Minors Confirmation Form

---

Minors Confirmation (Form C) Family Name: ______________________________ Other Names: ___________________________________________ Student ID: _________________

Date: ___/___/_____

Our records show that you are under the age of 18 years as of today’s date. DIBP (Department of Immigration and Border Protection) visa regulations require that all students under 18 year old are living in appropriate accommodation. If your details are incorrect or unacceptable, your student visa could be cancelled and you may then have to return home. Therefore, it is crucial that ECC have your details and that your parents have confirmed with us that they approve of them. Please complete the information below: Current Local Address (Perth): ______________________________________________________________________ Home Phone: __________________________ Mobile Phone: ______________________________________________ Email: ___________________________________________________________________________________________ Please indicate if you are: Living in Homestay arranged by ECC Living with parents or legal custodian Living with relative who is over 21 years approved by parents* Living with a local carer nominated by parents and approved by the College** *Relative means a relative who is one of the following - brother, sister, step-parent, step-brother, step-sister, grandparent, aunt, uncle, niece, nephew, step-grandparent, step-aunt, step-uncle, step-niece or step-nephew. ** Police Clearance required. Local Carer Duty Statement will be supplied by College directly to Carer.

Relative’s or Local Carer’s details: Relationship to student or student’s family: ______________________________________________________________ Family Name: ___________________________________________ First Name: _______________________________ Address: _________________________________________________________________________________________ Home Phone: _________________ Work Phone: __________________ Mobile Phone:__________________________ Email: ___________________________________________________________________________________________ Parent’s details: Family Name: ___________________________________________ First Name: _______________________________ Address: _________________________________________________________________________________________ Home Phone: _________________ Work Phone: __________________ Mobile Phone:__________________________ Email: ___________________________________________________________________________________________ Student Declaration Are your parents aware of your accommodation arrangements? Yes

No

This form must be completed in full and returned to ECC AS SOON AS POSSIBLE. If any of the details above should change, you MUST inform us immediately BEFORE the change occurs. Please sign below to indicate that you are aware of your obligations as a Minor in Australia. (Student’s) Signature: _____________________________________ Please see me if you have any questions. Maria-Elena Johnston Student Counsellor OFFICE USE ONLY: Has the Relative’s/Local Carer’s Police Clearance been confirmed and is it on file?

QMKFO009 H:\Forms\Current Forms\ECC Forms\Minors Confirmation Form (C).doc

Yes

No

Last Updated: 30/09/2016 Page 1 of 1.