structure
1.1a
1.2
Information
Submitted
the campus or school’s strategic plan and business plan incorporating the new campus certified by a qualified
accountant, ensuring that it includes:
•
enrolment estimates and assumptions
•
the estimated socioeconomic status of students and assumptions underpinning this
status
•
estimated State and Commonwealth grant funding
•
five year forecast financial statements
•
a description of any service agreements between the school and third parties.
Tab number

Not-for-profit status
1.2a
the school’s constitution

1.2b
the constitution of the legal entity or proprietor

1.2c
the Attestation of the school’s not-for-profit status.

Information
Submitted
Tab number
2.
Curriculum and student learning
2.1
Curriculum framework (Do not complete if proposing to offer a senior secondary qualification only.)
2.1a
an explanation of how appropriate time will be allocated across the eight learning areas

2.1b
an explanation of how and when curriculum and teaching practice will be reviewed

2.1c
an outline of how the school will deliver its curriculum, whether through the Australian Curriculum, AusVELS or
other approved curriculum programs, integrated programs or online learning

2.1d
a whole-school curriculum plan showing how the curriculum will be organised

2.1e
yearly curriculum program plans for each cohort of students

2.1f
an indication of how the eight learning areas will be addressed across the years of schooling

3.
Student welfare
3.1
Care, safety and welfare of students - Please attach policies and procedures for:
Information
Submitted
3.1a
policies and procedures for the on-site supervision of students

3.1b
arrangements for ill students

3.1c
policy and procedures for the distribution of medicine

APPENDIX March 2015
Tab number
29
3.1d
3.2
emergency management plan for the new campus which must be reviewed at least annually and immediately
after any significant incident. (This must be site specific and include guidelines on emergency bushfire
management.) Note: The evacuation map can be submitted at a later date. The plan should be submitted
with the application.

Emergency Bushfire Management
For all schools
3.2a
a schedule for monitoring and removal of materials that may be easily ignited, including branches
overhanging buildings, debris and rubbish around and under buildings, including gutters, and dry grass and
vegetation

3.2b
procedures to ensure safe storage of flammable materials

3.2c
building exits will be continuously kept clear of obstructions

3.2d
assembly points are designated and have appropriate access to emergency equipment

3.2e
there is access to facilities and grounds for emergency vehicles

For a schools on the Bushfire-At-Risk Register extra procedures apply in addition to the above
3.2f
Emergency Management Plan (EMP) that details the school’s response to managing bushfire risk including:

closing the school on days declared Code Red

on non-Code Red days in the event of bushfire or elevated risk:
o
maintaining a heightened state of readiness
o
ensuring open lines of communication from local emergency services
o
be prepared/on standby to enact their EMP by:
o

relocating students and staff to a nominated ‘shelter-in-place’ within the
school site that is compliant with relevant regulations, and/or

evacuating students and staff to an off-site safe area

responding appropriately to instructions from emergency services
3.2g
provision of information on bushfire preparedness policy and procedures to staff (including relief staff) and
parents/guardians

3.2h
closure arrangements for Code Red days as per the school’s Emergency Management Plan

3.2i
training of staff with specific roles and responsibilities in preparing for, monitoring and executing emergency
bushfire procedures, including the effective operation of relevant emergency equipment

3.2j
practice of evacuation procedures and drills at least once per term during the October- April bushfire season.
School evacuation drills must involve all students and staff moving to either a nominated on-site ‘shelter-inplace’ or an off-site evacuation point as per the school’s Emergency Management Plan

3.2k
a register of bushfire emergency equipment, in working order, which may include water systems and
equipment; fire hydrants; hose reels and extinguishers; sprinkler systems; alarms; first aid materials and
medical equipment; fire blankets and communication systems

3.2l
notices of bushfire evacuation procedures and bushfire emergency contact numbers located appropriately
around the school

3.2m
a record of annual visitation or consultation with relevant local agencies, (the Country Fire Authority,
Metropolitan Fire and Emergency Services Board, local Council) on bushfire preparedness and compliance
with local bushfire regulation of buildings, facilities and grounds.

3.2n
documentation certifying that any on-site ‘shelter in place’ is compliant with relevant agency minimum
standards

APPENDIX March 2015
30
3.3
Discipline
3.3a
a policy that explicitly states that corporal punishment is not permitted

3.3b
the school’s behaviour management policy and procedures which includes how the policy and procedures
ensure procedural fairness

3.3c
an outline of how the school communicates these policies and procedures to the school community

4
Staff employment
4.1
Teachers’ requirements
4.2
4.1a
an indication of the number of teaching staff to be employed at the campus

4.1b
a statement of intent to maintain a register containing each teacher’s name, academic qualifications and their
Victorian Institute of Teaching (VIT) registration number and VIT category of registration (provisional
registration, full registration, permission to teach) and the expiry and renewal date of the teacher’s registration

4.1c *
the list of all teachers containing each teacher’s name, academic qualifications, their VIT registration number
and VIT category of registration (provisional registration, full registration, permission to teach) and the expiry
and renewal date of the teacher’s registration

Tab number
Compliance with Working with Children Act 2005
4.2a
procedures to ensure that all staff required to do so by the Working with Children Act 2005 have a current
Working with Children Check

4.2b
a register of the Working with Children Check for all non-teaching staff (a proforma is acceptable)

4.2c
procedures for maintaining the register

5
School infrastructure
5.1
Buildings, facilities and grounds
5.2
Information
Submitted
Information
Submitted
5.1a
permit to operate an education centre on site (in some cases, a certificate of continual use can be provided in
lieu of a planning permit)

5.1b
maintenance schedule for buildings, facilities and grounds

5.1c
occupational health and safety policy and procedures

5.1d
rental or lease arrangements (if applicable)

5.1e *
documentation showing that buildings and facilities comply with local planning regulations and the Building
Code of Australia, including a 9B occupancy certificate

5.1f *
essential services register

Tab
number
Educational Facilities
5.2a
a plan of the school showing the location of facilities available for each program offered across the school day
APPENDIX March 2015

31
SECTION 2
Information to be forwarded for any listed item if it varies from the current registration details of the school
6
School Governance
6.1
Structure
6.2
6.1a
an outline of the governing body’s structure and membership, including details of the experience and
expertise of the members of the Board, and the name and registered type of the legal entity (where
applicable

6.1b
the company or association's constitution or rules of association which outline the structure and legal
obligations of the Board of the company or association

6.1c
the most recent financial statement for the company or association which must be audited

6.1d
the school’s governance charter, outlining the key functions and responsibilities of the school board

6.1e
policies relating to the operation,
governing body and its members.
professional
development,
review
and
induction
of
the
Tab number

Philosophy
6.2a
a copy of the school’s philosophy which includes the vision, mission, values and objectives of the school

6.2b
an explanation of how the school’s philosophy is enacted

7.
Enrolment
7.1
Enrolment policy
7.1a
a copy of the school’s enrolment policy which is consistent with all legal requirements, and details of how it will
be implemented
8.
Curriculum and Student learning
8.1
Student learning outcomes
8.1a
8.2
Information
Submitted
the school’s documented strategy to improve student learning outcomes. Such a strategy must include
statements of:

what data (such as National Assessment Program – Literacy and Numeracy (NAPLAN) testing, senior
secondary and On Track data) the school will collect to monitor outcomes

how the school will analyse and use data to set goals and targets for outcomes, including for students
at risk

how the data will be analysed, used and reported.
Information
Submitted
Tab number

Information
Submitted
Tab number

Monitoring and reporting on students’ performance
8.2a
the school’s assessment and reporting policies and procedures, including how it will meet Commonwealth
Government student reporting requirements
9.
Student Welfare
9.1
Monitoring and reporting on students’ performance

Informatio
n
Submitted
9.1a
Student Welfare

9.1b
bullying and harassment, including cyber bullying

APPENDIX March 2015
Tab number
32
9.1c
management of complaints or grievances.

9.1d
supervision of students when engaged in off-site activities and which includes consideration of the risk of
bushfire in the activity location

9.1e
ensuring the safety and welfare of students learning with an external provider, when the school contracts with
another school or RTO, or an organisation not registered as an education and training provider

9.1f
anaphylaxis management policy containing matters required by Ministerial Order 706 and the (associated)
Anaphylaxis Guidelines issued by the Department of Education and Training (DET). The website
http://www.education.vic.gov.au/school/teachers/health/Pages/anaphylaxisschl.aspx may assist schools to
develop this plan.

9.1g
register of staff trained in first aid (a proforma is acceptable)

9.1h
records of student medical conditions and management (a proforma is acceptable).

Please attach the campus:

9.1i
mandatory reporting policy and procedures

9.1j
accidents and incidents register

first aid policy and procedures

internet use policy and procedures

critical incident plan

9.1n
emergency management plan which must be reviewed at least annually and immediately after any significant
incident. (This must be site specific and include guidelines on emergency bushfire management.)

9.1o
evidence of how the school communicates policies and procedures on the care, safety and welfare of students
to staff, students, parents and the school community.

9.1k
9.1l
9.1m
9.2
Attendance monitoring
9.2a
the campus documented procedures to :

 check attendance at least twice per day
 monitor daily attendance and to identify absences from school or class
 follow up unexplained absences
 notify parents or guardians of unsatisfactory attendance
 record unsatisfactory attendance on each student’s file
APPENDIX March 2015
33
SECTION 3
Senior Secondary – Information to be forwarded by schools proposing to offer a senior secondary qualifications, e.g. the VCE,
VCAL or the IB Diploma.
10
Student learning outcomes
Information
Submitted
10a
current student and staff handbooks and course outlines for the accredited qualification

10b
sample student learning sequences or plans for the accredited qualification

10c
procedures and documentation to indicate that staff and students have been provided with current and
accurate information about the awarding body’s requirements including course standards, timelines and
qualification requirements

10d
If the school shares responsibility for a senior secondary course with another provider, there must be evidence
of a copy of a written agreement between the providers stating how the requirements of the student learning
outcomes standard will be met.

11
Student records and results
11a
11b
12
Information
Submitted
the policy and procedures for senior secondary assessment, administration of records and monitoring and
analysis of results to meet the requirements of the standard

If the school shares responsibility for a senior secondary course with another provider, there must be evidence
of the written agreement between the providers stating how the requirements of the student records and
results standard will be met.

Student welfare
Information
Submitted
12a
an outline of how students with special needs will be provided with opportunities to access the course

12b
If the school shares responsibility for a senior secondary course with another provider, there must be evidence
of a written agreement between providers stating how each manages its legal responsibilities for students who
attend the course, travel between providers or go on excursions

13
Teaching and learning
13a *
13b
13c
13d
13e
Information
Submitted
a register of teachers’ qualifications or the principal’s attestation of teachers’ qualifications

a plan of the school showing the location of physical facilities to support the course

an overview of teaching resources

Tab number
Tab number
Tab number
Tab number
the policy and procedures to ensure the consistent application of assessment criteria and practices and to
oversee the conduct of assessments of the course.
If the school shares responsibility for a senior secondary course with another provider, there must be evidence
in the form of a copy of a written agreement between the providers stating how the requirements of the
teaching and learning standard will be met.

DECLARATIONS
Schools must complete the columns on the right indicating which information has been submitted as part of the application.
Declarations
Information
Submitted
Section 1 – to be completed by all schools

Section 2 – to be signed by schools offering a senior secondary qualification

APPENDIX March 2015
Signed
34
Appendix 1 – Declaration of good character

Appendix 2 – Attestation of school’s not-for-profit status

APPENDIX March 2015
35