Autism School-Register new student

First Name

Last Name

Date of Birth

Age

Gender

Nationality

Home address

State of origin

Local Government Area (LGA)

Does the child currently live with both parents?

Yes No- see guardian section

Previous school attended (if any)

Class / Level attended

Does the child have a formal autism diagnosis?

Yes No- suspected/ awaiting assessment

Diagnosis provided by (tick all that apply)

Name and contact of diagnosing professional / facility

When was the most recent diagnostic assessment completed?

Less than 1 year ago 1–2 years ago 2–3 years ago More than 3 years ago

Do you have a copy of the diagnostic / assessment report?

Yes No

Other diagnosed conditions (tick all that apply)

Additional details / specify other conditions

Current medications (name, dosage, frequency)

Known allergies (food, drug, environmental)

Any other medical considerations the team should be aware of

COMMUNICATION

Primary mode of communication

Describe your child’s current communication level and any key phrases or words they use

SENSORY & BEHAVIOUR

Sensory sensitivities (click all that apply)

Behaviours of concern (tick all that apply)

Describe any triggers and strategies that have been helpful for managing these behaviours

DAILY LIVING SKILLS

Independent with the following (tick all that apply)

Any additional daily living support needs

ACADEMIC & COGNITIVE

Current academic functioning level

Describe the child’s strengths, interests, and areas where they show the most progress

Interventions / therapies the child has received (tick all that apply)

Are any of these services currently ongoing?

Yes No

If yes, please provide details (provider, frequency, duration)

First name

Last name

Relationship to child

Occupation

Primary phone number *

Alternate phone number

Email address

Residential address (if different from child’s)

First name

Last name

Relationship to child

Phone number

Email address

This person will be contacted in the event the primary guardian cannot be reached.

Cadeau Spectrum Academy’s payment policy requires 60% of fees to be paid before admission, with the remaining 40% as a second installment as agreed. Please complete this section for our admissions team to process your application.

Is the financial sponsor the same as the primary guardian above? *

Yes No — different sponsor (complete below)

SPONSOR DETAILS (COMPLETE ONLY IF DIFFERENT FROM GUARDIAN)

Sponsor’s full name

Relationship to child

Phone number

Email address

Sponsor’s residential / business address

Occupation / profession

Employer / organisation

PAYMENT

Preferred payment method *

Are you able to meet the 60% upfront payment before admission?

Yes No — please contact me to discuss options

Any questions or concerns about fees / payment arrangements

Will the child require school transport / pickup?

Yes No Not sure yet

Home area / nearest landmark (for transport planning)

Preferred enrolment period

Immediate Next term Within 3 months Flexible / unsure

How did you hear about Cadeau Spectrum Academy?

Please tick documents you are attaching

Diagnostic / assessment report Previous school reports or IEP Medical records / prescription summary Immunisation records Passport photograph of child (2 copies) Birth certificate or age declaration Parent / guardian ID (National ID, passport, or driver’s licence) Any court or legal guardian documents (if applicable)

Upload Documents here

Name of referring professional / organisation (if applicable)

I, the undersigned parent / guardian / sponsor, declare the following:

The information provided in this form is accurate and complete to the best of my knowledge. I will inform Cadeau Spectrum Academy promptly of any changes.

I understand that submission of this form does not guarantee admission and that enrolment is subject to assessment, capacity, and payment of the required deposit.

I consent to Cadeau Spectrum Academy collecting, storing, and using the information provided — including health and diagnostic information — for the purpose of planning and delivering appropriate educational and therapeutic support for my child.

I authorise Cadeau Spectrum Academy to contact the professionals listed in this form (e.g. previous therapists, schools) to obtain relevant records to support my child’s learning plan, with my prior notification.

I consent to be contacted by the admissions team via phone, email, or text message regarding this application and future programme updates.

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What to Expect After Registration

Thank you

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