/ Wavell State High School
RugbyLeagueSchool of Excellence
Certificate III Sport & Recreation
Application Form - Years 11 and 12 / / Office Use Only
Date Application Received
/ /
Student Personal Details
Surname
Given Names / Date of Birth / / /
Street Address
Suburb / State / Postcode
Home Phone No. / Student’s Mobile No.
Current Student / New Student / Proposed date to start school
(if not a current Wavell SHS student) / / / / Current Year Level
Student’s Parent/Carer Details
Surname
Given Name / Title (Mr/Mrs/Ms/Miss/Dr etc.)
Relationship to student
Street Address
(if same as student
please write ‘As Above’)
Suburb / State / Postcode
Home Phone No. / Mobile No.
***** Attach a copy of your last school report to this application. *****
No application will be viewed unless it includes your latest report.
Students are reminded that the selection process will be based on the following three (3) criteria:
  1. behaviour and effort grades
  2. attendance records
  3. playing ability

Student’s Sport Details
CurrentSchool, Grade & Team
Current Club & Team
Referee Name (e.g. current Coach)
(not required for current Wavell SHS students) / Phone:
Preferred Position / (1)
(2)
(3)
Playing Experience
Representative Experience
/ Wavell State High School /
Write a brief statement about your special interest in School of Excellence – Rugby League.
Do you intend to enrol in subjects that lead to an OP for University entrance: /  Yes /  No
Would you be interested in a School Based Traineeship or Apprenticeship? /  Yes /  No
If yes, indicate which fields would be of interest to you:
(1) / (2)
I understand that there are limited places in the School of Excellence – Rugby League Program and that submission of an application form does not mean automatic acceptance into the Program.
Parent/Carer Signature / Date
Expectations
  • You must complete all assessment and training modules for the Certificate III course.
  • All students must meet the criteria in Behaviour and Effort outlined in the Behaviour Management Process.
  • Students will be expected to attend school regularly and to work diligently in all their school subjects.
  • Students will be expected to follow the School of Excellence Behaviour Management process to remain enrolled in the course.
School of Excellence – Rugby League will be studied during normal class time allocated for senior subjects, as well as during additional hours in the gym and on the training field. A high degree of commitment to this course is essential and students must be prepared to sacrifice their own time for training, gym work and games, both before and after school, as well as in the evenings and on weekends.
An additional levy of approximately $400 will be charged per student. This will assist in providing specialist tutors, strapping, camps, training and playing apparel and guest speakers for workshops. Other costs, such as transport may need to be met by students.
Office Use Only
 Successful /  Unsuccessful
Signed / Date

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