Student Information |
| Family Name |
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| First Names |
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| Preferred Name |
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| Residential Address |
Number and Street Name/ Rapid Number and Road Name, Suburb name / Rural Delivery Number, Town / City/ Area / Country
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| Present Year Level |
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| Enrolling Into Year Level |
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| School Currently Attending |
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| Boarding |
Has an application been made for Enwood House, our student residence?
Contact the Director of Boarding on 2169148 for information.
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House Affiliation (if any, please select one) |
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Ethnicities
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(required for Ministry of Education Statistical returns)
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(Please Specify)
(Please Specify Iwi Affiliations)
(Please Specify)
Specify Other Details / Affiliations
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| Date of Birth |
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Student Type
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(required for Ministry of Education Statistical returns)
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(New Zealand Born)
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I agree to abide by the rules and requirements in the Plan book, and/or 'Achieve' book as given to each family. Type your full name in the field below which will be considered your electronic signature.
Type Your Full Name
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Caregivers
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(Caregiver is a term used by the Ministry of Education to describe the person(s) taking care of the student. This may include a stepmother, stepfather, partner, relative, homestay or legal guardian - whoever has day to day responsibility for the student.)
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| Student Lives With |
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Mother or Caregiver 1
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(at student's home address)
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| Relationship |
(mother, grandparent, aunt, step mother etc)
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| Family Name |
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| First Name |
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| Title |
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| Physical Address |
(If different from student)
Include: Number and Street Name/ Rapid Number and Road Name, Suburb name / Rural Delivery Number, Town / City/ Area / Postal Code / Country
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| Postal Address |
(If different from above)
Include: Number and Street Name/ Rapid Number and Road Name, Suburb name / Rural Delivery Number, Town / City/ Area / Postal Code / Country
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| Home Phone |
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| Cell Phone |
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| Occupation |
(required for Ministry of Education Statistical purposes)
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| Place of Work |
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| Work Phone |
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| Email Address |
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| Please tick as appropriate: |
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I request that my daughter be admitted into Southland Girls' High School. I agree that she, and I as a parent or guardian, are bound by these rules and regulations as published and given to each family in the 'Achieve' booklet each year and will support them accordingly. Type your full name in the field below which will be considered your electronic signature.
Type Your Full Name
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Names of Sisters / Family Members currently attending SGHS
Name
Relationship
Year Level
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Father or Caregiver 2
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(at student's home address)
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| Relationship |
(father, grandparent, uncle, step father etc)
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| Family Name |
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| First Name |
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| Title |
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| Physical Address |
(If different from student)
Include: Number and Street Name/ Rapid Number and Road Name, Suburb name / Rural Delivery Number, Town / City/ Area / Postal Code / Country
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| Postal Address |
(If different from above)
Include: Number and Street Name/ Rapid Number and Road Name, Suburb name / Rural Delivery Number, Town / City/ Area / Postal Code / Country
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| Home Phone |
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| Cell Phone |
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| Occupation |
(required for Ministry of Education Statistical purposes)
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| Place of Work |
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| Work Phone |
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| Email Address |
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| Please tick as appropriate: |
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I request that my daughter be admitted into Southland Girls' High School. I agree that she, and I as a parent or guardian, are bound by these rules and regulations as published and given to each family in the 'Achieve' booklet each year and will support them accordingly. Type your full name in the field below which will be considered your electronic signature.
Type Your Full Name
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Duplicate Reports
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Is a duplicate report required for a non-custodial parent?
If yes, please give the name and address for this report to be sent to:
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Emergency Contact
We will always attempt to contact the main caregivers should your daughter be unwell, or in the case of an emergency. However we do require an alternative contact person to act on your behalf should we be unable to contact you.
Emergency contact details:
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| Relationship |
(grandparent, neighbour, aunt, uncle etc)
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| Family Name |
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| First Name |
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| Title |
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| Home Phone |
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| Cell Phone |
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| Place of Work |
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| Work Phone |
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Medical Information
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| Doctor |
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| Dentist |
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| Medication regularly needed at school |
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| Medical conditions: |
(Allergies, asthma etc)
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Problem
Degree
Details (as appropriate)
Medication at school? Y/N
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Please give details of any issues with:
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| Hearing |
Hearing Aid Worn?
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| Vision |
Glasses Worn?
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| Speech |
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File Attachments
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Please attach the following files in PDF format only (if applicable):
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| Copy of Birth Certificate |
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| Copy of Visa (if appropriate) |
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