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Perth Modernian Society Biographical Info Form

Note the form below can also be printed, filled in and mailed to:
Perth Modernian Society Inc., c/o Perth Modern School, 90 Roberts Road, Subiaco, WA 6008 AUSTRALIA
(or Fax to (08) 9380 0550).

BIOGRAPHICAL INFORMATION is sought for inclusion in the archives of the Historical and Museum Committee to facilitate enquiries by former students and staff, family members and other approved researchers.

If you have not already done so please register with the Society using the online Membership Form.
This will enable you to receive our eNewsletter and (for Contributing Members) our magazine "The Perth Modernian ".

Please note: Completion of details marked with a double asterisk ** will be considered permission to publish.

* indicates required field

Family Name at School*:
Given Names:*
Given/Nickname at PMS*:
Year Attended PMS** Yr1(8):
Year Attended PMS** Yr2(9):
Year Attended PMS** Yr3(10):
Year Attended PMS** Yr4(11):
Year Attended PMS** Yr5(12):
Years on Staff 1st Appointment:
Years on Staff 2nd Appointment:
Years on Staff 3rd Appointment:
Primary School(s):
Year and Place of Birth:
Secondary School (Other than PMS):
Suburb/Town of Family Home during time at PMS:
Entrance Qualification:
Other Entrance Qualification (If applicable):
Faction/House:
PMS Highlights:
Further Education** (uni, tech college,etc):
Degrees or Other Qualifications**:
Occupation(s) on leaving School or after subsequent education:
Current Occupation**:
Career Highlights**:
Lifetime Achievements:
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