Online Enrolment

Please note maximum Total file size allowed on this form is 8 MB.

Student Details
Student's Name*
First Last
Student's Preferred Name
First Last
Date of Birth*
DD slash MM slash YYYY
Gender*
- Male
- Female
- Other
If "Other", please specify*
Place in Family
Pre-School Attended
Time in Pre-School
Do you have an early education portfolio of your child’s progress at pre-school, we could see?
- Yes
- No
Last School Attended
Time in Last School Attended
Last Teacher
Last Teacher - Level/Year
Religious/cultural considerations
Address*
Street Address Address Line 2 City Suburb Post Code
Ethnicity
Iwi/Hapu
Affiliation
Ethnic Group/s*
Language Spoken at Home*
Country of Birth*
Country
Nationality*
Country
Date Of Arrival in NZ*
DD slash MM slash YYYY
Status*
- New Zealand Residency
- Migrant
- Refugee
- New Zealand born
Mother's Country of Birth*
Country
Father's Country of Birth*
Country
Parent/Caregiver Details (1)
Name*
Prefix First Last
Primary Caregiver*
- Yes
- No
Relationship to Student*
Address*
Same as Student Home Address

Street Address Address Line 2 City Suburb Post Code
Occupation/Where Employed*
Email*
Home Phone
Work Phone
Mobile Phone*
Parent/Caregiver Details (2)
Name
Prefix First Last
Primary Caregiver
- Yes
- No
Relationship to Student
Address
Same as Student Home Address

Street Address Address Line 2 City Suburb Post Code
Occupation/Where Employed
Email
Home Phone
Work Phone
Mobile Phone
Emergency Contact (1)
Name*
Prefix First Last
Relationship to Student*
Address*
Street Address Address Line 2 City Suburb Post Code Country
Home Phone
Work Phone
Mobile Phone*
Emergency Contact (2)
Name*
Prefix First Last
Relationship to Student*
Address*
Street Address Address Line 2 City Suburb Post Code Country
Home Phone
Work Phone
Mobile Phone*
Health
Allergies
Medication
Hearing
Vision
Speech
Other Health Issues
Special Learning and Behavioural Needs
Immunisation*
- Yes
- No
Medical Center Name*
Doctor's Name*
Phone*
Custody/Access Arrangements
Court Order Issued*
- Yes
- No
Court Order Documents
Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.
Access Arrangement
Early Childhood Education
Prior-Participation in Early Childhood Education
Please select (up to 3 services) for the last Early Childhood Education service(s) attended in the six months prior to starting school
- Kohanga Reo
- Play Center
- Kindergarten or Educations and Care Centre
- Home based service
- Playgroup
- The Correspondence School - Te Aho Te Kura Pounamu
Hours per Week at Kohanga Reo*
Hours per Week at Play Center*
Hours per Week at Kindergarten or Educations and Care Centre*
Hours per Week at Home based service*
Hours per Week at Playgroup*
Hours per Week at The Correspondence School - Te Aho Te Kura Pounamu*
Documents
Proof of in zone address*
Council rates, water care, electricity bill etc.
Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.
Student's Birth Certificate/Passport*
If student is a New Zealand citizen
Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.
Student's Passport*
If student is not a New Zealand citizen.
Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.
Parent's Passport*
If student is not a New Zealand citizen.
Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.
Parent's Visa*
If student is not a New Zealand citizen.
Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.
Immunisation Documents*
Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 8 MB.
Additional Fields
Names of everyone who lives at home and their relationship to child
Names of other relatives at Dyer Street School
Names of pre-schoolers who may attend Dyer Street School in the future:
Please write full name and DOB (Date of Birth)
Name of contacts / Sponsor
Prefix First Last
Contacts / Sponsor Phone No.*
Contacts / Sponsor Address*
Street Address Address Line 2 City Suburb Post Code
Other Countries Lived In
Country
Time in New Zealand Schools
Please describe when, where and level
Time in Overseas Schools
Please describe when, where and level
ESOL Funding*
- Yes
- No
Dietary Requirements
Lunch is supplied free of charge every day for all students. Our supplier is Kapura and sample menus can be viewed in the school office.
Dietary Requirements: Please select the most appropriate option for your child*
- No pork or Ham
- Gluten-free
- Dairy Free
- Vegetarian
- Vegan
- No food restrictions
- Other
Dietary Preferences : Other*
Languages
Languages Child Can Speak
Home’s Main Language/s
Child - Writes
- Fluent
- A little
- Not at all
Child - Speaks
- Fluent
- A little
- Not at all
Child - Read
- Fluent
- A little
- Not at all
Caregiver 1 - Writes
- Fluent
- A little
- Not at all
Caregiver 1 - Speaks
- Fluent
- A little
- Not at all
Caregiver 1 - Read
- Fluent
- A little
- Not at all
Caregiver 2 - Writes
- Fluent
- A little
- Not at all
Caregiver 2 - Speaks
- Fluent
- A little
- Not at all
Caregiver 2 - Read
- Fluent
- A little
- Not at all
Closest contact who can speak English
Please write name and phone no.
Closest contact who can read English
Please write name and phone no.
Names of other children at Dyer Street School who can communicate in this child’s first language
Please write name of child and room.
Privacy & Policy
Permissions
- I give permission for my child's image to be used where appropriate. Eg. newsletter, school website, classroom displays etc.
- I give permission for the school staff to administer general first aid. Staff are not permitted to give any medication without a separate signed consent form.
- I give permission for my email to be used for newsletters, notifications, fundraising, initiatives and emergencies such as evacuations and lockdowns etc.
Privacy Statement
The information collected will be used by the school for enrollment and forms an essential part of the information held by the school on your child. The records made from this information may be viewed on request at the school. The information collected may be disclosed to appropriate education, health and welfare authorities and for data-gathering purposes by the New Zealand Ministry of Education, in accordance with the principles of the Privacy Act. It will not be disclosed to any other person or agency unless such disclosure is authorised or required by law.
Parent Declaration
I agree that the school will take action on my behalf in case of sudden illness or injury, to abide by the school’s policies, that my child’s work and image may be used in accord with the school’s online publishing policy/procedures and that the school may forward my child’s name and address to a potential intermediate or secondary school. All information that I have provided is true and correct.
Signature
By signing this below, I confirm that the information given in this form is true, complete and accurate.
Full Name*
Date*
DD slash MM slash YYYY
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.

Student Details

Ethnicity

Parent/Caregiver Details (1)

Parent/Caregiver Details (2)

Emergency Contact (1)

Emergency Contact (2)

Health

Custody/Access Arrangements

Early Childhood Education

Documents

Additional Fields

Languages

Privacy & Policy

Signature

Contact

Quick Links

2023 Term Dates

2024 Term Dates