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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: Anton Chiavone

School: St Louis de Montforts Primary School
Class:1BM
Date of Birth:10/02/2019
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:03/06/2026

Name: Leo Monardo

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

Name: Harper Menzies

School: Our Lady of the Way Primary School Wallan East
Class:A
Date of Birth:13/03/2021
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: Leonardo Horj

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

Name: Jack Currie

School: St Louis de Montforts Primary School
Class:PM
Date of Birth:29/10/2020
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: Matilda Velasquez-Mesa

School: Our Lady of the Way Primary School Wallan East
Class:C
Date of Birth:20/06/2018
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:03/06/2026

Name: Louis Currie

School: St Louis de Montforts Primary School
Class:3G
Date of Birth:29/10/2017
Eligible:No
To Be Treated:No
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: Tomas Reina

School: St Louis de Montforts Primary School
Class:KO
Date of Birth:18/07/2018
Eligible:No
To Be Treated:Yes
Treatment Date:N/A
Paying?:Yes
Treatment Done:No
Date Submitted:03/06/2026

Name: Austin Smith

School: Our Lady of the Way Primary School Wallan East
Class:A
Date of Birth:27/09/2014
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: Caleb Sowerbutts

School: St Louis de Montforts Primary School
Class:3SS
Date of Birth:19/11/2017
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

Name: Isabella Astone

School: St Louis de Montforts Primary School
Class:Pjs
Date of Birth:20/10/2020
Eligible:Yes
To Be Treated:Yes
Treatment Date:N/A
Paying?:No
Treatment Done:No
Date Submitted:03/06/2026

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