• Social

Enrolment Form





Pupil Details (One form per student)

Student’s full name (required)

Student’s preferred name

Home Address (Required)

Home Telephone

Person mail should be sent to?

Email Address

Student Gender (Required)MaleFemale
Date of Birth
Date first started school?
Date first attended Paparangi School?
PLEASE NOTE: YOUR CHILD’S BIRTH CERTIFICATE NEEDS TO BE SIGHTED BY THE SCHOOL

Ethnicity (Cultural identification with a particular ethnic group. Up to three ethnic groups may be nominated. Please advise if you are affiliated with any iwi? Please separate multiple entries with commas.)

Ethnicity

Iwi

Country of Birth

Are you a permanent resident? (Required)YesNo
Can he/she speak English? (Required)LittleSomeFluently

Language spoken at home?

If a new entrant or Year 1 student – Did they attend Early Childhood Education? YesNo

If yes, name of ECE attended?

Number of Years attended?

Is the student transferring from another school? YesNo

If yes, name of previous school?

Medical Details (Please describe any medical issues and information the school should be aware of):

Doctor

Contact Telephone

PLEASE NOTE: YOUR CHILD’S IMMUNISATION CERTIFICATE NEEDS TO BE SIGHTED BY THE SCHOOL

Caregiver 1 details:
RelationshipMotherFatherGrandparentOther
If other, please provide details

TitleN/AMrsMsMissMr

Name

Address

Primary Contact Telephone NumberHomeWorkCellphone

Secondary Contact Telephone NumberHomeWorkCellphone

Caregiver 2 details:
RelationshipMotherFatherGrandparentOther
If other, please provide details

TitleN/AMrsMsMissMr

Name

Address

Primary Contact Telephone NumberHomeWorkCellphone

Secondary Contact Telephone NumberHomeWorkCellphone

Emergency Contact details (to be used for illness or accident when primary caregivers can not be contacted):
RelationshipGrandparentFriendNeighbourOther
If other, please provide details

TitleN/AMrsMsMissMr

Name

Primary Contact Telephone NumberHomeWorkCellphone

Secondary Contact Telephone NumberHomeWorkCellphone

Other sibling likely to attend? YesNo

Name

Date of Birth

Name

Date of Birth

Confidentiality
This information is requested by Paparangi School in order to communicate with parents and caregivers to maintain the safety of our students as well as meeting the statutory requirements of the Ministry of Education. Information is held securely (consistent with the school’s privacy policy) and used for the purpose of education only.

Parent/Caregiver Verification
The information above is true and correct at the time of completion. I undertake to advise the school of any change in circumstances so that accuracy and contacts may be maintained.

Submitted by

Date

Office Use Only
Class: Room:
Date Enrolled: Admin #:

Birth Certificate verified?
YesNo

Immunisation certificate sighted?
YesNo