Student Enrolment In Zone
ID:0 | 21/11/2024 |
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. *
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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: *

Address 1:
Town: *

Postcode: *

Residential Address (if different from above)
Address 1
Town:
Postcode:
3
Alternate Postal Address Details - if applicable ( A copy of information forwarded to another Natural Parent)

Family Address Title:
Address Owner:




Postal Address:
Address 1:
Town:
Post Code:
4
Emergency Contacts

If we are unable to reach any of the listed Parents/Caregivers, please provide additional contacts which could be used in case of emergencies.  Please note, students can only be collected from the school by any Parent/Caregiver or emergency contacts listed in this Enrolment Application Form.
4
Details

Other Emergency Contact Name:
Relationship to Student:
Please note any current or previous relationships they have had with KKHS? eg past student, current of past caregiver, staff member
Best Phone Number to Contact:
















5
Medical

Family Medical Centre
Do you authorise the School to provide panadol, ibuprofen, antihistamine? *

Asthma *

Please check any known Medical Conditions:
Severity of Condition: 
Full details and action plans will be requested for any moderate or serious medical condition. *




Please specify type of allergy:

Do you give consent for Y7-8 students to have Vision & Hearing testing done at School? *
5
Student's Wellbeing

If English is not the first language for your child, how long has he/she learnt English for?

Please provide details of any shared care arrangement and supply documentation for any Custody/Court or Protection Orders in place.

Please provide details if your child has any needs which may impact on their education (eg. medical, disability or learning/behavioural needs).

Please provide detail if your child receives support from any of the following professionals such as a tutor, psychologist, physiotherapist, occupational therapist, speech pathologist, teacher aide etc.

Please provide details if your child has received any additional funding support from previous schools.
6
Documents

All In Zone enrolments must have correct documentation provided to be accepted.  This can be uploaded now in the following fields which will speed up the enrolment process. 

Alternatively, you may provide a copy of this documentation to the Dean once a meeting has been arranged with you. 

TIP - Take a photo of your document to upload but please ensure it is legible and the file size is not too large. Preferred format is PDF

Please upload evidence of your physical residential address proving you and your child lives within our School zone as per our zone map http://www.kerikerihigh.ac.nz/info/zone_map.pdf).  This documentation must show a supply or physical address rather than just a postal address, eg a power (usually on page 2), sky, gas account or tenancy agreement.

Please upload a copy of your child's Birth Certificate to verify parent details.


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6
Documents

If your child was not born in New Zealand please upload documentation showing permanent residence or citizenship.

Please upload evidence of legal custody should the student not be residing with a natural parent.  If this is not available please complete a guardianship declaration and signed by a Justice of the Peace.  http://www.kerikerihigh.ac.nz/info/kkhs_enrolment_statdec.pdf

Pleave upload or provide a copy of any Protection/Custody/Court Orders in place.

Any comment you would like to provide on the documentation availability/upload:
6
7
Declaration

I/We have read the Kerikeri High School Prospectus (http://www.kerikerihigh.ac.nz/info/kkhs_prospectus.pdf) and agree to abide by the following conditions:

Our School Behaviours

  • I/We have read the school behaviour expectations outlined in our WAKA Matrix.
  • I/We agree to the wearing of the official school uniform or dress code.
  • I/We agree that full attendance is to the benefit of every student.
*

Privacy Act

  • I/We agree to the School collecting appropriate educational information on this school student.
  • I/We agree that all information relating to this student can be used for school purposes.  Contact details may also be passed onto the Ministry of Education and the Ministry of Social Development (MSD).  This is so young people who may have difficulty finding future employment, training or further education can be identified and offered support by organisations contracted by MSD to help re-engage young people in education or training when they leave school.
  • I/We agree to the publishing of school photos in both internal/external publications and media.
  • I/We give permission to be automatically subscribed to the Kerikeri High School News and/or PTA News to receive email notification of school information.
*



Education Outside the Classroom

  • I/We give permission for this student  to participate in all LOW RISK EOTC activities run by Kerikeri High School for every year that he/she attends Kerikeri High School.  Detailed information will be sent home for all higher risk activites.
*

Appointments

  • I/We understand the school will allow student to attend appointments such as dental, doctor or counselling during school hours, however the school will not be liable for the student while they are out of the school to attend any appointment arranged by any member of the family or the school at the request of any member of the family.
*

Acceptable Use

  • I/We have read the Cybersafety Acceptable Use information in the Prospectus.   I/We undestand the conditions and agree to abide by it.  A Student Network Account will be created upon agreement of these conditions.
*

Medical Authorisation *







Student Confirmation

I agree to abide by the above conditions. *


Parent Confirmation:

I/We confirm that all the infomation and evidence provided on this application is true and correct: *


Any Additional Comments you would like to advise on this enrolment: (eg best time for meeting availability)

Date of Application: *
8
Save

To temporarily save your data, enter the Verification Code and click on the blue Temporary Save button.  You will be emailed a link to reload your data to the email supplied at the start of the form.

If you have completed the application, we thank you.  Please enter the Verification Code below and click on the green "Save and Submit" button to send the application.  

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