Student Details

*Name (First & Family)

Preferred Name

*Date of Birth

*Gender

*Place in Family

Preschool

Date Started School

NEW ENTRANTS: We will need to be witness to a form of ID (Birth Certificate, Passport etc)
Also immunisation Records.

*Address

Email

Caregiver Details

*Mother/CG1

*Relationship

*Address

*Phone Number

Mobile Phone Number

Work Number

Occupation

*Father/CG2

*Relationship

*Phone Number

Mobile Phone Number

Work Number

*Address

Occupation

*Emergency Contact 1 Name and Phone Number

*Emergency Contact 2 Name and Phone Number

Other Information - Access etc

Future Attendees

Ethnic Background

*Country of Origin

Entry Date into New Zealand

*Ethnicity European/Pakeha NZ Maori Samoan Niuean Cook Is Maori Tongan Tokelauan Fijian Indian Chinese Vietnamese Filipino Other

Iwi (if NZ Maori)

Medical Information

*Doctor

*Address and Phone Number

Dentist

Address and Phone Number

*Allergies, Medication requirements, etc

Other Information

*Check the box for permission

Buses

*My Child will travel on bus to and from School NO Tangaihi Bus Red Hill Bus

Previous School Details

Previous School

Class

Year

Address