Student Enrolment In Zone
ID:0 | 05/12/2023 |
Recipient: Guest
Originator: Guest
1 1. Student Details
1. Student Details
2 2. Family Details
2. Family Details
3 3. Address Details
3. Address Details
4 4. Emergency Contacts
4. Emergency Contacts
5 5. Medical/Wellbeing
5. Medical/Wellbeing
6 6. Documents
6. Documents
7 7. Declaration
7. Declaration
8 8. Save
8. Save
* Mandatory fields | 
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1
Please enter the details of the person completing this form

Full Name *

Email Address *

Important Notes when completing this form:

  • To temporarily save a partially completed form, so you can come back to it later, please go to the Save tab on Page 8 of this form, enter the Verification Code and click on the blue Temporary Save button.  An email will be sent to the address you've entered above, with a clickable link that you can use to return to the form.  
  • Please do not use all CAPITAL LETTERS or abbreviations when filling out this form.
1
Previous Schooling

Has the student attended Kerikeri High School previously? *

Is the student currently under suspension or excluded/expelled from another school? *

Student's Previous NZ School or select "Overseas":
Click on the drop down list or just start typing the answer required. *
1
Student Details







Student's Preferred Surname: *

Student's Preferred First Name: *



Student Legal Surname: *

Student's Legal First Name: *

Middle Names:

Gender: *

Date of Birth: (Use the date picker or the arrows keys to go back) *

Student's Mobile Number:

Please select the intended Start Date: *

Entry Year Level (e.g Year 7):
Student's Country of Birth: *

Student's Nationality:
Student's First Language: *

Student's Ethnicity:

Iwi Affiliation:
Please note any other additional Ethnicity or Iwi Affiliations:
Please provide any Hapu affiliations, if applicable:
















1
Residential Address where student physically lives

Address:
Address 1:
Residential Town: *

Postcode:
1
Sibling Details

List Names of Siblings Currently Enrolled at KKHS:
List Names of Siblings Previously Enrolled at KKHS:
1
Senior Students

For Y9-13 enrolling students, please list possible options you are interested in.
http://www.kerikerihigh.ac.nz/about-academic.php
For Y11-13 enrolling students, please advise of any current NCEA/Cambridge/IB credits/results received to date:
2
Parent/Caregiver 1

Title:  *

Surname: *

First Name: *

Mobile Number:
Email Address:
Work Phone:

Home Phone:
Relationship to Student: *

Lives with Student: *

Please note any current or past relationship you have with Kerikeri High School.  eg, past student, current or past caregiver, staff member or emergency contact
Emergency Contact: *

Communication Options:
2
Parent/Caregiver 2 Details - if applicable

Title: 
Surname:
First Name:

Mobile Phone:
Email Address:
Work Phone:

Home Phone:
Relationship to Student:
Lives with Student:

Please note any current or past relationship you have with Kerikeri High School.  eg, past student, current or past caregiver, staff member or emergency contact
Emergency Contact:
Communication Options:
2
Parent/Caregiver 3 Details - if applicable

Title:
Surname:
First Name:

Mobile Number:
Email Address:
Work Phone:

Home Phone:
Relationship to Student:
Lives with Student:

Please note any current or past relationship you have with Kerikeri High School.  eg, past student, current or past caregiver, staff member or emergency contact
Emergency Contact:
Communication Options:
2
Parent/Caregiver 4 Details - if applicable

Title:
Surname:
First Name:

Mobile Number:
Email Address:
Work Phone:

Home Phone:
Relationship to Student:
Lives with Students:

Please note any current or past relationship you have with Kerikeri High School.  eg, past student, current or past caregiver, staff member or emergency contact
Emergency Contact:
Communication Options:
3
Postal Address

Family Address Title: (eg Mr G & Mrs S Smith) *

Address Owner: *





Postal Address: *