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Enrolment Form

STUDENT DETAILS
First Name(s) (Legal) *
Preferred First Name (Alias) *
Surname (Legal) *
Preferred Surname *
Gender *
Date of Birth *
Caregiver(s) Name (To Whom) for mail purposes *
Primary residential address of child - Number and Street *
Suburb *
Town/City *
Postcode
Country of Birth *
Date of entry to New Zealand (if not born in NZ)
Ethnicity 1 *
Ethnicity 2
Ethnicity 3
IWI 1
IWI 2
Citizenship *
Current Year Level (if new entrant use Year 0) *
Early Childhood Centre (new entrant) or Previous School (for other year levels)
Please provide the full name and date of birth for any siblings likely to attend this school in the future:
Please list any siblings who already attend Pillans Point School
PRIMARY PARENT/CAREGIVER DETAILS
Contact 1's First Name and Surname (please include title) *
Contact 1's Mobile number *
Contact 1's Home number
Contact 1's Work number
Contact 1's Address (if different to primary residential address)
Contact 1's Email address (type n/a if you don't have one) *
Please subscribe this email address to receive Pillans Point School newsletters *
Contact 1's Relationship to student *
If Other, please state relationship to child
SECONDARY PARENT/CAREGIVER DETAILS
Contact 2's First Name and Surname (please include title)
Contact 2's Mobile number
Contact 2's Home number
Contact 2's Work number
Contact 2's Address (if different to primary residential address)
Contact 2's Email address (type n/a if you don't have one)
Please subscribe this email address to receive Pillans Point School newsletters *
Contact 2's Relationship to student
If Other, please state relationship to child
EMERGENCY CONTACTS
Emergency Contact 1 Full name - An alternative contact other than Parent/Caregiver/s *
Emergency Contact 2 Full name
Emergency Contact 1 Mobile Number *
Emergency Contact 2 Mobile Number
Emergency Contact 1 - Relationship to student *
Emergency Contact 2 Relationship to student
PRE-SCHOOL INFORMATION
Did your child attend an Early Childhood Centre? e.g. Kindergarten, Daycare etc) *
If so, for how many years or weeks?
Who was the main service provider of their Early Childhood Education?
What were the average hours per week?
Did they also attend a second provider of Early Childhood Education?
What were the average hours per week?
HEALTH, LEARNING & BEHAVIOUR
Does your child have any Medical conditions which may affect your child's schooling? *
If so, please provide details of the condition or further information
Does your child have any medications that they take on a regular basis? *
If so, please state the medication and dosage
Does your child have any allergies? *
If so, please give details of treatments needed for these
Is your child fully immunised? *
If partially, please give us more details
Does your child have any Health, Learning or Behavioural needs the school needs to be aware of? Please include details on any support agencies
CUSTODY INFORMATION
Is there a court order in place? *
If so, please provide some more information. We will also require a copy of the court order to keep on your child's file
Are there any custody or access arrangements which we should be aware of? If so, please give details
ESOL (if applicable)
What is the main language spoken at home? This helps us to determine if your child will need support in this area
Does your child require English language support?
PERMISSIONS
I give the school permission to publish my child's work, images and recordings online. We use Seesaw, a digital portfolio children use in class to journal their learning and share, the Pillans Point School Facebook page and our School newsletters *
I give permission for the information contained in this enrolment form to be made available to any other educational or support agencies *
I give permission to seek medical assistance for my child, if required urgenty, and I cannot be contacted *
I support the school's ICT Agreement and will read through and discuss with my child before they start at Pillans Point School *

Click here to read the agreement 

I give permission for the school to take my child to local events and trips *

Click here to find out more about Education Outside The Classroom (EOTC)

OTHER
I would be interested in being a host family for short term International students who visit Pillans Point School throughout the year (Choosing yes doesn't commit you to being a host family, the International Student Manager will be in contact to discuss)
I may be interested in joining the PTA (Parent Teacher Association) so would like more information
If so, please provide the email address we should send more information to
I will require a second report to be printed for my child. PLEASE GIVE DETAILS OF THE PERSON TO WHOM THIS SHOULD BE ADDRESSED, AND THE ADDRESS OF WHERE THE SECOND REPORT SHOULD BE SENT TO
I declare that the information given on this online enrolment form is true and correct *
Full Name of person/s enrolling student *
Relationship to student (only required if you're not one of the contacts listed on this form)
If you are filling out on behalf of the child's parent/caregiver please confirm you have their permission to do so