Enrolment Form Demo

Student Details

Family Name *

First Name(s) *

Preferred Name *

Date of Birth *

Gender *

Year Level *

Country of Birth *

Note: Birth certificate to be sighted as part of enrolment; as per Ministry of Education requirement.

Residency/Citizenship *

Student in NZ on Student Visa? *

Previous School or Preschool last attended *

B4 School Check completed *

More info on b4 School

Choose up to three Ethnic Groups, which you feel your child belongs to:

Home Language(s) *

Brothers/sisters at school *

Iwi 1 (if applicable)

Iwi 2 (if applicable)

Contact Details (Caregiver 1)

Relationship to child *

Family Name *

First Name(s) *

Home Address *

Post Code *

Please note: you may be required to provide proof of your residential address, such as a recent power account.

Mailing Address (if different)

Post Code

Home Phone *

Mobile *

Work Phone *

Please advise if there is any problem with leaving voicemail messages.

Occupation *

Email *

Contact Details (Caregiver 2)

Relationship to child *

Family Name *

First Name(s) *

Home Address *

Post Code *

Please note: you may be required to provide proof of your residential address, such as a recent power account.

Mailing Address (if different)

Post Code

Home Phone *

Mobile *

Work Phone *

Please advise if there is any problem with leaving voicemail messages.

Occupation *

Email *

Emergency Contact #1

When above caregivers cannot be contacted

Relationship to child *

Family Name *

First Name(s) *

Home Phone *

Mobile *

Work Phone *

Emergency Contact #2

When above caregivers cannot be contacted

Relationship to child *

Family Name *

First Name(s) *

Home Phone *

Mobile *

Work Phone *

Student Health Record

When above caregivers cannot be contacted

Immunisation Certificate? *

Family Doctor *

Phone *

Early Childhood Education

Please select:

Kindergarten, Playcentre, Education & Care or Home-based Service
Kohanga Reo
Pacific Islands EC Group or Playgroup
ECE Group, type unknown, including Overseas
Did not attend any type of ECE
Unable to establish if ECE attended or not

Other Information

I consent to my child's vision and hearing being tested: *

Other Information from Caregivers (if applicable)

Sensitive Information (if applicable)

Any custody arrangements / access restrictions?

Court Order?

Learning and behaviour needs (if applicable)

Special needs (if applicable)

Other Family Members likely to be attending Deanwell Primary School in the near future? *

Child 1 Name

Child 1 Date of Birth

Child 2 Name

Child 2 Date of Birth

Please type your name to acknowledge you have read and agree to the below terms and conditions *

I/We:

acknowledge that the information is true and correct in every particular and can be relied upon by the school.
agree that our child shall abide by all School Rules, Regulations and policies.
understand that the information on this form will be used by the School to maintain appropriate school records and effective contact with the enrolled pupil's parents and caregivers.
agree to the school requesting relevant information from other schools for enrolment purposes and class placement.
I/We understand that the School will take action on my/our behalf in case of student illness or injury.

Privacy Statement

The information on this form is collected to form part of the essential information the school hold on your child. The information collected will be used by the school for the following purposes: enrolling your child at school, assessing the education needs of your child and ensuring that education services and resources in respect of your child are provided to the school. The information on this form is collected and used by the school in educating your child, and for associated school activities. It is available to all staff of the school and to members of the Board of Trustees. Please advise the school if you have any concerns about disclosure of any of the information within the school. The school is sometimes obliged by law to give information to Government Departments (e.g. Ministry of Education and Ministry of Health) but it will not otherwise be disclosed without your authorisation. The records made from this information may be viewed on request at the school You have the right to request access and to request correction of information held about you by the school. We would be grateful if you could contact the school office if any details need to be changed; especially contact details. The information collected may be disclosed to education and health sector agencies in accordance with the principles of the Privacy Act. Except with your specific authorisation, it will not be disclosed to any other person or agency unless such disclosure is authorised or required by law.

Student Details

Contact Details (Caregiver 1)

Contact Details (Caregiver 2)

Emergency Contact #1

Emergency Contact #2

Student Health Record

Early Childhood Education

Other Information

Privacy Statement

ABOUT DEANWELL

GET IN TOUCH

QUICK LINKS