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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: GRACE NGUYEN

School: Christ the Priest Primary School
Class:PREP BLUE
Date of Birth:11/05/2020
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: Liana Kundu

School: Our Lady of the Way Primary School Wallan East
Class:C
Date of Birth:25/07/2019
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:03/06/2026

Name: Isaac Gleeson

School: St Louis de Montforts Primary School
Class:PGY
Date of Birth:14/09/2020
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:03/06/2026

Name: Esmay Gleeson

School: St Louis de Montforts Primary School
Class:2KO
Date of Birth:11/08/2018
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:03/06/2026

Name: Robert LoPiccolo

School: Our Lady of the Way Primary School Wallan East
Class:D
Date of Birth:25/10/2019
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: Francesca LoPiccolo

School: Our Lady of the Way Primary School Wallan East
Class:A
Date of Birth:11/10/2018
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: FRANKIE TOMARCHIO

School: Our Lady of the Way Primary School Wallan East
Class:D
Date of Birth:18/12/2019
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:03/06/2026

Name: LEONARDO DI VITTO

School: Christ the Priest Primary School
Class:4 Green
Date of Birth:08/11/2016
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: Evana John

School: Christ the Priest Primary School
Class:2 Blue
Date of Birth:19/11/2018
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:03/06/2026

Name: Ava John

School: Christ the Priest Primary School
Class:4 Blue
Date of Birth:31/08/2016
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:03/06/2026

Name: Easton Dyer

School: Our Lady of the Way Primary School Wallan East
Class:2D
Date of Birth:10/07/2018
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: Myriam Jwaid

School: Christ the Priest Primary School
Class:Perp blue
Date of Birth:07/07/2020
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: Abbey Johnson

School: Our Lady of the Way Primary School Wallan East
Class:A
Date of Birth:03/08/2019
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:03/06/2026

Name: SETH CONNOR

School: Our Lady of the Way Primary School Wallan East
Class:FOUNDATION A
Date of Birth:24/03/2021
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: Landon Hagan

School: Our Lady of the Way Primary School Wallan East
Class:D
Date of Birth:21/09/2017
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:03/06/2026

Name: Ava Missailidis

School: Our Lady of the Way Primary School Wallan East
Class:A
Date of Birth:12/12/2019
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:03/06/2026

Name: MASON BULLAS

School: Our Lady of the Way Primary School Wallan East
Class:B
Date of Birth:10/04/2020
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: ROSAVIN BACULO

School: Christ the Priest Primary School
Class:2 RED
Date of Birth:16/05/2018
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: Zara Mhande

School: Christ the Priest Primary School
Class:Red
Date of Birth:16/06/2026
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:03/06/2026

Name: Thomas Long

School: Christ the Priest Primary School
Class:Green
Date of Birth:01/05/2019
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026
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