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Submitted Consent Forms

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Student Name:
School
Class
Date of Birth
Eligible
To Be Treated
Treatment Date
Paying?
Treatment Done
Date Submitted

Name: Bei Quan

School: St Theresa's Primary School Albion
Class:1/2S
Date of Birth:07/02/2019
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:07/06/2026

Name: Mara Ezerins

School: St Louis de Montforts Primary School
Class:PGY
Date of Birth:21/07/2020
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:06/06/2026

Name: Eloise Jones

School: St Louis de Montforts Primary School
Class:PJM
Date of Birth:11/03/2021
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:06/06/2026

Name: Shanaya Sri Parakrama

School: St Mark's Primary School Dingley
Class:3/4K
Date of Birth:20/05/2017
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:06/06/2026

Name: Shehana Sri Parakrama

School: St Mark's Primary School Dingley
Class:FB
Date of Birth:26/08/2020
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:06/06/2026

Name: JAIDEN SEBASTIAN

School: Holy Cross Primary School
Class:PREP - BS
Date of Birth:31/01/2021
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:06/06/2026

Name: JAX DAY

School: St Theresa's Primary School Albion
Class:PREP/1E
Date of Birth:15/02/2021
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:05/06/2026

Name: oaklee PORTELLI

School: Our Lady of the Way Primary School Wallan East
Class:b
Date of Birth:21/12/2018
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:05/06/2026

Name: hunter portelli

School: Our Lady of the Way Primary School Wallan East
Class:a
Date of Birth:29/03/2017
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:05/06/2026

Name: harlow PORTELLI

School: Our Lady of the Way Primary School Wallan East
Class:b
Date of Birth:03/07/2014
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:05/06/2026

Name: Ryan Nguyen

School: St Mark's Primary School Dingley
Class:F
Date of Birth:15/05/2020
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:05/06/2026

Name: Aarul BHATT

School: St Mark's Primary School Dingley
Class:3/4
Date of Birth:22/03/2017
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:05/06/2026

Name: Avitaz Singh

School: Our Lady of the Way Primary School Wallan East
Class:B
Date of Birth:17/02/2020
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:05/06/2026

Name: Louis Wells

School: St Mark's Primary School Dingley
Class:3/4D
Date of Birth:31/01/2018
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:05/06/2026

Name: Edith Wells

School: St Mark's Primary School Dingley
Class:Foundation B
Date of Birth:24/08/2020
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:05/06/2026

Name: Louis Wells

School: St Mark's Primary School Dingley
Class:3/4D
Date of Birth:31/01/2018
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:05/06/2026

Name: Mila Ngo

School: St Mark's Primary School Dingley
Class:3/4N
Date of Birth:23/08/2017
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:05/06/2026

Name: PHIACLARE SIAMANI TOFILAU

School: Holy Cross Primary School
Class:5/6MS
Date of Birth:23/07/2015
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:04/06/2026

Name: KARLA QADSO

School: Holy Cross Primary School
Class:0JC
Date of Birth:26/03/2020
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:04/06/2026

Name: NICK-JUNIOR SIAMANI TOFILAU

School: Holy Cross Primary School
Class:3 CL
Date of Birth:06/09/2017
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:04/06/2026