Enrolment Form

To submit a student enrolment online use the form below.

To contact us, please fill in the form below.

Students Full Name:*
Student's Address:
Entry Level:*
Student's date of birth?
Nationality*
Country of Birth*
Ethnic Group NZ Maori
Samoan
Niuean
European
Indian
Tongan
Tokelauan
Chinese
Cook Island Maori
If New Zealand Maori indicate iwi (if known)
What is the main language spoken at home?
Has your son/daughter had any previous learning/ESOL support?
Do you wish your child to be considered for the E tipu e rea (bilingual) classes? yes no

Mother's/Caregivers Details

Mother/Caregiver's Name
Home address
Telephone Home
Telephone Work
Mobile
Email
Occupation
Place of work

Father's/Caregivers Details

Father/Caregiver's name
Home address
Telephone Home
Telephone Work
Mobile
Email
Occupation
Place of work

Emergency Contact Details

Emergency Contact
Emergency Home address
Telephone Home
Telephone Work
Mobile
Email
Occupation
Place of work

Medical Problems

This information is held on your child's file to assist in the case of an emergency or to assess any special needs your child my have.
Doctor's Name
Does your child have any of the following health problems? Asthma
Hearing
Diabetes
Sight
Allergies
Epilepsy
Other:

If other has been checked above please give more detail:
Any medication taken regularly? If so please specify:
Present/Previous School
Does your daughter/son have a sister or brother at the school? * yes no
If you answers yes to the previous question please state their name/s

Declaration

I/we undertake to ensure that the above-named student will attend school regularly, in the correct school uniform, and abide by the school rules. I/we will meet all school related costs. I/we consent to the college sharing information about my child if it is in the best interests of my chil
Mother/Caregiver (please type you name and today's date)
Father/Caregiver (please type you name and today's date)
Students Full Name:*
Student's Address:
Entry Level:*
Student's date of birth?
Nationality*
Country of Birth*
Ethnic Group
NZ Maori
Samoan
Niuean
European
Indian
Tongan
Tokelauan
Chinese
Cook Island Maori
If New Zealand Maori indicate iwi (if known)
What is the main language spoken at home?
Has your son/daughter had any previous learning/ESOL support?
Do you wish your child to be considered for the E tipu e rea (bilingual) classes?
yes no

Mother's/Caregivers Details

Mother/Caregiver's Name
Home address
Telephone Home
Telephone Work
Mobile
Email
Occupation
Place of work

Father's/Caregivers Details

Father/Caregiver's name
Home address
Telephone Home
Telephone Work
Mobile
Email
Occupation
Place of work

Emergency Contact Details

Emergency Contact
Emergency Home address
Telephone Home
Telephone Work
Mobile
Email
Occupation
Place of work

Medical Problems

This information is held on your child's file to assist in the case of an emergency or to assess any special needs your child my have.
Doctor's Name
Does your child have any of the following health problems?
Asthma
Hearing
Diabetes
Sight
Allergies
Epilepsy
Other:

If other has been checked above please give more detail:
Any medication taken regularly? If so please specify:
Present/Previous School
Does your daughter/son have a sister or brother at the school? *
yes no
If you answers yes to the previous question please state their name/s

Declaration

I/we undertake to ensure that the above-named student will attend school regularly, in the correct school uniform, and abide by the school rules. I/we will meet all school related costs. I/we consent to the college sharing information about my child if it is in the best interests of my chil
Mother/Caregiver (please type you name and today's date)
Father/Caregiver (please type you name and today's date)
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