Enrolment Form » Koraunui School

In accordance with the provisions of the Privacy Act (1993), this school requires information for educational purposes from families with pupils enrolled at the school; for the welfare, safety and health needs of the child; to ensure the functioning of the school and its related support and health organisations. The school will take all reasonable steps to protect personal information. Caregivers can request to view, and have corrected, information held by the school relating to their family. Caregivers have a responsibility to keep the school informed of any changes to the information held, particularly contact information and addresses.

THE CHILD’S BIRTH CERTIFICATE/PASSPORT AND VACCINATION CERTIFICATE MUST BE PRESENTED BEFORE A CHILD CAN BE ENROLLED.

(WE CAN PHOTOCOPY THESE FOR YOU IF YOU ARE UNABLE TO SCAN AND UPLOAD THEM)

Child being enrolled

It is important that the child's full legal name (surname and first names) are recorded on the enrolment form. These are used as verification for eligibility to enroll as a domestic student.

Child’s last name:

Child's first names:

Child is known as:

Date of birth:

The child's birth certificate / passport must be presented before a child can be enrolled. We can photocopy these for you at the office if you are unable to scan and upload them.

File Upload

Address

Home Phone:

Cell Phone:

E-mail

Country of birth

If 'other' please give details

If 'Maori" please specify the Iwi

Early Childhood centre or previous school attended

Siblings

Name and Room of other children in the family currently attending Koraunui School

Name and Date of Birth of other children in the family who will be attending Koraunui School

Child’s place in family: eg 1/4 (eldest child of four children)

Caregiver Details

Mother's Details

Mother's First Name

Mother's Last name

Mother's Country of Origin

Mother's Occupation

Mother's Email

Mother's Cell Phone

Mother's Home Phone

Mother's Work Phone

Mother's Address

Father's Details

Father's Firstname

Father's Lastname

Father's Country of Origin

Father's Occupation

Father's Email

Father's Home Phone

Father's Cell Phone

Father's Work Phone

Father's Address

Custody and Access Arrangements

Caregiver details

Only complete this section if the child lives with someone other than a parent listed above.

Caregiver 1 Relationship to the child

Caregiver 1 First Name

Caregiver 1 Last Name

Caregiver 1 Country of Origin

Caregiver 1 Occupation

Caregiver 1 Email

Caregiver 1 Home Phone

Caregiver 1 Cell Phone

Caregiver 1 Work Phone

Caregiver 1 Address

Caregiver 2 Relationship to the child

Caregiver 2 First Name

Caregiver 2 Last Name

Caregiver 2 Country of Origin

Caregiver 2 Occupation

Caregiver 2 Email

Caregiver 2 Home Phone

Caregiver 2 Work Phone

Caregiver 2 Cell Phone

Caregiver 2 Address

Emergency Contacts

People who live locally who we can contact if we can't get hold of you.

Emergency Contact 1 Name

Emergency Contact 1 Relationship

Emergency Contact 1 Phone

Emergency Contact 1 Address

Emergency Contact 2 Name

Emergency Contact 2 Relationship

Emergency Contact 2 Phone

Emergency Contact 2 Address

Emergency Contact 3 Name

Emergency Contact 3 Relationship

Emergency Contact 3 Phone

Emergency Contact 3 Address

Emergency Contact 4 Name

Emergency Contact 4 Relationship

Emergency Contact 4 Phone

Emergency Contact 4 Address

Emergency Evacuation

As well as the people above, who else has your permission to collect your child if we have to evacuate the school? Write names and phone contacts:

Evacuation Contacts and Phone Numbers

Health

Child's Doctor

Location

Doctors Phone

Do you have any concerns with...

Hearing

Vision

Co-ordination

Speech

Any medical conditions (please specify)

Medical Conditions

Does the child have Asthma?

Mild Asthma

Moderate Asthma

Severe Asthma

Is an inhaler required at school?

Please list any allergies the child suffers from and how severe they are.

Please list all regular medications the child takes and what they are for

School administered medications

Does medication need to be given at school? If so, Please ask for a Medication Administration form. We cannot administer medication without this.

Vaccination Certificate

Your child's vaccination certificate can be uploaded or we can photocopy these for you at the office if you are unable to scan and upload them. We must have a copy before your enrollment is completed.

Vaccination Certificate

Free School Lunch

I would like my child to be offered the free school lunch each day

Does your child have any special dietary requirements ?

Te Reo Maori Medium Education

This is development of spoken te reo Maori. Reading and writing is in English.

I am interested in my child being enrolled in the age-appropriate Whanau class

Yes

Want to know more

Agreements

Medical attention: I understand that the school will obtain the necessary assistance, at my expense, in the event of an accident requiring immediate professional attention. In all situations, the school will attempt to contact caregivers first, however this will not delay seeking urgent medical attention.
Local trips: School staff can take my child out of the school grounds for trips related to the school programme. I understand I will be advised of trips involving transport out of Stokes Valley and/or payment of money.
Fundraising: I understand the school fundraising group may contact me, usually through the school newsletter, seeking support for fundraising activities.
Internet: I have returned the separate ‘Koraunui School ICT Acceptable Use Policy’, which covers cyber safety aspects of the education my child will increasingly receive at Koraunui School.
Communication: I understand my obligation to keep myself informed of school activities, by reading the weekly newsletter, received in paper form delivered by my child, and/or by e-mail.
Record of schools attended: I understand that, within the Education Act, my child’s schooling history will be tracked through the Ministry of Education secure ENROL register, which can be accessed by all schools my child attends.
Attendance: I understand that my child’s education is of high priority and will ensure his/her regular attendance. I also understand the importance of my child arriving at school on time (by 8.30am)

By Typing your name here you agree that you have read and understand all of the above

Name

Date

Early Childhood Information

This Early childhood information is required by the Ministry of Education. In the six months before starting school……

If the child attended more than one service in the same time period, please enter hours per week for up to 3.
If the child attended one service, but changed to a different service, please only enter hours for the most recent.
If the attendance hours varied, or you are uncertain, please enter the average weekly hours.

Service 1 hours per week attended

Service 2 hours per week attended

Service 3 hours per week attended

OR choose One option from the following

Attended, but only outside New Zealand

Attended, but don’t know what type of service

Did not attend

Pre-school history not known

Did the child regularly attend Early Childhood Education?

(‘Regularly attend’ means the child was booked in to a service for sessions each week/fortnight, and generally went to those sessions unless sick, or on holiday, or had a family occasion etc.)

Please select ONE option

Yes, (please enter the number of years)

Not regularly, only occasionally with no ongoing schedule

No, did not attend ECE

If yes, how many years did they attend.

Name of parent or legal guardian

Date completed

To be completed upon arrival at school

Signature of parent or legal guardian

Date