NSW Community Languages Schools Program
Sample of class roll
IBNID: ___________
Location Name & Suburb: _________________________
Student Name (Please Print)
Family Name / Given Name
1
2
3
4
5
6
7
8
9
10
11
Total
Classes
Attended
Class Roll for Year: ________
Gender
M/F
Date of
Birth
dd/mm/yy
Day
School
Level
Day School
Name
Class Level: ____
Day School Suburb
Term: _____
Home
Address
Contact
Phone
Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Name of Teacher:
________________________________________
Name of Principal:
____________________________________________
(please print)
(please print)
We certify that the above roll records are correct and that the teacher (please tick )

has the qualifications that meet the Program’s Funding Requirements

is enrolled in the Program’s Professional Development Course (minimum 50 hours
or
________________________________________
Signature of Teacher
________________________________________
Date
_____________________________________________
Signature of Principal
_____________________________________________
Date